Ovulation seems like a pretty straightforward event, right? But then why is getting pregnant so hard? 

The reproductive system is so beautifully complex. Each and every step involves a cascade of finely-tuned hormonally-synchronized events. And without x-ray glasses or a reproductive Magic-8 ball, it may be hard to read your ovulation symptoms and time intercourse accurately.  

You’re likely already familiar with the basic ovulation symptoms: clear stretchy egg-white cervical mucus, ovarian twinges or mild cramps, increased libido, a positive ovulation predictor kit (OPK) reading, breast tenderness, and/or abdominal bloating. 

If you have a “textbook” 28-day menstrual cycle then you’re ovulating around day 14. But of course all women are different. 

The Luteal Phase (Post-Ovulation)

Your period ideally arrives 14-16 days after ovulation unless you have a Luteal Phase Defect (LPD), meaning your cycle is short on the post-ovulation end. This may be a cause of progesterone deficiency.

If your luteal phase is longer than 14-16 days, you may have had a chemical pregnancy meaning an embryo implanted but the pregnancy was not viable and miscarried.

Your progesterone peaks about 7 days past ovulation. This is the best day to have your progesterone tested if you suspect yours may be low. Other signs of low progesterone may be spotting before your period arrives and/or low post-ovulatory temperatures on a Basal Body Temperature (BBT) chart.

Ovulation

Ideally you’ll see fertile cervical mucus for 2-4 days before you ovulate. The purpose of cervical mucus is to extend the fertile window by assisting the sperm to the target area so they can be ready and waiting for your egg to make her appearance. Once she’s arrived, the cervical mucus plays less of a role and begins to dry up within 24 hours, the length of your egg’s lifespan.

If you’re using an OPK, usually you’ll get peak positive readings for about 2 days. Ovulation usually occurs 24-48 hours after your first positive reading. However for women over 35-40 years old or diagnosed with Premature Ovarian Failure (POF) or Diminished Ovarian Reserve (DOR), it’s common to ovulate within 12 hours after a positive OPK reading.  

If you see multiple positive OPK readings at separate times during your cycle, this may be a sign of Polycystic Ovarian Syndrome (PCOS), in which case you should consult a Reproductive Endocrinologist for further testing. 

In the case of extended positive OPK readings, such as more than 3 days in a row, you may have Premature Ovarian Failure (POF) or Diminished Ovarian Reserve (DOR). This is because the ovaries and pituitary gland are over-stimulated and release excessive hormones to compensate for a decrease in ovarian function.

If you’re keeping a BBT chart, your temperature should rise the day after ovulation. By combining your BBT chart, the presence of cervical mucus, OPK readings, counting back from the first day of your period, and other ovulation symptoms like cramping, you can best guess when you ovulated. It’s kind of like being a reproductive Sherlock Holmes!

I recommend keeping notes (and a BBT chart) so that after a few cycles, you’re more in tune with your cycle and can better guess when you’re ovulating. (Don’t bother with BBT charting if you’re on fertility medication because the temps won’t be accurate.)

Ovulation Symptoms and Chinese Medicine

By keeping a BBT chart, you can observe which ovulation symptoms may be related to hormone imbalances. 

For instance, if you experience low back pain, from a Chinese medicine perspective, you may have Kidney Yang Deficiency. This means that your “reproductive fire”, so to speak, may be weak, in which case you lack the warmth and function to produce enough ovulation-promoting hormones to mature your egg and successfully release it from your ovary.

If you experience bloating and breast tenderness, you may have Liver Qi Stagnation, meaning your Liver energy is backed up and cannot smoothly distribute blood, hormones and energy to your reproductive organs. 

If you see spotting with your period, you may have Blood Stasis. In other words, blood is not flowing efficiently to and from your uterus and ovaries. Old blood may get stuck and block the tubes, ovaries, or gather on the uterine wall. Mid-cycle spotting may be a sign of this as the egg releases and causes old blood to discharge.

Acupuncture and herbs are very effective ways to improve ovulation symptom imbalances and increase your chances of fertilization and pregnancy.

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