[beginning fertility issues]

Information for TTC Couples...

Written by TTC Couples.


Low-Tech Ways to Help You Conceive - Chapter 9

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Low-Tech Ways to
Help You Conceive


    9.1 Are her periods typically regular? If so, what is the typical cycle length (from beginning of period, through the day before beginning of next period)? [cycles of irregular length can make it more difficult to predict timing of ovulation; there is little or no evidence that long cycles are linked to fertility problem, but shorter cycles may be a problem -- see "luteal phase" section below]

    9.2 Has she ever gone a significant length of time with no periods (amenorrhea)? [this likely indicates non-ovulation]

    9.3 Did she chart BBT (basal body temperature) accurately? For how long? [usually the first step in determining fertile time of the cycle; helps by establishing ovulation timing in a "typical" cycle; the single most-common initial recommendation for women trying to conceive]

    9.4 Did she typically have a luteal phase (time of elevated BBT between ovulation and beginning of next cycle) of at least 10 days? [a too-short luteal phase can cause problems with implantation of the fertilized zygote]

    9.5 Did she monitor cervical fluid? For how long? [clear, plentiful, and stretchy/stringy "mucus" or fluid usually signals ovulation within 24 hours after first appearing]

    9.6 Did she monitor position of cervix? For how long? [a high, soft, and open cervix usually signals imminent ovulation]

    9.7 Did she use an ovulation predictor kit (OPK)? [kits can detect LH (luteinizing hormone) surge that precedes ovulation by about 24 hours in most women]

    9.8 Did she typically experience mid-cycle spotting of blood from the vagina? [another sign of ovulation in some women]

    9.9 Did she monitor mittelschmerz pain? How often? [some women experience a sharp pain in abdominal area in conjunction with ovulation]

    9.10 Were any other signs of ovulation monitored? For how long? [monitoring other miscellaneous signals has been suggested - e.g., home microscope device to detect "ferning" in saliva]

9.1 Are her periods typically regular? If so, what is the typical cycle length (from beginning of period, through the day before beginning of next period)?

RAH - Okay, this is always confusing, I know... how about a chart?

*BIG FAT WARNING* before you read any further: This discussion concerns a "textbook" statistical average. However, you are not a textbook -- you are a person! :-) This means several things:

* No individual can or should expect that her cycle will necessarily follow the average;

* Even if you do have a "typical" 28-day cycle (or a regular cycle of any other length), that doesn't mean you will have that same cycle *every* month; and

* Even if one or more aspects of your cycle fit the textbook model, that doesn't mean that ALL parts of your cycle do! For example, you might have a textbook 28-day cycle, every month like clockwork -- but if you ovulate on Day 19 rather than Day 14, and therefore your luteal phase is only 9 days long instead of 14 days, you've still got a problem!

So, with that in mind, here's a "textbook" cycle:

    Day 1 to Day 5: Period.

    Day 6 to Day 9: Pre-ovulatory phase; usually infertile.

    Day 10 to Day: 13: Fertility "window"; intercourse every day or every other day recommended (since sperm can live up to 5 days in favorable cervical [fluid]).

    Day 14: OVULATION - intercourse on, or just before, this day will give you best odds!

    Day 15 to Day 28: Luteal phase; usually infertile.

    Day 29 = Day 1 = Period begins; new cycle.

The most variable part of the whole cycle from month to month is the part from Day 6 through Day 14, when a variety of things can throw off the actual ovulation date. On the other hand, the luteal phase doesn't vary much from one month to the next. This is why the "14 days before your next period starts" rule-of-thumb [for estimating when ovulation takes place] is more reliable than the "14 days after period begins" rule.

A word of explanation about my note for Day 14 above: Sometimes you will get even better odds by having intercourse on the day before ovulation, rather than the day of ovulation. Why? The role of cervical fluid is critical here. The "texbook" pattern is for the fluid to being drying up (rather abruptly) as soon as the estrogen level begins dropping (estrogen is the hormone primarily responsible for causing fluid to be produced). Because estrogen is only indirectly connected to ovulation itself, this can vary in how long before ovulation it happens. However, without good-quality cervical fluid, sperm lifespan and therefore conception become much more difficult! So, the Peak Day for intercourse is the last day of fertile quality cervical fluid. (A slippery vaginal sensation is also indicative of peak fertility, for those who don't have easily-readable cervical fluid.)

TCoYF has a color chart (p. 5 of the color pages in center) showing the rise and fall of the four primary reproductive hormones at work during the monthly cycle (FSH, estrogen, LH, and progesterone), and how they relate in sequence to follicle development, uterine lining, cervical position, quality of cervical fluid, and BBT readings, all for a "textbook" cycle.

Again, the key thing to remember is that ALL of the above is based on statistical averages. For this reason, nobody should "rely on" ovulating on Day 14, Day 18, or any other particular day, unless you have charted your own cycles for several months at a minimum, and understand how your cycle operates -- and even then, you might have a different cycle this month. Statistics are only general guidelines, and can be misleading when applied to individual circumstances.

Example: Suppose you wanted to buy riverfront property to build a house, and the real-estate agent told you (truthfully) that the "average" flood caused a 4-feet rise in water level. So your built your house at 7 feet above river level. Well, the actual flood pattern might be an average of two years of 1-foot floods, and a 10-feet flood in every third year. The average is (1 + 1 + 10 = 12)/3 = 4, so the agent told you the truth -- but your house is still under three feet of water!

Moral: Please be sure to chart YOUR cycle, and don't merely rely on averages! Everyone should be using at least one, and preferably more than one, of the monthly-cycle monitoring techniques (BBT charting, cervical [fluid], and/or cervical position) to determine your personal pattern. - RAH

Having a period does *not* prove that one is ovulating. My girlfriend tried for 18 months to get pregnant; her period came like clockwork every 28 days. Finally, she started charting BBT and found she didn't have a biphasic chart. She went to the doctor who diagnosed that she was not ovulating and put her on Clomid. My friend now has two kids, the second of whom was conceived right away, without the use of Clomid.

My midwife has also explained to me that neither a biphasic BBT chart nor a positive on an ovulation prediction kit *prove* that one is ovulating. Rather, they show that you are producing enough progesterone to get the temperature up and get the postiive on the OPK. An endometrial biopsy is the definitive test for ovulation.

