Danielle / Aidan in the Making: Monitoring your Fertility

Before reading this page, you may want to have a look at TTC Basics if you're not entirely certain about some of the basic little details relating to your cycles and ovulation. :)

I monitor my fertility mainly by using bbt charting. Other ways of monitoring your fertility include an ovulation microscope, ovulation predictor tests, checking your cervical fluid and even your cervical position and whether it's softer or harder. I'll be writing about the following below:

1. BBT charting
2. Ovulation microscope
3. Ovulation predictor tests / kits (opk's)

No. 1. BBT Charting

Before I go into the "how" of bbt charting, let me start with the "why"...

Basically, here's what bbt charting is about, in short:

Bbt charting means to measure and chart your basal body temps on a daily basis, ie your temp first thing in the morning. Your temps tell you a few things about your menstrual cycles and your fertility, eg it could tell you when your period is about to come, when you ovulate, whether you ovulate or not, whether you have a luteal phase defect, whether you may have thyroid problems, and even whether you're pregnant.

To help explain, here's one of my pretty-average charts --- I keep online record of my charts on Countdown to Pregnancy.

The temps are on the left side of the graph, and the cycle days are on the bottom (the first row). This chart displays my complete cycle. Below that is the actual date, and below that it indicates DPO (days past ovulation) - the blue blocks. Below that is a row called CF, where you chart your cervical fluid (ie your period and other cervical fluid through out the month). Below that you record when you have intercourse (also known by it's scientific name of BD...baby dance), and the last row is where you record what you see on your ovulation microscope.

From my chart you can clearly see a temp shift after the red line. The red line indicates the day that I think ovulation occurred, and afterwards you see the temps are clearly higher than before ovulation. This is called a bi-phasic chart and is an indication that you have indeed ovulated - if there is no obvious temp shift by the time your cycle ends, it very likely means that you've had an anovulatory cycle (ie you didn't ovulate).

When reading your charts, it's important to note that it's not so much the individual temps day-to-day that are the most important, but the pattern that you see as a whole. As you see, the daily temps can be quite erratic, but that's normal.

Bbt charting doesn't always tell you when you're about to ovulate, you usually only see that you've ovulated after it's already happened. You know that you've ovulated when your temp rises sharply (or some people have a more gradual temp increase over a few days) and remains on this higher level for the remainder of your cycle. This is because after the egg is released, your body begins to produce progesterone, which is responsible for elevating your temps. During the first part of your cycle (pre-ovulation), estrogen dominates, and after ovulation, progesterone dominates.

Some people (like me it would seem!) are lucky in that their temps tell them the day on which they ovulate - the temp dips noticlably on day of ovulation (that's where I put the red line on my chart). Sometimes the dip is even more noticable. This is due to an estrogen surge when the egg is released.

Once you've been charting for at least 2 months, you should recognize a pattern on your charts and you should be able to predict when ovulation will occur in future months, since ovulation usually happens on about the same day each cycle. Once you know this, you can time your intercourse more accurately!

As your cycle comes to an end, your temps will drop again - mine usually drop a day or so before my period arrives, so I know exactly when it's coming.

So, now onto the HOW of bbt charting!

What you need:
1. a digital basal thermometer that can read up to 2 decimal points (ie it measures up to the .10 degree) - you absolutely need this more sensitive thermometer because your temps shifts are usually too small to be accurately detected by a less sensitive thermometer.
2. a bbt chart - you can either sign up to a site like Countdown to Pregnancy and chart online, or print a chart that you'll easily find if you google "printable bbt chart". That's all you need!!

How to take your bbt:
1. It must be taken in the morning before you get out of bed or even really move at all (and you're not allowed smoke, eat, drink or brush your teeth before taking your temp either), and it must be done at the same time every day. If you get up at the same time everyday, that's good, just take your temp before you get up and move around too much. If you never know when you're going to get out of bed, do what I do - set your alarm for early in the morning...choose a time that you KNOW you'll never get up before then. Mine's set at 6am. Keep your thermometer on your bedside table, and if it doesn't have a memory function that stores your temp until you can read it later in the day, keep something to write with next to your thermometer too. All you do is reach out and take your temp....then you can go on snoozing. Simple!
2. You must get at least 4 hours straight & uninterrupted sleep before taking your temp. This is important.

