Reproductive age women normally have regular monthly menstrual cycle intervals and premenstrual symptoms (these symptoms occur just prior to the onset of menses). Premenstrual symptoms are thought to be due to the (reproductive) hormone changes just prior to the onset of a new cycle, and may include tender breasts, bloating of the abdomen, headaches, and emotional irritability. A history of regular menstrual cycles and premenstrual symptoms is clinical evidence suggestive of regular ovulation. Since ovulation normally occurs about 2 weeks prior to the onset of the next menstrual flow, women with highly predictable menstrual cycle intervals can count back 14 days from the expected next menses to estimate the day of ovulation.
When greater reliability is desired, ovulation predictor kits are often useful in determining when ovulation is imminent. Normally, when the ovary contains a fresh mature egg then there is a surge (sudden rapid increase) in LH hormone concentration and this LH surge triggers the ovary to get the egg ready for fertilization and to release the egg into the pelvis (ovulate). Ovulation is thought to occur about 36 hours (one and a half days) after the onset of the LH surge. Ovulation predictor kits use test strips that are dipped in the woman’s urine on a daily basis, and LH present in the urine causes a chemical reaction the changes the color of the patient’s test result. When the patient’s concentration of LH is initially high enough to suggest the LH surge (trigger to ovulate) then ovulation is expected within about a day. The ovulation predictor kits are often very useful, but for some women these ovulation kits do not appear to be able to reliably predict ovulation.
When even greater reliability is desired, the ovaries can be examined with an ultrasound at a few different times within the follicular (egg growing) phase of the menstrual cycle, and when a mature egg is identified then ovulation can be triggered by the administration of hCG (human chorionic gonadotropin). hCG hormone acts exactly like LH within the ovary, so administering a large bolus of hCG simulates the LH surge and will trigger ovulation in about 36 hours. Ultrasound examinations to determine the presence of a mature egg and hCG trigger of ovulation usually allows prediction of ovulation within a few hours.
Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has extensive experience with ovulation dysfunctions and detecting ovulation. He would be happy to help you. For an appointment to discuss your situation with Dr. Daiter, please call the office at 908 226 0250. Visit us on the web at http://www.drericdaitermd.com http://www.infertilitytutorials.com or http://www.ericdaiter.com