I've had long and irregular cycles from 4 weeks to 8 weeks, averaging 6 weeks, and 2 years without a period when I was in college and running 40 miles a week. And I've had 3 pregnancies. The first one took no trying, the second one took 6 months, and the third one took a year. I now realize that "trying" actually made it harder for me to conceive because of my long irregular cycles, I was not timing things right at all! (I didn't do BBT or [cervical fluid], just kept an eye on the calendar).

I've never heard about the egg getting older because of a long cycle. You are born with all the eggs you'll ever have. The eggs get older as you age. Whether it is released early or later doesn't matter.

If you have long cycles, how does it diminish your chances of conception other than the obvious reduction in opportunities. Does the egg get too mature or anything like that? Say you ovulate on Day 33. Is it worth getting the hopes up, or should one just hope their period comes really soon? Some women with long cycles have no problem getting pregnant. I posted on MKP a while back about long cycles, and there were oodles of women with long cycles who very easily got pregnant.

I have long cycles (45 days was my last natural cycle) and I don't get pregnant. I have very low FSH, which causes my LH/FSH ratio to be high. Sort of like PCO but my ratio isn't quite as high as that.

Basically with my skewed hormones, my eggs are not stimulated correctly, so I think reason my cycle is long and the reason I don't get pregnant are the same reason.

I'm sick of charting, I'm tired of sex, I'm tired of checking my cervical [fluid] and my cervix position. My temp has not gone back up and I'm going insane. It's day 23!

How's this for comfort?

I got my last menstrual period [in early] May. I was charting my BBT back then, and I ovulated [in early] June...**28** days after my period began. [In late] June..., I found out that I was pregnant and my daughter was born [in] February. I had to bring my BBT chart in to my Ob at my first prenatal appointment because she didn't believe that I had such a long cycle and still conceived normally, so she was setting my due date too early by basing it on LMP...

So, it's very possible to have a very long cycle and be perfectly okay and able to have a baby. My daughter is living proof! As long as you menstruate 12-14 days after ovulation, then the time between your period and ovulation is not as important.

I know what you mean about being tired of sex. By the time we conceived [our daughter] that month, my husband actually had a sore!!

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9.2 Has she ever gone a significant length of time with no periods (amenorrhea)?

RAH - It may seem obvious, but I think it's important to state it in black and white: If you aren't having a period, you almost certainly aren't ovulating. (Specific circumstances to the contrary can occur for women who are breastfeeding; this is discussed in Sec. 11.)

The causes and treatments for anovulation / amenorrhea are complex and can't be summarized easily. If you are in this category, please consult your gynecological health-care provider; it would also be wise to read one of the published guides to fertility, in order to understand how this condition occurs and how to deal with it. Marilyn Shannon's book _Fertility, Cycles and Nutrition_ is particularly good in its discussion of anovulation and fertility. - RAH

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9.3 Did she chart BBT (basal body temperature) accurately? For how long?

RAH - Basal body temperature charting is the single best way for a woman to keep track of her monthly cycle and its regularities or irregularities. With respect to fertility, BBT charting can tell you your typical cycle pattern (that you usually ovulate around Day 17, for example). Other ovulation signs, notably cervical fluid, are better *advance* indicators of ovulation in a given cycle; BBT can only tell you that you've ovulated after it's happened, when it's too late to conceive.

But there are three advantages to BBT charting that no other method can give you: (1) It gives almost 100 percent confirmation that you're actually ovulating, since the BBT rise is directly linked to the release of an egg from the ovarian follicle -- neither cervical fluid, nor cervical position, nor ovulation predictor kits (OPKs) are direct evidence of ovulation; (2) it is the best direct measure of whether your luteal phase is too short, which is bad news (although correctable) for sustaining pregnancy (see Sec. 9.4); and (3) if nothing else, it enables you to understand your entire cycle, not just a single event (ovulation) within the cycle -- it's a good way to predict when your period will begin, for example, or if you're sick.

Explaining how to chart BBTs and how to interpret the results are beyond the scope of this FAQ (it really requires using sample charts to explain properly, and I want to keep this a text-only file for those without Web access). What I've included here are (literally) some of the most frequently-asked questions about BBTs. For further help, consult one of the standard published sources.

Finally, one of the most frequently asked questions is "How accurate are digital thermometers for taking BBTs?" By lucky happenstance, a new digital basal thermometer has just been approved (early July 1996) by the US Food and Drug Administration (FDA), and is now available on the market. The B-D Digital Basal Thermometer, manufactured by Becton-Dickinson, is product #524560 in the US. - RAH

BBT info:

You should take your temp at the same time every morning, before you get out of bed, go to the bathroom, eat, drink, or have sex. A basal thermometer is ideal... I use mercury and it works fine, although it can be hard to read in dim light.

During the beginning of your cycle (your period and the days following) your temp is low. Mine range from 97.8-98.2. This is the estrogen phase. At the end of the estrogen phase, before ovulation, there's an LH [luteinizing hormone] surge which may cause your temp to drop a little more for a day. During the ovulatory phase, your temp will rise over a couple of days, peaking after ovulation has occurred. Mine peaks at 98.6.

After ovulation, the progesterone kicks in and your temp will remain [in the higher second-phase for] at least 10 days. Your temp will then drop when your period is due, completing the cycle.

If you are pregnant, your temp may rise a little higher a few days after ovulation and stay there past when your period is due. Keeping your peak or higher temperature past 18 days is usually a sign of pregnancy. In my case it rose to 98.8 and stayed there.

Several things may throw off your temp - such as a lousy night's sleep, alcohol, sex. That's one reason to chart it over several months.

Best days to have sex are the 5 days before ovulation and the day of ovulation. Remember the [temperature shift to the higher levels] means ovulation is over.

I have begun taking my temperature every morning and am keeping track on a little chart that came with the ovulation kit my cousin gave me. I dont know how to read this chart. What am i looking for?? What is taking place here? Is my temperature rising because my body is getting ready to ovulate??? What will the sure fire indicator be that i am ovulating (temperature wise).

The [pattern should form a roughly horizontal line] but not exactly the same every day, up until ovulation. At that time, the morning [temperatures may dip down and then] rise well above the baseline. It [should] stay up there [at least 10] days before gradually coming down. A fertility specialist once told me that by the time this dip and rise become apparent, ovulation could already have occurred and the opportunity missed.

Ovulation prediction tests are apparently better predictors in that the positive test tells you that ovulation is about to occur in the next 12 to 24 hours.

