Progesterone Q + A: The Misunderstood Ovulation Hormone

Part 3: Understanding Ovulation Results

 

Often we meet women who have been mis-prescribed progesterone by doctors who aren’t as familiar with the nuances of fertility medicine and the physiology of ovulation.  If used incorrectly, prescribed progesterone can act as a birth control, rather than support fertility. Unfortunately, this is a common occurrence as there are so many misunderstandings around ovulations and progesterone. This is a huge key to fertility. At Famlee, our mission is to help bring clarity to women’s health and fertility—and that includes the ever-misunderstood ovulation hormone: progesterone. Today, we continue with part three of our four part series… 

 

Can progesterone levels tell me about the size of the egg ovulated?

Yes! Progesterone levels not only tell us if you ovulated but the size of the egg released. If it was a healthy sized egg, compatible with pregnancy, then the ovarian scar is bigger and it releases a healthy amount of progesterone. If it was a small egg, and not as compatible with pregnancy, the ovarian scar is smaller and releases a smaller amount of progesterone.  

What is a suboptimal ovulation?

A suboptimal ovulation is an egg that was ovulated but is a little too small to create a healthy embryo. Usually, these small eggs don’t result in pregnancy at all.  Sometimes, they result in an early miscarriage, also called a chemical miscarriage.    

What do I do if I rarely ovulate?

We know how hard it is to try for pregnancy when you only ovulate a few times per year. This is very common with PCOS. There are many ways to try to help you ovulate more regularly and more efficiently, however. The more opportunities to try for pregnancy (more ovulations per year), the better. Should it be necessary, we can prescribe medications specifically for this if you need it.

 

What is anovulation?

Anovulation is where a cycle occurred without an ovulation. This is common in PCOS, especially with cycles that are several months long. We often work with women during our telehealth calls to help them resume ovulation in these cases.

Are there lifestyle changes that can help me ovulate better?

Absolutely! At Famlee, we specialize in helping to optimize ovulations through holistic means. The healthier a body is, the better ovulation it will have. Getting better sleep is a key to improving ovulation, for example. 

Are there supplements that can help me ovulate better?

Yes! Taking the better sleep tip for example, 3mg of melatonin at night can really help. (There are many ways to improve ovulation. If you want to schedule a free 15-minute consult, we invite you to do so here: 

How will I know if my ovulations are improving?

Your body will show you—and it really is so empowering to witness. The first sign is usually an increase in cervical mucus. When the body is growing a large, healthy egg it calls out for the sperm to come to meet it! 

Clear, stringy “egg-white” cervical mucus will greatly increase, in quantity and number of days present.  Think of it as an elevator for sperm. This can occur for several days before ovulation, as the sperm can live for 5-7 days, whereas the egg only lives about 24 hours. It is best to have the sperm waiting for the egg.

Libido will also increase. Other ovulation sensations will be more dramatic—trust us, your body won’t let you miss it. If all you can think about is sex, don’t wait for your +OPK and just follow your body signs.  

 

If I have a better ovulation, will that change my BBT?

Yes. The presence of progesterone, which is only present after ovulation, raises the basal body temperature (BBT). If the ovulation is stronger (larger egg), then the BBT rise will be more dramatic.  

If I have a better ovulation, will that change my progesterone level?

Absolutely! That’s what it means to go from not ovulating to ovulating or suboptimal to optimal ovulations.  Whether with supplements or medications, that’s what an improved progesterone level means—you are ovulating better! 

What is my “fertile window”?

Your fertile window includes all the signs your body gives you that it wants to get pregnant. It is best to be intimate with your partner, or time donor inseminations during this window. 

• Your fertility window starts with your cervical mucus changing from watery to stringy/egg-white. 
• It then goes to the +OPK about 12-48 hours before your ovulation.
• It ends with ovulation, which can be inferred from a rise in BBT 1-2 days after ovulation.
• Depending on the person, the fertile window can last for 2-9 days.  You can double check that you ovulated by checking your progesterone a week later or waiting for a positive pregnancy test.  

When should I try to get pregnant?

If you know your fertile window, it is best to try for pregnancy during that time. The most fertile days are typically 5 days prior to ovulation plus the day of ovulation. Statistically the highest fertile days are 1-2 days before ovulation. Remember, our goal is to have the sperm waiting for the egg, as it can survive longer than the egg. 

Fertility is typically low >5 days before +OPK and >3 days after a + OPK. It is best to time intercourse or insemination at least 1-2 days prior to ovulation and on the day of ovulation. If you aren’t sure when you will ovulate, it is often recommended to time intercourse or fresh inseminations every 1-2 days starting after the end of menses (your period), approximately day 5-7, and increasing frequency (daily vs every other day), 1-2 days before ovulation and during ovulation.

Semen quality (motility, morphology and count) decreases if there are more than 2-3 days of ejaculatory abstinence. This means there is usually better sperm quality—and therefore better pregnancy rates—if there is more frequent intercourse or inseminations. Remember to keep this fun, though—find the right balance for your relationship.  

 

This concludes Part 3 of our 4-Part Progesterone Q+A Series—check back soon for Part 4. Click here for more information on the Famlee Fertility Kit.