Each month young, healthy couples who aren’t using birth control typically have about a 20% percent chance of getting pregnant depending on their age.
That’s actually a surprisingly HIGH percentage considering that you can only conceive around the time of ovulation — the small window every month (between 12 and 24 hours) when the egg is viable and ready for fertilization.
So, it’s only natural to wonder…
“What can I do to enhance ovulation and naturally boost fertility?”
Well, one of the best ways to increase your chances of getting pregnant is to have intercourse in the days leading up to ovulation! More on that in just a moment…
With that said, many of the best lifestyle changes to improve your overall health also happen to improve ovulation and reduce your risk of ovulatory infertility.
So let’s explore some important ways to increase fertility and naturally support ovulation!
Here’s a quick overview of what you’ll discover:
As ovulatory dysfunction is one of the most common causes of infertility it’s pretty important to understand how ovulation really works. And for that, we need to have a basic understanding of the menstrual cycle.
As you may know, the menstrual cycle can be divided into 2 phases:
The follicular phase (think building follicles)… generally this phase is 14-21 days long and it’s the variable part of the cycle.
The luteal phase (think corpus luteum)… this phase is the fixed part of the cycle and lasts 14 days.
The first day of full flow is considered cycle day 1…
The follicular phase follows the cessation of menses and is marked by an increase in follicle-stimulating hormone (FSH) from the anterior pituitary (the brain) that stimulates the ovarian follicles to produce estradiol (estrogen). A dominant follicle is selected and once estradiol levels peak for an extended period of time and the LH surge is triggered which subsequently results in ovulation.
The onset of the LH surge precedes ovulation (release of the egg) by ~36 hours.
Once ovulation occurs and the egg is released by the ovary, this signals the transition from the follicular phase to the luteal phase of the menstrual cycle. Progesterone is then produced by the corpus luteum (the follicle that ovulates) while the egg travels down the fallopian tube.
The egg can only survive for 12-24 hours if it’s not fertilized which is why having intercourse in the days leading up to and on the day of ovulation is most important- so sperm is waiting in the fallopian tube when the egg arrives!
There are a variety of different causes of ovulatory dysfunction including dysfunctional thyroid hormone or an elevated prolactin level. Conditions that result in an overabundance of estrogen and a relative decrease in progesterone, like polycystic ovarian syndrome (PCOS), are also common.
The reproductive system is complex but it’s important to understand in the preconception period as women who have irregular periods as a result of ovulatory dysfunction should seek care sooner than later.
There are 3 primary ways to figure out when you’re ovulating from the comfort of your own home: LH predictor kits, basal body temperature, and cervical mucus monitoring.
In general LH predictor kits are the least amount of work with the least amount of subjective interpretation so that’s where we’ll start!
So, how does the LH predictor kit work?
Well, at home LH predictor kits detect luteinizing hormone in a urine sample. As mentioned above, the onset of the LH surge occurs ~36 hours prior to ovulation. Therefore, the use of the LH predictor kit can help you time intercourse or insemination most effectively.
The kits come in many varieties, but in general, the basic kit is all you need. Just a simple yes or no. Either the LH surge is present or not – the kits will detect the lowest levels of LH signaling at the onset of the LH surge.
Other versions can be difficult to interpret adding an extra layer of subjective interpretation to an already stressful process indicating “low,” “medium” or “high” fertility. These types of kits are also detecting estrogen levels which can be harder to detect reliably in the urine. Why complicate something that’s already a bit stressful even further?
Work of caution… false positive tests can occur so the kits should be used as directed.
Now if you prefer to save some money or are interested in the other methods of at-home ovulation detection, here’s the breakdown of how they work…
Cervical mucus is produced by the cervix at the entrance to the uterus. While the cervix is constantly producing mucus it varies in amount and consistency throughout the menstrual cycle.
Just after menses, the cervix produces very little mucus and you might notice a “drier” sensation during this time. As you progress throughout the follicular phase (the first ~14 days of the menstrual cycle in a 28-day cycle) it will increase in volume and have a somewhat sticky consistency.
As ovulation approaches, the consistency turns more similar to egg whites. It is creamier in nature and functions to nurture and protect sperm as it travels through the reproductive tract to the egg… not to block it.
If you note you don’t produce much cervical mucus or it’s hard to detect changes in consistency make sure you are staying hydrated and drinking plenty of water.
Over-the-counter supplements such as cough syrup to “improve cervical mucus” have not been rigorously studied and are not recommended.
Basal body temperature is the body’s temperature under resting (basal) conditions and should be measured upon awakening each morning.
BBT works as a means to detect ovulation due to the thermogenic or warming properties of the hormone progesterone. If ovulation occurs, progesterone levels will rise in the second half of the menstrual cycle. This rise in progesterone to at least 3 ng/mL correlates with a slight (0.4-0.8 degrees Fahrenheit) increase in BBT during the luteal phase.
The rise in BBT will occur up to 4 days after ovulation.
Tracking your basal body temperature over the course of 1-3 months should generally reveal a biphasic pattern wherein you reliably see an increase in your BBT in the second half of your cycle.
A nadir in BBT occurs just prior to ovulation, but ovulation can only be assumed after the sustained rise in BBT is identified. Menses should begin 12 days or more after the elevation in BBT. Although this method of tracking ovulation is free, the temperature shift is subtle and can be difficult to detect.
Another key point that many women don’t realize is that once the temperature rise has occurred and is evident, the most fertile window has already passed. So, the real utility of BBT for timing intercourse is best utilized over pattern recognition throughout many cycles. Having intercourse every other day beginning 7 days prior to the earliest rise in BBT and ending on the last day is best to optimize chances of conceiving with this method.