[RAH - Not all women experience the "dip" in temperature mentioned above, or the nadir mentioned in the following post. In those who do see this low point in their charts, it can be a reasonably reliable indicator. However, the primary key to BBT interpretation is understanding the biphasic pattern of low and then high temperatures. See pp. 52-56 in TCoYF. - RAH]

BBT increases in response to increased progesterone... This means that the jump in temperature should always occur after ovulation. In fact, at the time of ovulation the temperature should be at its nadir (lowest).

[RAH - Many women do not experience this nadir, although it's helpful if you do -- see my note immediately above. - RAH]

My advice for anyone trying to get pregnant is to follow the BBT for several months in advance, or while trying. If the average cycle is 28 days long, then have sex every one or two days, from days 10 through 16. If the cycle is greater than 28 days, add the number of days greater to these figures--i.e., for a 34 day cycle, have sex every day or two from days 16 through 22. Meanwhile, chart ovulation to try to be more precise, and just to make sure that ovulation is occurring, as you'll want several months of charts in hand when you first consult a fertility doctor, if it comes to that. If you can predict ovulation, be sure to have sex *before* it happens.

If your wife wants to know HER fertile time, she'll have to learn to take her basal temperature. It's easy. We decided we were ready, I started taking my temperature, then one morning said, "Sweetheart, I think it's today." I'm due in June.

Basically, the way it works, she takes her temperature (anally, vaginally or orally, but always the same one - I preferred orally!) at the same time every morning before rising or moving at all. Keep the thermometer where she can reach it by just reaching out her arm. When the temperature takes a nosedive and then climbs to a point higher than it's been the past two weeks, she has just ovulated. We jumped the gun when my temperature nosedived, but it was about 2 weeks from my last period, so I figured the odds were good. Anyway, a doctor would be able to tell you and your wife more. BTW, this is the same method the Catholic church advocates for birth control.

The jumping the gun you indicate was probably when it worked and not after temp rise. Maybe I misunderstood what you meant though...

You need to have sex PRIOR to the temp rise. The temp rise registers the rise in progesterone level, which is produced by the corpus luteum formed by the collapsed ovarian follicle after ovulation when egg is released. At the same time as the progesterone rise, the estrogen level goes down. When the estrogen falls the cervical [fluid] gets thick, scant and hostile to sperm. The BBT method is good for knowing when it is safe to have sex again for NOT getting pregnant. It is also good for knowing your cycles, if regular, since you get to know about what time of month the rise occurs. Have sex for the few days prior to anticipated rise in BBT. (Some women have a dip in temp just about ovulation time, but this is not always the case.)

The LH ovulation kits are better at timing for trying since the LH surges prior to ovulation, which is the optimal time for conception. When LH is surging the hormone estrogen is also high. The cervical [fluid] in response to estrogen is thinner, watery and optimally stretchy like egg whites. This is great [fluid] for sperms to hang out in and swim through. The sperm can live in fertile time of month cervical [fluid] for days (record is 5 days).

As many have recommended: "Taking Charge of Your Fertility" by Toni Weschler is a good book to help you learn about your monthly cycles and when fertile and infertile times of month are for your body.

PS - Catholics will use a combo method of BBT with cervical [fluid] monitoring with abstinence periods.

One can assume that ovulation occurs on or before the first day of the temperature rise, as it is the corpus luteum's secretion of progesterone that causes the temperature rise. There is no corpus luteum until the egg is released. Therefore, conception must always occur within 12 to 24 hours after the temperature *first* starts to rise, according to the dogma, and I have been unable to locate any reason to disbelieve this dogma. My temperature continues to rise for another day or two after ovulation, but that is irrelevant.

I used BBT and observation of cervical [fluid] to make sure to time intercourse appropriately. I think that this is the key. I would expect someone for whom BBT doesn't work to spend money on ovulation prediction kits, if they're at all uptight about not knowing how long conception is going to take. Some people find cervical [fluid] to be very helpful, but I and a friend agree that it's too hard to detect to be very useful.

I had very scant cervical [fluid] so it was not very helpful to me. Also, when you have intercourse, the semen looks a lot like fertile [cervical fluid], so that makes it difficult to tell whether you have [fluid] or not.

For the BBT, I thought that was very helpful. I quickly recognized a pattern to my ovulation so I could make sure I was having sex at the right times, and I knew when I could let my poor husband off the hook! Also, it was helpful at the end of my cycle, to identify the temperature drop and confirm that the period was "real" and not just one of those "fake" periods some women get while pregnant.

By the way, you have to be willing to get up at the same time each day to have your BBT charts be most helpful. The little formulas you see (subtract/add X number of degrees if you get up at a different time) were totally useless to me. I floundered for a while, but started getting perfect charts when I started waking myself up at 5:30 am every day to do the BBT (then sometimes went to work, other times went back to sleep).

I do both [BBT and cervical [fluid],] but only use BBT to confirm that I have ovulated (i.e. I use the [cervical fluid] to know when to have sex and the BBT to know when to stop - although we usually do it a day or so beyond the temperature rise).

I find the BBT hard to do every morning because we get up a different times and I refuse to wake up extra early just to take my temperature.

It was good to see the pattern for a month or two to know that I am ovulating and things are happening normally.

[RAH - Concerning the problem with semen "masking" cervical
fluid: there are techniques to expel the semen so that this
problem is minimized. See Sec. 9.5. - RAH]

As for BBT and [cervical fluid] - I do both, but I've found BBT to be the easier to read - particularly near ovulation. I've had a hard time reading [cervical fluid] because of sex/semen. Just looking at my [cervical fluid] charting, I couldn't pinpoint ovulation to less than a four day range. With BBT alone, I can get it down to two days.

I use both the temperature and the [cervical fluid] to know when I am and am not fertile. I find that the temperatures are probably more accurate for me than the [fluid] and that they clarify what the [fluid] is saying.

I also teach sympto-thermal nfp [natural family planning], and I find among my students that most..., while doing both sorts of observation, will come to rely more heavily on one or the other of the signs, while using the other to cross-check. I like having both signs for the greater knowledge it gives me, but I trust the temperature more as it is not subject to my interpretation of its quality in the way the [cervical fluid] is. I also do not find that my temperature is easily disturbed (upward, but unrelated to ovulation) or that taking it at the same time each day is especially difficult as my husband hands me the thermometer each morning--his schedule is more rigid than mine.

I also find that a vaginal temperature is more accurate than an oral one. Some of my students say that they have difficulty keeping a thermometer in their mouths for five minutes--they go back to sleep and it falls out of ther mouths. Some also have erratic schedules or simply find the [cervical fluid] sign to be stronger -- clearly present or clearly absent. We also teach a cervix sign -- looking for changes in the cervix itself -- position, softness, openness of the os -- but many women find this to be more difficult to determine and so it is just another cross-check.

