Ovulation on the 12th day of the cycle when menstruation. Early ovulation: to be or not to be pregnant? Methods for determining ovulation

The question of what ovulation is is usually asked only by women planning a pregnancy.

And for good reason, because understanding this process is simply necessary for quick conception, if you seriously set out to get pregnant. From the snippets of knowledge about ovulation and certain “auspicious days,” you might think that this is a very complex science. But we will now prove that everything is much simpler and more interesting than it seems at first glance.

About ovulation simply and clearly

From birth, the ovaries of a girl, and then a woman, contain about a million eggs. Not all eggs survive until puberty, but those that have matured are quite capable of fulfilling their main duty - the formation of a new human body.

But only a few eggs manage to fulfill their functions. From the moment a girl begins her first menstruation, every month one of these eggs matures and leaves the ovary.

In fact, ovulation is the release of a mature egg from the ovary, somewhere in the middle of the menstrual cycle (normally 14 days before the onset of menstruation). Naturally, ovulation does not occur during pregnancy.

In the menstrual cycle of every woman there is a special day when there is the greatest chance of getting pregnant - this is the day of ovulation.

Ovulation occurs once a month, and the egg lives for about 24 hours. Ovulation itself is like a small explosion when a mature follicle bursts in the ovary and the egg is released. Everything happens very quickly, within a few minutes.

Now the task of the egg is to meet with the sperm within 24 hours in order to conceive a child. If a meeting with a spermatozoon occurs, the fertilized cell passes through the fallopian tube and is introduced into the uterus. As a result of this process comes. If, for some reason, pregnancy does not occur, then menstruation occurs, and the egg is excreted from the body.

In very rare cases, ovulation can occur 2 times a month, but at about the same time with an interval between the first and second no more than 2 days. It is during this short period of time that conception is possible. Without ovulation, conception is impossible.

Therefore, for successful pregnancy planning, you need to be well versed in matters of ovulation and be able to calculate favorable days for conception.

How to seize the moment?

The egg matures and is released in each woman about 14 days (plus or minus 2 days) before the next menstruation. And on what day it will be from the date of the beginning of the last menstruation, it depends on the length of the cycle of a particular woman.

This is where the whole complexity of calculating ovulation by the calendar method lies. If you have a 28 day cycle, you will ovulate around day 14 of your cycle. If you have a cycle of 32 days - on the 18th day of the cycle, and so on.

Based on this knowledge, you can calculate the date of ovulation using. But, if a woman has an irregular cycle, then its length changes every time, for example, from 30 to 40 days, and it is almost impossible to calculate ovulation in this way. Therefore, they came up with ovulation tests, the basal temperature method, which help in the realization of our maternal destiny. But more on that later.

Interesting! Infertility: causes and treatment

There are such terms as early and late ovulation.

If the egg is released, for example, on the 12th day instead of the 14th day of the menstrual cycle, then this ovulation is early. Therefore, late ovulation is when the egg is released later than the middle of the cycle. There are several reasons for such phenomena:

irregular periods
Hormonal disbalance
postpartum period
Regular stress
Postponed abortion
Gynecological diseases
Premenopausal period in women over 40 years of age.

How does ovulation happen?

Just recently, scientists for the first time captured the moment of ovulation on video during an operation for IVF. Previously, it was a mystery shrouded in darkness, and one could only guess about what was happening in the female body.

The process only takes about 15 minutes. A hole is formed on the wall of the follicle, resembling a wound, from which a small cell emerges. It is small and invisible to our eyes, but in fact it is the largest cell in the human body.

Some women are able to feel ovulation. They note some dull or stabbing growing pain, which is barely perceptible if you do not pay attention to it. Then there is a fairly sudden cessation of pain - this means that ovulation has occurred.

The egg, leaving the ovary, is picked up by the villi of the fallopian tube, and they direct it towards the uterus and towards the spermatozoa. The egg cell waits for a meeting with them only 24 hours, and if not a single spermatozoon has reached it, it dies.