Charting your temps:
1. Begin a new chart on the day your period begins, ie the day you begin true red menstrual flow (spotting does not count here). This will be Cycle Day 1 (CD 1).
2. Every day fill in your temp on your chart, and connect the dots as you go, so that you can more easily see the pattern forming.
3. Sometimes you need to mark some temps as invalid, either because you did not get enough sleep before taking your temp, or because you didn't take it at the same time, or because you're ill - these temps will not be accurate and so you must disregard them when reading your chart. Below is a sample of one of my charts where I had a one-day flu or something, you'll see my temp sky-rocketed on that day (CD 18, my temp is the little green circle at the top of the chart):

You'll see a little green cirlce on CD 15 as well...I took my temp late that morning, at 7am, so I disregarded it as well.

Also, during winter your temps will probably generally be lower due to the cold weather. This is what I've noticed on my charts anyway.

What else your bbt chart can tell you:
1. There are so many conflicting ideas about what's considered a normal bbt, so you can google this topic and decide for yourself. But consistently unusually low bbt temps could indicate that you have a thyroid problem (even if your blood tests show up normal - source). Just something to keep in mind.
2. Some women get a tri-phasic chart when they become pregnant. This means that your temps go to another higher level even above your post-ovulation temps, hence the name tri-phasic chart - there are 3 noticable temp levels. Not everyone gets this though, so if your temps just remain elevated past the date on which your period should have been due, this could be an indication that you are pregnant. So take a test already! They usually say that if your temps remain elevated for at least 18 days past O, then you're probably pregnant.

As an example, here's what my chart looked like when I got pregnant: (click on the image to enlarge it...it's a bit small!)

I'm not sure if I marked the day of O accurately at that stage, but never mind that. You can see more or less where the temp shift happened around the red line - the temps are higher afterward. The temps also remained elevated for 24 days, which is an indication of pregnancy. I didn't have a clear third thermal shift like some people do get (although if you disregard the last few days where the temp began to drop before the miscarriage, you may be able to see a slight 3rd level of higher temps)(see update just below!). Neither did I have an implantation dip - sometimes your temp dips noticeably on day of implantation (about 6-12 days after O), but everyone doesn't get that dip either.

I got a +hpt on CD33 and on CD40, as well as a + blood test (which happened to be taken on 25 dpo - the day on which the miscarriage happened). It got to 5 weeks along.

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UPDATE: Since I got my + hpt on 18 Apr, here's my latest chart showing a triphasic chart:

If you can see the CD's at the bottom, you'll notice the 2nd thermal shift from CD34 onwards.

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No. 2. Ovulation Microscope

This goodie uses a sample of your saliva to tell you when you're about to ovulate. It's a lipstick-sized microscope:

It works by identifying your estrogen surge, which happens each time you ovulate. What's nice about it is that it can predict ovulation days in advance. Since the estrogen surge usually precedes the luteinizing hormone surge (which is the surge that urine-based ovulation tests detect before ovulation), this microscope gives you a greater advance notice of when you're ovulating.

Here's how you use it:

You need to use it first thing in the morning before you eat, drink, brush your teeth, smoke or put anything else into your mouth!

1. First you need to un-assemble it by removing the lid and the lens - don't unscrew the lens, just pull it up and out:

You'll see at the bottom of the tube is the little switch that you need to press to switch the light on when you want to check your sample.

2. Now you need a fresh saliva sample, and the best place to get that is under your tongue. Wash your hands first with just water, no soap. Use your finger to collect a sampe and dab it onto the microscope:

The side of the lens that was facing in toward the inside of the tube is the side that you need to place your saliva sample onto. You don't need a huge blob of saliva, just a small amount is enough.