We teach that the first day of temperature rise, especially the morning of the first day of temperture rise, is a very fertile day, as well as the last day of the more fertile [cervical fluid] and first day of dry-up.

[RAH - There is controversy surrounding how effective it is to have intercourse the day of the temperature rise. The rise
comes after ovulation, so at first it might seem to be too late. On the other hand, a number of variables -- lifespan of
the egg, for example -- can still make it worthwhile. The safest advice is probably to have sex the *morning* of the
temperature rise, when the egg is most likely to be viable still. - RAH]

I am wondering if anyone here has concieved the morning of the rise in temp. Suppose you ovulate the night before. Would the temp still rise the next morning?? The epitome of irony is we had sex the night I ovulated, but he was so tired that he couldn't climax. So when my temp was high the next morning I went ahead and tried anyway.

here's what I'm hoping: Yes, you can still conceive on the morning of the temperature rise. The theory is that the temperature rise is due to progesterone being secreted by the follicle and then by the corpus luteum, and this may begin even before ovulation has occurred and is over. So some experts believe that you can get pregnant even on the second day after the temperature rise.

My husband and I didn't get busy this month until the day before the temperature rise, so I am hoping that we could have hit it anyway!

[RAH - It's definitely a minority point of view that intercourse the second day after temperature rise can still be
effective; the same is true for the idea that the corpus luteum can secret progersterone before ovulation. Of course,
it does no harm to continue intercourse through a couple of days after the rise, provided you're both up for it! - RAH]

Can anyone tell me if ALL women who are pregnant experience tri-phasic temperatures? Wondering if I should give up hope since my temps only rose once (from around 97.8 to 98.6)

Definitely not triphasic for me. The only BBT Clue was that it stayed elevated after day 30 when I expected it to have already dropped.

I'm interested that you specify you take rectal temperatures (do most people assume oral?). I'd always been told that they're more accurate this way, and your experiences seem to confirm it. I take my temperature vaginally, and was wondering if anyone knows how that compares in accuracy with rectal vs oral.

Most people today do use oral temps, especially with improvements in the digital variety. Oral temp readings can also be just as accurate as rectal or vaginal ones on a case by case basis. I choose to do rectal readings because digital thermometers were not sufficiently developed in the mid 80s to trust, and my own preference--being a slowww waker--was to let the thermometer sit in my behind where I wouldn't have to worry about keeping my mouth tightly closed, dozing off or inconsistent placement under the tongue. A friend of mine began charting her temps using oral readings, but switched to rectal soley for her own convenience because allergies made her a mouth-breather early in the morning.

All in all, I doubt there's any significant long-term difference in outcome based on different sites or even types of thermometer. Rectal (and this ought to work as well for vaginal) readings seem to make it easier to establish a baseline early on, and hence spot changes, but this works as well for oral temps if one uses diligence and consistency.

Gee, I guess what I'm saying is that rectal readings are the lazy woman's method of BBT charting;)

I've been using a digital thermometer ever since I broke my special bbt glass thermometer. I'll be using this data soon to -try- to get pregnant (up until now, it was to -avoid- conceiving) and was wondering just how inportant those 1 tenth fluctuations are, anyway. My temp is consistently 97.something and then rises to 98.something and stays there until my period. Simple. Or should I be looking for something more complex?

No. You're looking for deviation not related to infection or body processes aside from ovulation. That's why all methods of temperature taking require time and consistency in order to establish proper causality -- ie, temp spikes due to ovulation and only that.

It sounds like you're on the right track now.

[Concerning accuracy of fever or "regular" thermometers, and of non-BBT digital thermometers:]

What does plus or minus 0.2 degrees Fahrenheit mean? Let me give you an example. Suppose that your actual body temperature is 97.3 on two consecutive days. On the first of these two days, the thermometer might chance to read 0.2 degrees low, giving you a reading of 97.1 degrees. On the next day, it very well might chance to read 0.2 degrees high, giving you a reading of 97.5 degrees. This *looks* like a 0.4 degree shift--thus indicating that ovulation has occurred--when in fact nothing of the sort has happened and the temperature has held steady.

Unless a thermometer is accurate to within plus or minus 0.1 degree Fahrenheit, or the Celsius equivalent, it is useless for BBT purposes, and may give readings that are 'all over the place' even for a woman whose temperatures are very steady.

The thermometer I use is the B-D (Becton Dickinson Canada Inc.) Basal Body Thermometer. It is celsius and reads to the 10th of the degree i.e 37.55. That's about [two-10ths of a degree, or] 98.4 for you farenheiters. This thermometer has been very accurate for me. Pop it in 4-5 times in a row and every time same reading. Memory too so if I'm too tired, I can see what temp. was later. It beeps when it has teld temp. for 10 secs. and automatic shutoff after 1 min. in case you forget to turn it off. I know taking BBT is a pain but this thermometer is the best! I had 3 glass ones and I broke them within 1 month of getting each one (Klutz!) and I hated having to keep my eye on clock for 3 long minutes. Annoying when you are tired anyhow.

So it takes all kinds. Different strokes for different folks. .. Hope this helps anyone who still needs to go out and buy one ($19.00 Canadian approx.).

Does a regular digital term. from a drug store work for BBT charting?

To be useful, a BBT thermometer has to be accurate to within 0.1 degree Fahrenheit (Note: That's not necessarily the same thing as displaying a *reading* to within 0.1 degree Fahrenheit.)...

At any rate, check the packaging statistics to make sure.

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9.4 Did she typically have a luteal phase (time of elevated BBT between ovulation and beginning of next cycle) of at least 10 days?

RAH - One of the "hidden" types of infertility is a luteal phase that's not long enough to allow the fertilized egg to implant in the unterine lining. In other words, the egg is successfully fertilized by the sperm, but by the time this zygote (fertilized egg) makes its way from the Fallopian tube down to the uterus, the uterine lining has already begun to disintegrate, in preparation for ending the cycle and menstruation.

A short luteal phase, [sometimes unfortunately called luteal phase defect (LPD)], is not hard to detect if you are monitoring BBTs. The guideline recommended in TCoYF is that you should have at least 10 days of elevated temperatures after ovulation. Authorities vary on "how short is too short"; some authorities believe that a luteal phase of 12-13 days can be problematic for fertility. As you will see below, there are different opinions about "how short is too short" on the newsgroups as well. Certainly a luteal phase of 14 days seems adequate for most; on the other extreme, 10 or less indicates a problem.

Correcting the too-short luteal phase can require medical assistance (for example, the drug Clomid is often prescribed for this condition.) One low-tech treatment that seems helpful, based on anecdotal evidence, is Vitamin B-6 supplements.; opinion varies on the proper dosage. See Sec. 2.3 ("Tales from the ONNA List") for several examples of how B-6 has been used for this condition. Beyond this measure, if you think you have a too-short luteal phase, it's best to consult your gynecological health-care provider. - RAH]

I've just started charting my BBT and this month my temperature was up only twelve days. I had understood it's supposed to stay up for fourteen. Does this indicate that I have a luteal phase problem, or is it still within the normal range?

My understanding is that that's still within the normal range and that a luteal phase of only 10 days is still considered [borderline] normal.

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9.5 Did she monitor cervical fluid? For how long?

RAH - For many women, monitoring the presence and quality of cervical fluid [also known in older references as cervical mucus] during the cycle is one of the best ways to determine when you are within the "window" of maximum fertility.

In theory, the idea is simple: As ovulation gets nearer and nearer, your lower reproductive tract begins producing cervical fluid that is not present at any other part of the cycle. This cervical fluid is specifically "sperm-friendly", and enables sperm to travel quickly through the cervix, uterus, and into the Fallopian tubes, where (hopefully) they will find an egg and fuse to begin pregnancy. In many women, the pattern of cervical fluid undergoes a steady build-up in quantity as ovulation day approaches; the cervical fluid also changes consistency, from sticky, through creamy, to the highest-quality which resembles raw eggwhite. (If you aren't accustomed to seeing the cervical fluid, you should consult one of the reference books -- pictures and diagrams really help! TCoYF has a series of excellent color photograph of cervical fluid throughout the cycle on pp. 1-3 of the color-pages insert in the center of the book.)

The presence of eggwhite cervical fluid in many women signals the peak time for intercourse, since it reaches this peak during the 24 hours or so immediately preceding ovulation. If you do fit this pattern, it's time to go for it! On the other hand, some women may not have the "textbook" pattern of cervical fluid (in a particular month or in general), and other women may find it hard to check for cervical fluid. And there is always the possibility that you aren't ovulating at all (in a particular month or in general), since cervical fluid is triggered by rising levels of estrogen, and not by ovulation itelf.

On the whole, though, it's *always* a worthwhile investment of time to try monitoring your cervical fluid through several cycles. If nothing else, you can eliminate poor-quality cervical fluid as a possible cause of infertility or sub-fertility.

There is one potential difficulty that many women encounter when trying to gauge presence and quality of cervical fluid: the presence of semen in the vagina and around the cervix can mask or obscure the fluid. The two liquids do in fact have some confusing similarities, such as appearance (after the semen liquifies) and slipperiness. One important difference, though, is that semen won't stretch out to form a string between thumb and forefinger.

Especially if you follow the frequency and timing recommendations for intercourse, you'll find that you have a lot of semen to deal with, at the very time you want to check the changing condition of your cervical fluid. How to make sure you don't have semen obscuring your cervical fluid? Toni Weschler recommends a Semen Emitting Technique, which essentially is using Kegel exercises to expel remaining semen from your vagina, some time after intercourse (see TCoYF, p. 85 for instructions). I would add that, if you want to be very cautious and make sure that as much semen as possible gets a chance to enter the uterus, wait until around 12 hours after intercourse before you begin squeezing the extra semen out. - RAH

My question is, as I've been hearing about the BBT, which my husband and I are about to start, how does one try and use the cervical [fluid] as an indicator? I understand the temperature chart, but what do you record, or watch for, in the [fluid]? You should look for clear, slippery, & stretchy [cervical fluid]. Kinda like the same consistency of egg whites.

Try to have sex right at the cervical [fluid] peak (that stringy eggwhite-like [fluid], not the creamy kind and not the sexual arousal slippery fluid stuff either...) ..... we'll see if it works for us... of course you can't guarantee anything!!

Help! Now I'm totally confused. Right now I have heavy [cervical fluid] ... Do we have sex now up until the [cervical fluid] is scant? When it stops, is that when ovulation occurs???? I can't figure this out. My temperature is a low 98 degrees.

If it's the more clear egg-white type, go for it!! I read that other types can be fertile too, like thin, wet, copious. Usually the good [cervical fluid] lasts about 5 days, start to peak. Ovulation occurs right after the peak day, I recently read.

I would go for "it" until I no longer see fertile [cervical fluid] AND until my temperature has clearly gone into the higher range of the luteal phase. (Sometimes the [cervical fluid] could be way up there and not easy to perceive, (for me at least).

I've been using both the BBT and the cervical [fluid] method for about 3 months now. I find I can tell better when I'm close to ovulation by the [cervical fluid] method. My temp does take the dip but takes 3-4 days to rise to the higher temp and I get low dips every now and then when I'm in the luuteal phase of my cycle. My [cervical fluid] is a clear indicator if you'll pardon the pun. It definitely gets very stretchy and clear and then boom, back to cloudy and not abundant.

Did she monitor cervical [fluid]? For how long? [clear, plentiful, and stretchy/stringy indicates usually signals ovulation within 24 hours after first appearing]

Tried this last month, and resulted in pregnancy #3. Besides Toni Weschler's book, simpler instructions on charting cervical [fluid] are found in _Your Fertility Signals -- Using Them to Achieve or Avoid Pregnancy, Naturally_ by Merryl Winstein.

I have a slight twist to this question. If you are seeing stringy clear [fluid] for a couple of days during the month when you should be ovulating, does that mean you are definitely ovulating? I do have changes in my discharge every month, but I have yet to chart my temperature. Should I do this as well? Am I definitely ovulating?

The best way to understand your cervical [fluid] would be to get the book "Taking Charge of Your Fertility". Probably, the cheapest way you can find out if you are ovulating is by charting your temp. Ovulation Predictor Kits can tell you that, too, and many women use them in conjunction with the temp. charting.

One slight correction: The OPKs can't tell you directly that you are ovulating -- they can only tell you that you are experiencing the LH (luteinizing hormone) surge that triggers ovulation in *most* (not all) women, during *most* (not all) months.

Cervical [fluid] is not always a guarantee that ovulation is happening, either -- the [cervical fluid] is produced by the rising level of estrogen in the body, which is one of the "leading indicators" of impending ovulation; but just because you have rising estrogen doesn't necessarily mean an egg is about to be released.