If during these 24 hours the fusion of the spermatozoon with the egg cell occurred, we can say that conception has occurred. As you can see, the moment of ovulation and conception are somewhat different in time.

Signs of ovulation

As already mentioned, some women feel soreness in the ovary at the time of ovulation. It is difficult to say whether this pain is caused by a ruptured follicle or simply by tension in the ovarian area. According to doctors, ovulation cannot be felt, since the follicle does not contain nerve endings.

But it can definitely be said for sure that the process of ovulation is controlled by sex hormones that affect the emotional state of a woman and even her body temperature.

A day or two before ovulation, the level of the hormone estrogen in the blood rises sharply, due to which a strong emotional and physical upsurge is felt, a sense of sexuality and self-confidence increases. This hormone also contributes to increased vaginal discharge - cervical mucus, which becomes more liquid and transparent.

All this is not in vain, because these days are the most favorable conditions for conception. Ovulation has not yet occurred, but the sperm just has time to get to the location of the egg after it leaves the ovary. And cervical fluid has a composition that helps sperm reach their destination and stay active longer.

The hormone estrogen also affects basal body temperature, which is measured at full rest immediately after waking up in the rectum, vagina, or mouth. Only in this way of measurement can you see how the temperature before ovulation under the action of the hormone estrogen drops by 0.1 or 0.2 degrees.

At the very moment of ovulation, the temperature usually returns to its previous level again, but the next day it already rises significantly by a few tenths of a degree. It is on this principle that the method for determining ovulation by basal temperature is based.

Summing up, we can distinguish the following signs of ovulation:

Soreness in the ovarian region (doubtful sign)
Improved mood, increased activity and sexual desire
Liquid, copious and clear discharge
Decrease in basal temperature

Interesting! Delayed menstruation - causes and treatment

Methods for determining ovulation

There are several ways to determine ovulation.

Let's consider each of them.

1 calendar method used for a stable menstrual cycle. Any girl can do the count herself. With a menstrual cycle of 28 days, ovulation will occur on days 13-16. If the duration of the cycle is 30 days, then on the 14th - 17th day.

2 Also, with the determination of the time of the onset of the moment of ovulation, it can help determine Ultrasound - ultrasound diagnostics.

To do this, it is necessary to observe the process of maturation in the ovary of the follicle, from which the egg will subsequently be released. It will take at least three ultrasounds, but it's worth it. At the beginning of the cycle, several follicles of approximately the same size are visible in the woman's ovary. The follicle is the sac in the ovary that contains the egg.

Then one of the follicles begins to grow and it becomes clear that ovulation will occur from it. Its size increases gradually from 1 mm to 20 mm. When the follicle reaches its maximum size, the doctor concludes that ovulation is imminent and sends the woman home.

A few days later, she visits the ultrasound room again, and if the follicle is no more, then it has burst and an egg has come out of it. In other words, ovulation has occurred.

3 There is also a traditional method for calculating ovulation - keeping a basal temperature calendar.

It is necessary every day, as soon as the girl woke up in the morning, to measure the temperature in the rectum (introduce a thermometer there).

Usually, the temperature at the end of menstruation is kept at 36.6 - 36.9 °, before ovulation it decreases slightly, then rises sharply and stays within 37.0 - 37.3 ° until the next menstruation.

4 Most women use to determine ovulation rapid tests, which are freely sold in pharmacies. Such tests respond to the content of a special luteinizing hormone in the urine of a woman.

With a positive test result, ovulation will begin in 16 to 26 hours.

Method for determining the level of luteinizing hormone (LH) in urine.

The very peak of estrogen that occurs on favorable days before ovulation provokes the release of this hormone. Thanks to him, the follicle is ruptured and the egg is released.

What is ovulation? How not to miss a good moment for conception? Everything is very simple - we focus on the signs and symptoms of ovulation, use basal temperature, an ovulation test and folk remedies - and pregnancy is in our pocket!