3. Place the lens back into the tube as you would to re-assemble it back like it was:

4. Once you've let the sample dry for at least 5 mins (for a thin saliva sample) or up to a few hours (if you deposited a large sample), then you can read the result. Switch on the little light and examine the sample. You can turn the lens left and right to adjust the focus until you can see the sample clearly:

You'll see something like this:

Not fertile --- When you're not fertile, all you'll see is dot-like things.

Transitional --- (aka partial ferning) You'll see dot-like things as well as some little pieces of ferning / crystal-like things, or the beginnings of fern- or crystal-like patterns. This is when your body is gearing up to ovulate, which could begin happening around 3-4 days before day of ovulation - you should now begin ttc!

Fertile --- Strong ferning or crystal patterns will dominate on day of ovulation, so you'll see a lot of ferning and only a few or no dot-like things.

The ovulation microscope is said to be about 98% accurate!

The ferning patterns will be easily visible, you'll notice them for what they are at once. Here are a couple more pics of ferning:

Everybody has their own unique ferning or crystal-like patterns, so don't worry if yours doesn't look exactly like any of the pics above.
Also, the amount of ferning or crystalizing that appears on your microscope may also vary - you may have less ferning / crystalizing or you may have more - you need to get used to your own patterns.

You may also notice some ferning around the time of your period, but that's normal due to the increased estrogen in your system, which is responsible for bringing on your period.

Note: I think that if your hormones aren't 100% as they should be or if you have excess estrogen in your system, this microscope may not work accurately for you. When I use this goodie, sometimes I have partial or full ferning at all random times during my cycle, almost every day to every 2nd or 3rd day, and sometimes I have hardly any ferning except for 3 or 4 days. So I'm not sure what's up with that. I just continue using it because it's fun to see what's happening, AND they say that if you're pregnant, you'll see ferning after ovulation too - so big surprise as to why I still even bother using this goodie, hehe.

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No. 3. Ovulation Predictor Kits

Ovulation predictor tests are used pretty much the same way as pregnancy tests, but they are used to detect a surge in luteinizing hormone (LH) - a hormone which is present at the time the egg is released (ie ovulation), so you need to begin testing for ovulation a few days before you suspect you are entering your fertile period, so that you can be sure not to miss ovulation.

This LH is very brief - so timing of the test is very important. They say the best time to test is late morning or mid afternoon, because early morning is when the LH is still being produced (so the opk probably won't detect it yet). You have to test daily because skipping a day could mean that you miss the LH surge completely...that's how short it is. So if you decide to test in the early morning anyway and you get a negative, you need to test later that afternoon again, because waiting to test the following day could mean you miss the LH surge later that previous day.

I've read that sometimes the LH surge can be so brief that you may need to test twice a day - late morning and early afternoon, otherwise the LH could be missed again. So if you first begin using opk's, you may want to test twice a day to see how your LH works, since it's not the same for everyone. This is why you need to buy quite a few of them during any cycle, so that you have enough tests to use until you get a positive.

An LH surge could build very quickly, so you may be getting completely negative opk results one moment and the very next test you take later that same day could be a full positive.

If there is no test line or faint test line, then it means it's negative. This is where it differs from pregnancy tests, because with those even the faintest line could mean you're probably pregnant. With opk's, what you need is a test line that is as dark as, or darker than, the control line - anything less than that and you've got yourself a negative. There's always LH in a woman's system, which is why your opk results could show faint positives at any time during your cycle. So what you're looking for when trying to detect ovulation, is a strong LH surge, and that will show up as a dark test line. (see my test pics below)

Once you get a positive, it means that you will probably ovulate within the next 12-36 hours - so as soon as you see a positive, you need to drag your husband away from whatever he's doing and get busy. :) And it's best to keep at it until ovulation has been confirmed...or if you're not monitoring your fertility in any other way, it's probably safe to say that your fertile period will be over within about 2 days after getting a positive opk (but don't take my word for it! You'll know your body better than anyone).

An opk may however not detect your LH surge, even though you are fertile and have ovulated, so it's always best to use at least 2 methods of monitoring your fertility, and never to rely on only 1 method.

The top one is positive, and the one below taken the very next day was negative: