Let’s talk ovulation

Whether you are planning to get pregnant or looking for natural contraception methods, you must have dozens of questions about ovulation. In this article, you will find all the answers you need. You will know when ovulation happens, and how to calculate ovulation days. To enrich your knowledge in reproductive health, and fertility.

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Bohaira El Geyoushi
Published on:May 17th 2022 |Updated on:Feb 10th 2024
أيام التبويض

The Story of your eggs

A female fetus inside a mother’s womb has around two million immature eggs or (oocytes). They are reduced to about half a million by the time the baby girl is born. These eggs remain inactive until puberty, and by that time they are reduced to about three hundred thousand.  The peak of female egg production is during her late twenties and early thirties. After this age, they start to decline, in quality and quantity until the last menstrual period in a woman’s life.

It is essential that any woman who wants to conceive learns that her egg reserve is limited and that it declines with age. It is noteworthy that in some cases this decline happens at a younger age. Therefore, I stress the importance of reproductive health education and learning about fertility preservation methods, to be prepared for such cases. Following up with a fertility specialist is important in cases where women experience unusual symptoms during their period, even at a younger age, and before marriage. To ensure the health and the reserve of the eggs.

One common misconception about female oocytes is that the body develops one egg each month. If this was true, knowing that a fifteen-year-old girl has about 300000 eggs, which means she will be able to conceive her entire life. Each month eggs die during the menstrual cycle, and only one egg is mature enough two weeks after the period to start ovulation. And this doesn’t happen to all women.

When does ovulation happen?

The ovulation window is usually between the 10th and the 20th day of the period if the period happens every 28 to 35 days. If the menstrual cycle occurs after 28 days, ovulation typically happens between the 12th or 14th day of the cycle. It is noteworthy that ovulation days are different from one woman to another, depending on the length of her cycle. If the period is longer ovulation might occur on the 17th or 20th day of the cycle. And if periods happen at shorter intervals such as every 21 days in this case ovulation will happen on the 7th or 9th day of the cycle, even before the period bleeding stops.

Do all women ovulate?

Ovulation doesn’t happen to everyone. Some women who suffer from certain conditions like polycystic ovaries, which will affect their fertility, ovulate once every three to four months or don’t ovulate at all. Even if they get pregnant it is usually by coincidence. So, how can a woman know her ovulation period in such cases?  Whether she wants to know to try to conceive or to prevent pregnancy. It is noteworthy that many women who have PCOS do not have any issues with ovulating and getting pregnant.

How to determine the ovulation period

- The ovulation calendar method

In this method, ovulation is calculated based on the duration of the menstrual cycle as mentioned earlier. Usually, the fertile days are between days 10 and 20 of the cycle, which is between 26 to 40 days. These days can be tracked through an ovulation calculator available on some pregnancy tracker applications. These calculators predict the ovulation period based on the data entered into the application, such as the shortest and the longest menstrual cycle, and then provide approximate days of ovulation.

- Home ovulation test

This test works in the same way as a home pregnancy test. It tests the ovulation hormone in urine, and it is more accurate than the ovulation calendar, and easier than ovulation tracking at a doctor’s office.

- Ovulation symptoms

1- ovulation pain

Pain in the lower abdomen and pelvis in the form of cramps is different from period pain as it happens in the middle of the cycle. This pain is known as Mittelschmerz.

2- Changes in vaginal discharge

Some women experience a change in their vaginal discharge. It becomes watery like egg white, which indicates that she is about to ovulate.

3- Measuring body temperature

For this method to be effective in tracking ovulation, body temperature must be measured daily immediately after waking up, and before getting out of bed and doing any activity. Take your temperature daily at the same time and while in the same position, if you notice an increase of even half a degree, this indicates that you started ovulating.

A combination of tools can be used to determine when you start ovulating for more accurate predictions. If these methods were not useful, you can consult your OBGYN or fertility specialist for medical assistance.

Doctor’s role in determining ovulation period

- Ovulation tracking

Your doctor can track the activity in your ovaries to determine when you start ovulating. This tracking through ultrasound scans starting on the tenth day of the period. This scan looks for the egg ready to be fertilized which is bigger than the others, it measures between 18 and 20 millimeters when ready.

- Prescribing ovulation-stimulating drugs

This type of medication is prescribed for women who don’t ovulate regularly to enhance natural ovulation. These drugs are given at the beginning of the menstrual cycle, then the egg is checked on the 10th day to assess whether more stimulation is needed or not.

Do birth control pills affect ovulation?

There is a widespread misconception that birth control pills cause “sterility”, which is a term I have huge reservations against! I am a strong believer that delays in pregnancy happen due to fertility issues and not because of “sterility”. Birth control pills do not cause infertility, nor do they delay pregnancy once stopped. On the contrary, those pills are an excellent treatment for many conditions, and they lower the risk of ovarian cancer. Contraceptive pills also help regulate periods and treat many issues related to periods such as extreme cramping and excessive bleeding, and endometriosis.

A woman can ovulate soon after stopping the birth control pill. Contraceptive pills are divided into two types; combined oral contraceptives, containing Estrogen and Progesterone, and monophasic pills, containing only Progesterone. The latter type is usually prescribed to older women, or those who cannot have Estrogen, or during breastfeeding. Both types of pills prevent pregnancy while you take them only. You can start ovulating once you stop them any time between a month and three months later if there isn’t any other medical condition preventing ovulation.

When does a woman ovulate after miscarriage?

Sometimes a woman who just suffered a miscarriage is advised to wait before trying to get pregnant again. But the truth is, if there isn’t any medical reason that would prevent a woman from getting pregnant, such as going through complications during the miscarriage such as excessive bleeding, there is no need to wait. And the pregnancy can happen whenever the woman wants and feels emotionally and physically ready to go through pregnancy again. Ovulation can change after a miscarriage, and it would be difficult to determine the age of the fetus.

When does a woman ovulate after childbirth?

Exclusively breastfeeding is a contraceptive method, and it will also stop you from ovulating. However, when the baby starts eating solid foods, this will affect hormone levels and ovulation may occur. So, to prevent pregnancy, you should use a contraceptive method available to breastfeeding women. As it may be difficult to tell when ovulation may occur.

 

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Bohaira El GeyoushiConsultant in Obstetrics, Gynecology and fertility

Dr. Bohaira El Geyoushi is a Consultant in Obstetrics, Gynaecology & Reproductive Medicine, and IVF. She was a consultant and Head of the Fertility Department at East Kent University Hospitals NHS Foundation Trust, the second largest in the UK. Dr. Bohaira is a Fellow of the (RCOG) Royal College of ObStetricians & Gynaecologists and a Fellow of the (FSRH) Faculty of Sexual & Reproductive Healthcare in London/UK. She was awarded a Doctorate of Medicine from the University of Southampton in “Studies in Women’s Reproductive Healthcare”. Dr. Bohaira worked in many reputable medical centres in Dubai, UK & USA. She was awarded Adjunct Assistant Professor Position at Feinberg School of Medicine, Northwestern University Chicago, USA.  She is quite passionate about her work and believes in a holistic approach to women’s healthcare and fertility management. Dr. Bohaira strongly believes in the power of education and in empowering women with knowledge about their fertility so they can make informed decisions and choices about their reproductive health.

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