Charting BBT (basal body temperature), on the other hand, has a much more definite link to actual ovulation. The reason the BBT rises after ovulation is because the hormone progesterone is produced from the corpus luteum (the spot on the ovary where the egg was released) -- and the corpus luteum normally doesn't form unless the egg is actually released.

I whole-heartedly second [the] recommendation for _Taking Charge of Your Fertility_. The author is Toni Weschler, and the book was published in 1995. Costs about $20 (US) in the bookstore, but it's well worth it!

The study stressed something that we already knew from IUI studies: get the sperm there before the egg. This means to have intercourse prior and up to expected ovulation. Use your cervical [fluid] to help time ovulation. It is the stringiest and highest quantities are around on the day of ovulation.

This is not always true, is it? I have read that with some women, fertile [cervical fluid] peaks a day or two before ovulation. In my case, I get the most fertile [cervical fluid] about a day before the LH surge is detected by an ovulation predictor kit. Even when doing IVF, it seems to be the copious fertile [cervical fluid] produced by pergonal tapers off some around the day of the HCG shot.

The vagina is only a good place for sperm when the proper [cervical fluid] is present -- which happens at ovulation, just before and during... hence some women, myself included, follow their cycles by temperature and cervical [fluid] signs and have or not sex according to when I know i'm fertile...

Having sex during the cervical [fluid] "peak" as it is known is the most likely time to get pregnant bc this [fluid] actually feeds the sperm... which live, by the by, in little crevices in the cervix, not in the vagina itself.

Is it possible to have ovulated and not have any of the typical stringly, clear [cervical fluid] to detect?

I think it may be possible. When I had fertile [cervical fluid] checked by my midwife, I was surprised at how much she found when I hadn't had any indication that there might be that much. In my experience, it can also make a difference whether the [cervical fluid] you detect is only what comes to you or what you have to "go fishing for." Several months, I only found it if I went after it. However, if I couldn't find any, I would be concerned. Ovulation is useless if the [cervical fluid] is hostile because the sperm will be killed by the time they get to the cervix. You may find, though, that you will have to check several times a day. Some times of the day may be more forthcoming of [cervical fluid] than other times.

Is it possible to have ovulated and not have any of the typical stringy, clear [cervical fluid] to detect?

I haven't had much luck detecting my fertile [cervical fluid] for about a year (ever since we started trying. Grrrr!). Yet, I got pregnant last May (lost it in July, but not relevant to this), and I know I ovulate at least sometimes. Sometimes semen mixed in can make it harder to detect. That's one reason, I read, that if you are trying NOT to get pg, you are supposed to abstain until after you see that the [cervical fluid] dried up. Also, the [cervical fluid] could be high up, around the cervix, with not enough making its way down the vagina to detect it, but enough to get pregnant. I also recall when I got pregnant with my daughter 14 years ago that I never saw any "wet" stuff at all that cycle. Lastly, there are other textures that could be fertile too, like thin and wet, that don't fit the egg-white comparison.

Can anyone tell me how semen affects the look of fertile cervical [fluid]? And how long after sex will it have any affect?

Instead of clear and stretchy, the [cervical fluid] will be cloudier and won't form a string between thumb & forefinger. I think the stretchiness / stringiness is easier to tell than the change in visual appearance.

In our experience, the semen can sometimes persist for 2-3 days. However, you can get rid of the "excess" by doing Kegels exercises a few hours after intercourse; according to _Taking Charge of Your Fertility_ by Weschler, this still give the sperm plenty of time to get into the uterus and beyond. Hope this helps!

: Can anyone tell me how semen affects the look of fertile cervical [fluid]? And how : long after sex will it have any affect?

Semen (or seminal residue) looks much like the most-fertile-type [cervical fluid]; it can be difficult to tell the two apart.

Generally, it will last for about a day; if you have intercourse one evening, your [cervical fluid] observations will probably be obscured by the residue during the next day, but O.K. the day after that.

The Couple-to-Couple League recommends a "not on consecutive days" policy during the pre-ovulation phase, in order to help ensure that the onset of [cervical fluid] can be detected.

You can detect cervical [fluid] because much of the time gravity forces it down through the vagina. It would be wet, stretchy and clear, like egg white, but other consistencies can be fertile too. Sometimes it is hard to miss and other times (or for other women) hard to detect. It is harder to detect if semen is present, too.

You can have very little cervical [fluid] on the cervix that would still be effective in conveying sperm through to the uterus. You can reach in to your cervix and try to swipe some to look at it. If someone is worried that her body isn't producing fertile [cervical fluid] at all, a doctor can check the cervix around the fertile time. An instrument that looks like tweezers can test the "stretch" of it.

I have been charting my BBT and observing [cervical fluid] for only four months, after being on the pill for over a decade. (Yes, I ordered the "official" NFP books and thermometer from NFP; yes, I chart my temp the same time every day and note any reasons why my temp may be off [flu, alcohol, etc]).

My experience has been that I had [cervical fluid] while on the pill, but since going off I have had next to nothing - I mean on three days TOTAL in four months have I observed any [cervical fluid]. Nor have I had that "wet" feeling they say you may notice during your more fertile times if you don't have much [cervical fluid].

I am 28 years old, a non-smoker, in relatively good health (I am not a supermodel but I'm average build, etc.). I have been married for two years and we are using BBT right now to avoid pregnancy and become familiar with my fertility. We hope to begin trying to get pregnant in July of this year. Month 1 of BBT was so crazy I couldn't figure out heads or tails, let alone if I was ovulating. I had a 35 day cycle. Month 2 was a textbook chart. I ovulated on day 16 and I had a 28 day cycle. I did experience the mittleschmertz (pain) associated with ovulation. Month 3 was a wacko chart again, and was a 32 day cycle. I am on day 4 of Month 4.

My understanding is that the egg-white [cervical fluid] will occur slightly earlier than, or at the latest simultaneously with, ovulation -- since it's the rising estrogen (estradiol-B) that causes egg-white [cervical fluid] *and* triggers the LH surge. The connection between estradiol-B and LH isn't fully understood... But I don't think the timing sequence is in doubt.

[RAH - - RAH]

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9.6 Did she monitor position of cervix? For how long?

