Dear Doctor,

My husband and I are trying for a baby. It will be our first. However, it’s been six months now and nothing has happened. We had ourselves checked and everything seems to be okay. I suspect we keep trying at the wrong time. So, how can I tell that I’m ovulating? I’ve been told that is when I’m most fertile.

Stacy, 32

Dear Stacy

Six months is too early to worry about having a baby. However it is true that chances of conception increase when intercourse is done around the time of ovulation.

Normally ovulation is said to occur from 14 to 21 days of a menstrual cycle (counted from first day when bleeding occurs). Normally menstrual cycle varies from one woman to another; hence days of ovulation also vary. But there are other indicators as well which indicate that ovulation has occurred.

The cervical mucus (secretions of lower part of uterus) becomes clear and stretchy during fertile period of a woman to facilitate passage of sperm. Its consistency becomes like that of egg white. One can put a finger on the vagina to feel this mucus. The cervix also becomes soft and wet during this period and feels higher up.

The basal body temperature (BBT) rises by about 0.5 degrees during ovulation. One can measure it by putting a thermometer by the bed side and taking temperature first thing in morning. Begin taking temperature from first day of menstrual period. It should be done first thing in the morning before taking any water, tea or coffee.

Temperature can be taken from mouth, rectum or axilla but same technique should be used every time. It is a very old, but popular method. The rise in temperature may occur after ovulation has occurred. Thus a woman may miss her day of becoming pregnant. But if BBT is charted regularly, a woman can know her days of increased fertility accurately.

Serial ultrasound scans of the ovary show the ovarian follicles growing in size and rupture; thus releasing the egg. Intercourse, if done at such a time in coordination with an ultra sound examination, increases the chance of conception and getting pregnant.

Besides these methods, ovulation kits are available. These contain antibodies to leutinising hormones which peak around 12-36 hours before ovulation. Testing your morning sample of urine with these kits helps to determine whether ovulation has occurred or not. These home testing kits give accurate results in about 90 per cent cases.

As estrogen levels peak around ovulation time, the saliva may also thin out and look like what is called a ferning pattern under the microscope. However this does not predict ovulation accurately.

None of these methods are 100 per cent accurate. At times due to polycystic disease of the ovary, hormonal pills, or hormonal disorders, one may get false readings in these tests.

Ovulation is also influenced by other factors like a desire for sex, mental stress, and hormonal disorders.

Dr. Rachna is a specialist in internal medicine at Ruhengeri Hospital.