Ovulation Defects

There are only a few days in a woman’s menstrual cycle when pregnancy can occur.  If you are trying to conceive it is therefore important to have regular intercourse especially around the time an egg is released from your ovaries (the process known as ovulation). You are most likely to get pregnant if you have intercourse in the couple of days leading up to ovulation or on the day of ovulation itself. Pinpointing this time can be difficult as ovulation takes place roughly 14 days before your period arrives, so it varies from woman to woman and from cycle to cycle.

It is estimated that problems with ovulation occur in 25% of infertile couples. This is an important problem to identify, as most of these patients can be treated successfully.

Ovulation problems can be treated with tablets, usually Clomifene (Clomid) or Tamoxifen, or with gonadotrophin drugs. It is important that you are carefully monitored when on any drugs to avoid over stimulation of the ovaries. If you produce multiple eggs, there is a much higher risk of a multiple pregnancy.


Ovulation Predictor Kits

What are ovulation tests?
The best way to ensure you are hitting the right time is to have intercourse two or three times a week, but some women like to use ovulation prediction kits to help them to check when they are ovulating. The kits detect hormone changes that precede ovulation and so enable you to predict your most fertile days and to time intercourse to coincide with them. You can buy them online or at many pharmacies and supermarkets where they are usually on the shelves next to the pregnancy testing kits. There are a number of different types of kit and you may want to look at a few and read the online reviews before deciding which one to buy.

How do the tests work?
Ovulation is controlled by hormones, in particular one called Luteinising Hormone (LH), which can be detected in your urine. The level of LH increases rapidly 24 to 36 hours before ovulation. It is this rise in LH (the LH surge) that triggers an egg to be released from your ovaries. Ovulation prediction kits tell you the best days to conceive naturally by detecting the increase, or surge, of Luteinising Hormone (LH) in your urine.

(Diagrams showing LH surge and ovulation for different menstrual cycle lengths)

How are they used?
The kits are urine tests designed for you to use in the privacy of your own home.  You will either need to collect a sample of your urine in a cup or wee on a stick, depending on which type of test you are using. The instruction leaflet in the kit will tell you which day in the month you should start testing, and each kit will contain a number of tests. You should do a test each day until you detect the LH surge which marks the most fertile days of your cycle. Depending on which type of kit you are using, there may be coloured bands which appear on the stick or if you are using a digital kit, there may be a smiley face to let you know that you are ovulating.

In order for the ovulation kit to work, do make sure you follow the instructions properly. They will tell you what time of day to do the test. They may advise avoiding doing the test first thing in the morning as it is possible to miss your surge if you do it then, but you should always follow the instruction leaflet in your kit.

Are there any drawbacks?
Ovulation tests are designed to pinpoint the days in each menstrual cycle when you are most likely to conceive – and to help you to time intercourse accordingly. They can be useful for people who are trying to conceive. However, it is important to be aware that ovulation tests only pinpoint the LH surge. They cannot guarantee that an egg will be released, nor can they detect potential problems such as a blockage in the fallopian tubes or a low sperm count.

If having used the tests for several months you do not achieve pregnancy, you should seek medical advice. You will be able to help your doctor by providing a picture of when your LH surge occurs, and this information can be used to time further tests. If you have been testing according to instructions for three menstrual cycles in a row and you have not detected a surge, then you should consult your doctor for further advice.