Ovulation Myths
In my last post you learned about ovulation and the ways to detect ovulation also known as fertility awareness methods. I have seen so many misconceptions or things that are spread as truth and are misinterpreted. I am answering questions and debunking myths that have I have received.
Myth: Anovulatory cycles are common and happen all the time.
Truth: Most people ovulate and have regular, predictable periods. If your period is regular, you ovulated. Is everyone allowed a one off anovulatory cycle? Sure. If you got sick or you were stress, that may have led to your brain not secreting FSH or LH at the appropriate time. However, they do not happen all the time and they should happen in the minority. If your periods are not regular or predictable and they are all over the place, you should talk to your OBGYN, PCP, or fertility doctor.
Myth: If your BBT doesn’t rise, you don’t ovulate.
Truth: A lot of things can regulate the temperature of the body, and this is a hard thing to determine and why many fertility doctors do not give a second glance to BBT. It is an imperfect test, and in fact, your temperature only rises by .5 or .6 degrees. That is a very small change and can be easy to miss.
Q: When can you get a positive pregnancy test?
A: It depends on how well you checked your cycles. We use averages all the time but people perform above and below averages and so do embryos. In general, embryos implant about 7-9 days after ovulation. The embryo does not fully exist before that. Ovulation is when an egg is released and fertilization happens the next day within twenty-four hours. Then the embryo has to get to a blastocyst stage which is five or six days along before it can start to implant. We generally regard days 7-9 the earliest you can get a positive pregnancy HCG because it has to be made from the pregnancy and absorbed into your blood, filtered through your kidneys, and then peed out. Some ask “Is day twelve too late?” Not necessarily because every embryo is different, and implantation is an imperfect process. To have perspective, I have had embryos that I put in someone’s body on day five knowing it is ready to implant right away. When they have come in nine days later, which is essentially fourteen days after ovulation, they have had an HCG level of seven or ten. Those are low. Average levels are closer to 100 or 200. Those levels would have been a negative pregnancy test since most of them detect levels around twenty. I want you to know that you can have a healthy baby even if your HCG levels start to show up a little later.
Myth: You have to do OPKs your entire cycle because your LH will rise throughout your cycle especially as you conceive.
Truth: The reason why some people have a positive OPK when they are pregnant. HCG and LH are very similar in their receptor status and high levels of HCG can cause an OPK to turn positive. It has nothing to do with LH being important at that time because LH is no longer stimulating the corpus luteum. The HCG is.
Myth: You must take hormones like progesterone to lengthen your LH peak or luteal phase if it is too short.
Truth: The luteal phase is an essential time when implantation happens. I have done a lot of research on the luteal phase. I want you to view luteal phase defect as on the spectrum of an ovulation disorder. The luteal phase or corpus luteum is not the problem and giving it progesterone is like a band-aid. If you ovulate better, a better follicle will have a better base or foundation to make better progesterone. Most of use treat luteal phase deficiency with ovulation induction medications. Progesterone can have a role in early pregnancy lost. If you have loss pregnancies, there may be a circumstance where progesterone supplementation is beneficial. In these cases, it is most beneficial when started after ovulation. So some people do need progesterone supplementation, but it is usually on the basis of chemical pregnancies or miscarriages versus a short luteal phase. I usually do both because it is easy. If you have a luteal phase defect, you can treat that with ovulation induction medications and you can give progesterone after ovulation so you are covering everything. It is not wrong to do one, but I prefer using ovulation induction over using progesterone supplementation as a band-aid. You also need an evaluation for why your luteal phase is short. Is there a thyroid or prolactin issue? Is there a hormone imbalance? Is this just how your body ovulates?
I hope this helped answer some of your questions or clarified any myths you have heard.
