- Normal ovulatory cycles are 21-35 days in duration
- Normal cycles typically vary by only 1-2 days per month
- History
-
Suggesting Ovulation
- Keep a menstrual Diary for several months
- Record days of uterine bleeding and amount
- Record associated symptoms
- Document premenstrual and Menstrual Symptoms
- Breast tenderness
- Menstrual Cramps
- Depressed mood
- Mid-cycle pelvic cramping (Mittelschmerz)
-
Basal Body Temperature increase of 0.3 to 1.0 F
- Inaccurate method
- Ovulation could occur 6 days before BBT nadir
- Ovulation could occur 4 days after BBT nadir
- Labs
-
Indications of Ovulation (most accurate testing)
-
Mid-Luteal Serum Progesterone Level (Day 21)
- Level >5.0 ng/ml (15.9 nmol/L) suggests Ovulation
- Level <4.0 ng/ml suggests Anovulation
- Morning Urine LH surge testing
- Urine LH surge occurs 72 hours before Ovulation
- Efficacy
-
Ineffective methods of determining Ovulation
-
Salivary Ferning
-
Salivary B-glucuronidase activity
- Efficacy
-
Prediction of fertile window
- Prediction inaccurate in most women
- Days 6-21: 10% probability each day of fertile window
loading