Ovulation: what is it?

Ovulation(from the Latin ovum - egg) is one of the stages of the menstrual cycle, which is the process of rupture of a mature follicle with the release of a mature, capable of fertilizing an egg from the ovary into the abdominal cavity.

The process of ovulation is controlled by the hypothalamus by regulating (through gonadotropin-releasing hormone) the release of hormones secreted by the anterior pituitary gland: LH (luteinizing hormone) and FSH (follicle-stimulating hormone). In the follicular phase of the menstrual cycle, before ovulation, the ovarian follicle grows under the influence of FSH. When the follicle reaches a certain size and functional activity, under the influence of estrogens secreted by the follicle, an ovulatory peak of LH is formed, which triggers the "maturation" of the egg. After maturation, a gap is formed in the follicle through which the egg leaves the follicle - this is ovulation. Between the ovulatory peak of LH and ovulation takes about 36 - 48 hours. During the corpus luteum phase after ovulation, the egg usually travels down the fallopian tube towards the uterus. If the egg is fertilized during ovulation, then on the 6-12th day the zygote enters the uterine cavity and the process of implantation occurs. If conception does not occur, the egg dies in the fallopian tube within 12-24 hours.

Ovulation and conception

When does ovulation occur?

Average ovulation occurs on the fourteenth day of the menstrual cycle(with a 28-day cycle). However, deviation from the mean is often observed and to a certain extent is the norm. The length of the menstrual cycle by itself is not a reliable source of information about the day of ovulation. Although usually with a shorter cycle, ovulation occurs earlier, and with a longer one - later.

The ovulation rhythm that is constant for every woman undergoes changes within 3 months after an abortion, within a year after childbirth, and also after 40 years, when the body is preparing for the premenopausal period. Physiologically, ovulation stops with the onset of pregnancy, and after the extinction of menstrual function.

How does ovulation and conception occur?

The female body is endowed with two ovaries located on either side of the uterus. The ovaries produce hormones, the best known of which are estrogen and progesterone.

The ovaries contain eggs even at the stage of intrauterine development of the girl. There are hundreds of thousands of eggs in the two ovaries of a newborn. True, they are all inactive until the onset of puberty and the first ovulation, that is, up to about 12 years. During this time, a certain number of cells die, but 300,000 - 400,000 full-fledged eggs remain. From the moment of the first ovulation until the onset of menopause, a woman will experience from 300 to 400 menstrual cycles, as a result of which the same number of oocytes that can become fertilized will mature. During the menstrual cycle, one of the many eggs matures in the ovaries.

Under the influence of the follicle-stimulating hormone (FSH) of the pituitary gland - the endocrine gland on the lower surface of the brain, a follicle (sac) begins to grow with the egg selected for ovulation in this cycle. The diameter of the follicle at the beginning of the cycle does not exceed 1 mm, and after 2 weeks it reaches 20 mm. As the follicle grows, a bulge forms on the surface of the ovary, which by the middle of the cycle increases to the size of a grape. Inside the follicle contains fluid and a small nucleolus with a diameter of 0.1 mm.

The period of maturation of the egg until its release from the ovary can last from 8 days to a month, although on average it lasts about 2 weeks. The main factor influencing the duration of this process is the time it takes the body to reach the maximum level of estrogen. High levels of estrogen stimulate a sharp increase in luteostimulating hormone (LH), which causes the egg to break through the wall of the ovary within one to two days after a sharp rise in its level. In the middle of the cycle, approximately 12 days after the onset of menstruation, the pituitary gland releases large amounts of luteinizing hormone (LH), and ovulation occurs approximately 36 hours after that.