RAH - A third primary fertility signal, in addition to BBT and cervical fluid, is the position and condition of the cervix itself. You may not be accustomed to checking your cervix, so you may not realize that it changes in a regular predictable fashion during your monthly cycle. The best way to describe these changes is with an acronym used by Toni Weschler (_ TCoYF-, pp. 62-63): SHOW, which stands for Soft, High, Open, and Wet. The words are pretty descriptive of what happens when you are at your fertility peak! Briefly, the cervix softens, retreats farther up inside the body (lengthening the vagina), becomes wetter (due to presence of cervical fluid, as discussed in the preceding section), and opens to allow the sperm easy passage into the uterus and beyond.

As with BBT and cervical fluid, it's difficult to describe in a text-only document. For a full description and instructions, please refer to TCoYF, Chapter 5. - RAH

: What is the optimal cervical position and how can you tell when its at a : "good" position? I've seen it mentioned in several posts but never really : explained, and my Dr. has never said anything about it. This is my first : cycle on Clomid, I should be ovulating in the next couple of days and want : to do everything possible to increase my chances. Any information is : appreciated.

When you are in the fertile period, your cervix rises up high and starts to open up. You can actually insert a finger tip sometimes at your most fertile point. A high cervical position, an open cervical opening and egg-white like [cervical fluid] is your best best for timing intercourse. Look for the book, "Taking Charge of Your Fertility" by Toni Weschler. It will tell you everything you need to know about cervical position, [cervical fluid], etc.

: Thats really strange, sometimes my cervix assumes that position for up to : two weeks.. but I am still barren! :

I *am not* a doctor, but I read a lot! ;-)

Now that I have qualified that, let me say that as I understand it, the day after you ovulate, your cervix should "dramatically" close and your [cervical fluid] should start turning sticky. In Toni Weschler's book, she addresses having wet [cervical fluid] *all* month long and lots of other things. A really good book, a must have!! Personally, my cervix is always low right after my period, and then it starts to rise. I can tell I am approaching my fertile period when "the O's" (the opening to the cervix) starts opening up. You CAN tell the difference. This is the first month since my ectopic pregnancy that my cervix closed the day after ovulation so I am somewhat hopeful (and I *hate* getting hopeful!!).

You really need to get "Taking Charge of Your Fertility". Good luck!!

Your cervix is open at your most fertile time, but it's never fully "closed." So if you have intercourse when it's closed and you have fertile-type [cervical fluid], the sperm can still get in, it's just harder. On the other hand, you're more likely to have fertile [cervical fluid] when it's open.

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9.7 Did she use an ovulation predictor kit (OPK)?

RAH - Ovulation predictor kits have been on the market now for less than a decade (in the USA, at any rate). Their success rate in predicting ovulation seems mostly adequate, although this can vary greatly from one woman to another, from one month to another, and from one brand to another (sometimes even from one kit to another of the same brand!) In theory, they work on a simple basic principle: It's possible to detect in the urine the surge of luteinizing hormone (LH) with the kit; the LH surge in general immediately precedes (and in fact triggers) release of the egg fom the ovarian follicle -- so the kit will indicate ovulation within a short period, usually hours.

In practice, the kits can indeed be useful, if all conditions are favorable. There are a number of drawbacks to the kits, however, and you should be aware of those drawbacks. Toni Weschler lists eight in particular (_TCoYF_, pp. 134-135): (1) the kits don't definitely confirm that ovulation is taking place, just that an LH surge takes place; (2) mini-surges of LH can occur earlier in the cycle, before "the big one" hits; (3) cervical fluid may not be present in enough quantity for the sperm to get to their destination; (4) using the kits can be complicated; (5) if you have irregular cycles, it's hard to predict just when to start using the kits; (6) some fertility drugs can invalidate the kit results [if you're still using low-tech methods only, this should not be a concern]; (7) women over 40 and/or approaching menopause may have already-elevated LH levels, making the kits harder to use accurately; and (8) the kits won't work if you're already pregnant [this would be a nice reason, wouldn't it? :-)]. I would add a ninth caution: at present, the kits are pretty expensive!

These caveats notwithstanding, I think OPKs have a role in low-tech fertility methods, as long as they are used in conjunction with other methods -- BBT, for example, to confirm that you are really ovulating; and cervical fluid, to avoid springing for a kit too early in your cycle. For those who have trouble with BBTs and cervical fluid, the kits are a reasonable alternative. - RAH

Doesn't the ovulation kit predict the LH surge, just before ovulation??

I believe it does but only about 24 hours ahead. This study says that if you waited to try when you saw the surge, you would have "wasted" about 5 of your most fertile days. But, it did say that the two days right before and the day of ovulation are probably the MOST fertile.

When using an OPK, you will want to see it go from negative one day to positive the next. Check at the same time every day optimally around or before 2 PM. A positive means you are going to ovulate in the next 24 to 48 hours. In charting temperatures, ovulation can be over by the time you appreciate the dip and rise.

I have a question about the ovulation kits. I don't understand what day I should begin testing on. I went off the pill four months ago and I have had 30,26,30,32 day cycles. I don't know if that is considered irregular or not. Should I use the 26 day cycle to figure out the day to start or the 30 day cycles? Any suggestions would be greatly appreciated.

This might cost a little more because you might end up needing two kits for one month, but I think it's worth it because you'll get the test right during the first month. I used these things for 6 months and this is what I had to do in the end.

Just start testing on day 7. You should test negative. Keep testing until you get the positive result. You shouldn't have to test for more than 8 days, but you never know. BTW, I'd rather waste a little money by using too many tests than test too late in the month and miss my ovulation.

BTW, cervical [fluid] never told me anything useful. The tests were much easier.

How do you *know* that you have ovulated this month? I thought that the OPK tests indicated the LH surge only, it doesn't necessarily follow that you will ovulate. Please let me know since last month I did the OPK test, noticed the surge (which was clearly indicated), had intercourse during the next 3 days but had my period on day 30 (which was exactly on time!!!) I am so frustrated!!! However, I have been for my first blood test (day 3) so at least now I feel that I am on my way to solving whatever the problem is. (DH's sperm count came out OK so I'm the problem!!!)

You are exactly right -- you can have the LH surge, and yet not release an egg; and the OPKs detect only the surge. Of the "low-tech, at-home" methods, BBT charting is the only one that actually gives good evidence that ovulation itself is taking place. The BBT rise is due to the release of progesterone from the corpus luteum, which is formed from the collapsed follicle after it releases the egg.

There are exceptions when you can get a clear biphasic temperature pattern even though you're not ovulating -- the most "common" (but still relatively uncommon) cause is LUFS (luteinized unruptured follicle syndrome.) LUFS and other chronic anovulatory problems are usually diagnosed through frequent ultrasounds, which can follow the progress of the follicle(s) and its (their) development during the cycle.

