dreamstime_10014When we were writing our book Making Babies: A Proven 3-Month Program for Maximum Fertility, we devoted a lot of time to helping couples pinpoint the exact time of the month they should be trying to conceive. I get tons of questions, in my practice, about timing intercourse and also about how often to have sex during a woman’s fertile period. There’s a lot of conflicting advice out there so I thought I’d use the blog today to clear up some of the confusion.

The first task is to work out when you are ovulating and the biggest mistake women make is to assume that they always ovulate in the middle of their cycle. Some people’s GYN’s tell them to count back 14 days from their last period to calculate the day of their cycle that they ovulate on. This method can give you a general idea of when to have sex and will work for many women but if you are struggling to conceive it’s worth being a little more precise. Here are some of the ways our YinOva patients pinpoint ovulation.

  • Ovulation Predictor Kits — Available at drugstores without a prescription, Ovulation predictor kits (OPK) detect the surge in luteinizing hormone (LH) in your urine just before ovulation. It’s important to remember that they are only measuring LH and not your actual ovulation. However most women ovulate about 12 – 36 hours after their LH surges, so they are a good guide. This methods feels really scientific so some our patients are surprised to find it’s not foolproof. LH can surge with or without the release of an egg. Some women, particularly those suffering from PCOS, have false LH surges and women over 40 can have elevated LH when they are not ovulating. The kits can also get expensive as you have to test on several days each month.
  • Changes in Cervical Mucus — Your cervical mucus changes in both amount a consistency as you approach ovulation. Just after the period most women have little or no mucus. They then notice sticky mucus followed by fluid that is creamy and looks a bit like hand lotion. The creamy mucus is your sign that ovulation is imminent. At ovulation your cervical mucus becomes more abundant and takes on a watery, slippery consistency a bit like raw egg-white. Most women have a consistent number of days of egg-white mucus each month. Your most fertile day is usually your last day of egg-white mucus.
  • A rise in body temperature — After you ovulate, your temperature can go up by 0.4 to 1.0 degrees. This isn’t enough to feel but you will detect the shift if you use a Digital Basal Thermometer. This method can give you information about the time of the month you usually ovulate but unfortunately by the time your temperature goes up it’s usually too late to get pregnant. Most women find their temperature goes up 24 hours after ovulation but for some women their progesterone levels rise more slowly and it can take up to 48 hours to see a thermal shift. Because an egg can only survive for up to 24 hours you risk missing your ovulation if you rely only on tracking your temperature to establish when you are ovulating.
  • Cervical Position — Your cervix moves and changes throughout your cycle. This is one of those things that always makes me marvel at how well designed we are. Under the influence of estrogen the cervix becomes higher and soft and open around ovulation to allow the sperm to swim to the uterus on their way to the fallopian tubes.
  • Other Body Changes — Women who track their body’s rhythm soon become aware of many hitherto unnoticed signs of ovulation. Some women find that they have breast tenderness just before or after they ovulate. About one in five women feel some abdominal discomfort when they are ovulating. This can vary from mild twinges to pain and is known as mittelschmerz.
  • Saliva Ferning — A more unusual way of detecting ovulation is to examine your saliva. There are small Ovulation Microscopes on the market that are sold for this purpose. During the LH surge just before ovulation the saliva changes when looked at under a microscope. It takes on a ferning pattern and looks a bit like frost on a window pain. Some of our patients love this method whilst others find the ferning difficult to detect.
I often recommend Toni Weschler’s Taking Charge of Your Fertility to my patients. It really is an excellent book about how to work out when you are ovulating. 

Once you know when you are ovulating using one or several of the methods above, you may still have questions about when to have sex. We always tell our patients that it’s a good idea to have the troops there waiting for the egg, which means having intercourse one or two days before ovulation. It’s also a good idea to have regular intercourse throughout your cycle because a period of abstinence can lead to a reduction in the quality of sperm. It is reassuring to know that you don’t have to be absolutely precise when working out these timings. Sperm live on average for three or four days so as long as intercourse takes place in the fertile window everything should be fine. If your partner has a low or borderline sperm count it is sometimes helpful to have intercourse every other day, rather than every day, in order to give his body time to replenish the supply.
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