Chromosomes located in the nucleus of cells are carriers of the genetic code. The purpose of fertilization is the fusion of two germ cells (gametes) originating from heterosexual individuals. All cells in the human body contain 46 chromosomes. Therefore, two gametes must form a new cell containing also 46 chromosomes. With simple addition, 92 chromosomes would have been obtained, but this would have led to a biological error, the consequence of which would have been the termination of the genus. Therefore, each of the partners must halve their number of chromosomes (to 23). In the egg, a reduction in the number of chromosomes occurs after the release of luteinizing hormone by the pituitary gland several hours before ovulation. For such a transformation, 20 - 36 hours is enough for her. In preparation for the reception of the sperm, the egg pushes out to the periphery, into a small sac called the first polar body, half of its chromosomes. The meeting with the sperm must occur at a strictly defined time. If this happens earlier, the egg will not be ready to receive the sperm because it will not have time to divide its chromosomes; if - later, then she risks missing the period of maximum readiness for fertilization.

Next 14 days after ovulation, the second part of the cycle, take place in preparation for the conception of the uterine mucosa. All preparation is in vain if conception does not occur, and its biological consequences will pass along with menstrual bleeding. But in one of the ovaries, a new egg is already preparing for ovulation.

What happens after ovulation at conception?

The egg released from the follicle, having carried out the reduction of chromosomes, enters the fallopian tubes, which, with their soft fringes, are connected to the ovary. The fringes resemble an opened flower at the end of the stem. And its living petals capture the egg on the go. The fusion of the egg and sperm usually occurs in the fallopian tube itself.

The fallopian tube is a cylindrical muscular organ, inside it is lined with a mucous membrane covered with villi and containing glands that produce a secret. This structure contributes to the movement of the egg and (if fertilization has occurred) the embryo into the uterus.

To fertilize an egg, the sperm must enter the body around the same time that the egg leaves the follicle. This may seem easy to achieve, but the egg after ovulation lives only for 24 hours or even less, and the sperm remains capable of fertilizing it for only a few days. Thus, sexual intercourse should take place at your most appropriate time if you want to become pregnant.

Thus, ovulation period- the most successful period for conceiving a child. For this reason, it is important to be able to identify when does ovulation occur. You can do this yourself at home, for example, by measuring basal temperature. Special devices have also been developed (for example, the ClearPlan Easy Fertility Monitor), which, by the content of hormones in a urine test, can more accurately determine the moment of ovulation: ovulation tests. More accurate determinations can be made in the clinical setting, for example, by ultrasonic observation of the growth and development of the follicle and determining the moment of its rupture.

When planning a conception in a natural way, the procedure of in vitro fertilization and artificial insemination, one of the most important points is moment of ovulation.

Ovulation symptoms:

How to determine ovulation?

Symptoms of ovulation that a woman can notice without a doctor:

short-term pain in the lower abdomen,
increase in sex drive.

During a gynecological examination during ovulation, an increase in the amount of mucus secreted from the cervical canal is observed. In addition, extensibility, transparency of the mucus is sometimes used, and its crystallization is also observed, which can be done using a special microscope for home use.

The next most accurate method for determining ovulation is basal temperature measurement. An increase in mucous secretions from the vagina and a decrease in rectal (basal) temperature on the day of ovulation with an increase in it the next day most likely indicates ovulation. The basal temperature graph reflects the temperature effect of progesterone and indirectly (but quite accurately) allows you to determine the fact and day of ovulation.

All of these listed signs of ovulation and methods for determining it give only approximate results.

Signs of ovulation, which the doctor states:

How to accurately recognize ovulation?
There are methods that help to absolutely determine the moment of ovulation:

ultrasound monitoring (ultrasound) of the growth and development of the follicle and determining the moment of its rupture (ovulation), see photo. Ultrasound monitoring of follicle maturation is the most accurate method for determining ovulation. After the end of menstruation, approximately on the 7th day of the cycle, the gynecologist performs an ultrasound using a vaginal probe. After that, the procedure should be carried out every 2-3 days, to monitor the preparation of the endometrium. Thus, it is possible to predict the date of ovulation.

dynamic determination of luteinizing hormone (LH level) in the urine. This method is easier and can be applied at home using ovulation tests. Ovulation tests begin to be carried out 2 times a day, 5 to 6 days before the expected ovulation, strictly following the instructions.