If you suspect that your cycles may be irregular, then try making a few of the key lifestyle changes that have been backed by the most evidence below.
If you’ve read our mini-series on Decoding the Fertility Diet, you know that much of the initial research surrounding the principles of a pro-fertility diet was derived from nutritional factors that have been associated with ovulatory infertility.
And even though diet can be a big factor in controlling ovulation and your menstrual cycle, it can affect nearly every aspect of your reproductive health. That makes this lifestyle change one of the most important to undertake in order to reduce your risk of infertility and increase your chances of getting pregnant.
So, to quickly recap…
The top 3 principles of a pro-fertility diet include:
1) Choose “good” carbs including whole grains and antioxidant-rich leafy greens.
2) Eliminate trans fats and enjoy high-quality omega-3 fatty acids instead.
Yes, there are technically a few more elements to a pro-fertility diet. But make sure to start here when attempting to make changes. There’s a lot of information out there and it can be easy to get overwhelmed.
Weighing too much or too little can interrupt normal menstrual cycles, throw off ovulation, or stop it altogether. On top of that, excess body weight lowers the odds that in vitro fertilization (IVF) or other fertility treatments will succeed. It increases the chances of miscarriage, puts a mother at risk during pregnancy or developing high blood pressure (pre-eclampsia) or diabetes, and increases her chances of needing a Cesarean section.
Fertility researchers have described the Fertility Zone for Weight to be between a body mass index (BMI) of 20 to 24. This is based on research suggesting that infertility was least common among women with BMIs in this range.
The good news?
Relatively small changes are often enough to have the desired effects of promoting healthy ovulation and improved fertility. If you are underweight, gaining 5 – 10 pounds can sometimes be enough to restart ovulation and menstrual periods. If you are overweight, losing 5 – 10 % of your current weight is often enough to improve ovulation.
Findings from over a half-century ago that too much exercise can turn off menstruation have led some wellness experts (and even doctors) to instruct women to shy away from exercise while trying to conceive.
And while this might be the right approach for women who exercise incredibly hard for many hours a week (e.g., marathon runners) and who are extremely lean, it’s not the best strategy for the vast majority of women.
In fact, Dr. Rich-Edwards and her colleagues found that vigorous activity actually offered some protection against ovulatory infertility. Every hour of vigorous exercise per week translated into a 7 percent reduction in risk.
Take home message…
If you aren’t physically active, start a daily exercise plan. If you already exercise, pick up the intensity of your workout – unless you are very lean.
Most women trying to conceive have lots of questions about what they can safely drink. And most of the attention tends to be focused on coffee and alcohol intake. But…
When it comes to improving ovulatory function and decreasing the risk for infertility, the most important beverage to be mindful of is soda.
When looking at data from the Nurses’ Health Study, women who drank two or more caffeinated sodas a day were 50 percent more likely to have experienced ovulatory infertility than women who drank these less than once a week. And in case you’re curious, the link between soda and infertility actually became stronger when researchers accounted for caffeine in their analysis.
What can you do instead?
Try switching to carbonated water with a splash of lemon, lime, or pomegranate juice. You might notice we didn’t recommend diet soda – check out this article on artificial sweeteners for more information on why diet soda may not be the way to go when trying to conceive.
Another potential (and somewhat counterintuitive) beverage to try in place of soda is whole milk. Full-fat dairy products, particularly milk, have been shown to decrease the chances of having ovulatory infertility with as little as one serving per day. Keep in mind that whole milk has nearly double the calories of skim milk and these findings are only associative. You can read more about dairy and your fertility here.
When you’re trying to conceive, a daily multivitamin should be treated as more than just insurance against common micronutrient deficiencies (e.g., vitamin D). In fact, conception and pregnancy are two situations in which your body demands more nutrients than what food can typically provide – this is especially true for iron and the mighty b-vitamin folate.
Based on findings from the Nurses’ Health Study, at least 700 micrograms (mcg) of folic acid are needed to improve ovulation and conception. That’s nearly double what’s recommended for the average woman!
And when it comes to iron, fertility benefits begin to appear between 40 – 80 milligrams (mg) a day, which is 2 – 4 times higher than the general recommendation for women.
So, make sure to look at your multivitamin close and be sure to talk to your OB/GYN or fertility specialist to make sure it contains enough of the right pro-fertility nutrients.
We know it goes without saying, but ovulation is a pretty important step when it comes to getting pregnant, and knowing when you ovulate can help increase your chances of success.
Sometimes your body falls out of its natural rhythm which can be quite frustrating. Luckily, there has been a lot of great research on how to reduce your risk of ovulatory infertility and support a regular, healthy menstrual cycle.
If your cycles are not functioning normally (i.e., they are regular), you should consult your healthcare provider or a fertility specialist who will be able to understand the unique pattern of your cycles as well as your hormone levels and address the root cause of the problem.
In the meantime, be sure to incorporate the lifestyle changes we presented here to optimize your cycle regularity and ovulation as much as you can. You may find that’s all you need.
Weight and fertility. American Society for Reproductive Medicine.
Rich-Edward, JW, Spiegleman D, Garland M, et al. Physical activity, body mass index, and ovulatory disorder infertility. Epidemiology. 2002 Mar;13(2):184-90.
Chavarro JE, Rich-Edward JE, Rosner BA, Willet WC. Iron intake and risk of ovulatory infertility. Obstet Gynecol. 2006 Nov;108(5):1145-52.
Chavarro JE, Rich-Edward JE, Rosner BA, Willet WC. Use of multivitamins, intake of B vitamins, and risk of ovulatory infertility. Fertil Steril. 2008 Mar;89(3):668-76.
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