Ovulation kits all use the principle of indicating a jump in the level of Luteal Hormone which precedes ovulation by 12 to 24 hours. I say "jump" because there is always a background level of Luteal Hormone and it's the rise above this baseline that indicates the fertile time. The ovulation kits vary in their ability to detect this threshhold level--it pays to check this out. Also, it's best if used at the same time each afternoon.

You can see complete instructions for an Ovulation prediction kit at http://www.geodesicmeditech.com Also included are FAQ's. There is a new mid-stream ovulation test kit available now. This makes it even easier to test without the messy cups and droppers.

Yes, they work and much better than BBT's to predict ovulation before it happens, but the cost is a factor.

I feel that the best time to take your urine sample is in the morning, your first "pee" of the day. Supposedly, it LH hormone is more concentrated and it will give you the best reading.

Actually, that's not quite true, according to my RE. During the surge, the LH actually doesn't start to be secreted until very early morning (something like 3 am.) So first-morning urine will actually be somewhat diluted by the urine that had been "created" from the time you went to bed until the first time you pee that day, before the "LH urine."

That's why OvuQuick, one of the ovulation prediction kits that my RE's office recommends (along with ClearPlan Easy,) recommends that you test between 10am and 8 pm. They go on to say further that some women get their best results after 12 noon.

I think the less-expensive tests recommend first-morning urine since it's more convenient for the women.

Remember, too, that the luteal surge is best predicted if one checks at the same time every 24 hours and optimally around 2 PM. There is a diurnal variation of the Luteal Hormone. There is a background level of luteal hormone of about 20 units and during the surge, this goes to 40 or more. A test tells you when the threshhold unit number has been reached.

Have been tracking both [BBT and cervical fluid]. The best is ovulation predictor kit, Clearplan Easy leaves nothing to chance. BBT is too late, [cervical fluid] is too broad to pinpoint exact timing.

I did the Clear Plan Easy Ovulation Kit this morning. I tested around 10AM which was 2 hours since I last went to the bathroom. I had a light blue line in the large window. Does this mean I have had a surge? The pamphlet says you should have let build up for 4 hours, since I only waited 2 hours and the line was a very light blue was wondering if I should count that. I hate these OPK as I can never tell.

The line in the test area has to be equal in darkness to or darker than the control line. Otherwise, it is not considered a surge.

The only time I ever knew when I was ovulating was after I started using an ovulation test kit "ClearPlan Easy". The problem is that it determins when you will ovulate, approximately 24 hours in advance. It is almost too late to conceive at this point.

Sorry, but you're WAY OFF BASE here. Ovulation kits are used extensively in infertility treatments (which it appears you went through which surprises me you would say this). When the kit predicts ovulation that is THE PRIME time to have sex in order to get pregnant - it is by NO MEANS "almost too late to conceive at this point". The whole purpose of these kits is to help determine the best time to have sex. The most fertile times of the month is the day before and day of ovulation which is what the kit is telling you.

[RAH - I would add only that, if your cervical fluid is already drying up on the day of ovulation, then the day before is actually the best day for intercourse, since the poorer-quality fluid will slow down the sperm in their travel toward the Fallopian tubes -- possibly causing them to arrive too late, given the egg's short lifespan. All the better reason to "seize the moment" and have intercourse right away, if you get an unambiguous LH color surge with the OPK. - RAH]

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9.8 Did she typically experience mid-cycle spotting of blood from vagina?

RAH - Mid-cycle spotting of blood is on average a less-common indicator of ovulation, but for women who experience it, this can be a reasonably-reliable fertility signal. The spotting, which typically occurs for a day or two (much lighter than a menstrual period), is caused by the rapid plunge in estrogen that accompanies the other hormonal changes immediately preceding ovulation. If you have a pattern of mid-cycle spotting, keep an eye on its timing -- it's one more useful tool for enhancing fertility. - RAH

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9.9 Did she monitor mittelschmerz pain? How often?

RAH - Mittelschmerz pain is a pain in the lower abdomen that occurs about the time of ovulation. This pain may be a sharp twinge or a dull ache. The causes of mittelschmerz pain may range from the actual bursting of the follicle as it releases the egg, to a general crampy feeling as the hormones abruptly shift gears with the onset of ovulation.

Like mid-cycle spotting, mittelschmerz isn't present for all women in all months. However, like spotting, if you experience this it's worthwhile to monitor it. One caution: Mittelschmerz pain may occur before, during, or after ovulation -- so if you're using it as a fertility signal, it's best to take advantage of the moment as quickly as possible! - RAH

The pain a woman gets in the side, mittelschmerz, means a follicle or sac is forming in the ovary wall. It can become large pressing painfully on surrounding tissue. Pain can also be felt as the egg bursts through the rupturing sac. It would seem, then, that this discomfort indicates ovulation is about to or is occurring. However, side pain can also be due to other ovary cyst, torsion, ectopic pregnancy, infection, intestinal spasm, constipation, urinary tract problems etc. so as an indicator of ovulation, it's not very reliable.

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9.10 Were any other signs of ovulation monitored? For how long?

RAH - There might be as many different individual signs of ovulation as there are women on planet Earth! Rather than even attempt a comprehensive list, I'll just include those that have been discussed on any of the three newsgroups. - RAH

I recently noticed, in a health products catalog, a little device advertised that purported to signal ovulation by testing the saliva in the mouth. Its hook was that, whereas ovulation kits can cost anywhere from $20-70 a month, this was just a one-time cost of $48, and could be reused again and again. You simply put a sample of your saliva on the glass, examine it, and if it appears a certain way, then you are ovulating. Is anyone out there familar with this technique? Is it as reliable as a kit? And if so, then why aren't more people using it?

Not a lot of people use this technique because they don't have a microscope, which is what they are selling. It's a lot like a science experiment and lets face it peeing on a stick is a lot easier and faster. What you do is put a sample of spit on the glass plate and let it dry. If you're not near ovulation it will just look like what you'd expect dry spit to look like. If you're fertile then it will fern in these pretty neat patterns. And yes it is as reliable as a kit. Considering all the problems people have with the kits (is it lighter/darker, it never got darker, etc.) I'd say this may be even more reliable. And before you pay $48 dollars for a microscope go to the toy store and look at the chemistry sets that you can buy kids. Some of those microscopes are strong enough to detect the ferning pattern and they may be cheaper. By the way I'm not sure what magnification you need. I'd guess that 100X would be strong enough but someone may correct me if I'm wrong.

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