Ovulation test at home

The work of home ovulation tests is based on determining the rapid increase in the amount of luteinizing hormone (LH) in the urine. A small amount of LH is always present in the urine, but 24-36 hours before ovulation (the release of an egg from the ovary), its concentration increases dramatically.

Using ovulation tests

What day should you start testing? This day depends on the length of your cycle. The first day of the cycle is the day when menstruation began. Cycle length - the number of days elapsed from the first day of the last menstruation to the first day of the next.

If you have a constant cycle, then you need to start doing tests ~ 17 days before the start of the next menstruation, since the corpus luteum phase after ovulation lasts 12-16 days (on average, usually 14). For example, if the usual length of your cycle is 28 days, then testing should start from the 11th day, and if 35, then from the 18th.

If your cycle length varies - select the shortest cycle in the last 6 months and use its length to calculate the day when to start testing. With very unstable cycles and delays of a month or more, the use of tests without additional monitoring of ovulation and follicles is not reasonable due to their high cost (when using tests every few days, ovulation can be missed, and using these tests every day will not justify itself ).

With daily use or 2 times a day (morning and evening), these tests give good results, especially when combined with ultrasound. With simultaneous monitoring on ultrasound, you can not waste tests, but wait until the follicle reaches about 18-20 mm, when it is able to ovulate. Then you can start doing tests every day.

Performing an ovulation test

You can take an ovulation test at any time of the day, but you should stick to the same test time whenever possible. In this case, you should refrain from urinating for at least 4 hours before the test. Avoid excessive fluid intake before starting testing, as this can lead to a decrease in the amount of LH in the urine and reduce the reliability of the result.

Determination of ovulation using test strips: place the test strip in a jar of urine up to the line indicated on the test for 5 seconds, put it on a clean, dry surface, after 10-20 seconds look at the result.

Determination of ovulation using a test device: Holding the tip of the absorbent pointing down, place it under the urine stream for 5 seconds. You can also collect the urine in a clean, dry dish and place the absorbent in the urine for 20 seconds. Keeping the tip of the absorbent pointing downwards, remove the absorbent from the urine. Now you can put the cap back on. The result can be seen after 3 minutes.

Ovulation test results

Results of determining ovulation by test strip: 1 strip means that the increase in LH has not yet occurred, repeat the test after 24 hours. 2 strips - an increase in the level of LH was recorded, the intensity of the strip next to the control indicates the amount of the hormone. Ovulation is possible with the intensity of the band as in the control or brighter.

Ovulation test results: Look into the result window and compare the result line on the left of the arrow on the wand body with the control line on the right. The line closest to the arrow on the case is the result line, which shows the level of LH in the urine. Further to the right of the arrow on the body of the wand is the control line. The control line is used for comparison with the result line. The control line always appears in the window if the test was performed correctly.

If the result line is paler than the control line, then the LH surge has not yet occurred, and testing should be continued daily. If the result line is the same or darker than the control line, then the release of the ear hormone has occurred, and you will ovulate within 24-36 hours.

The best 2 days for conception start from the moment you determine that the LH surge has already occurred. If sexual intercourse occurs within the next 48 hours, your chance of getting pregnant will be at a maximum. Once you have determined that an outlier has occurred, there is no need to continue testing.

Types of ovulation tests

The most common disposable test strips for determining ovulation, by analogy with pregnancy tests, their price is not high.

There are also devices for determining ovulation, which are gradually replacing expensive one-time tests, they also accurately determine the moment of ovulation, but are also multifunctional and more economical, they do not need to be changed after each use and they are designed for many years of work.

Tests allow you to accurately determine ovulation, experts associate the existing errors in the results of ovulation tests only with their incorrect use.

Thus, by combining several methods to determine the moment of ovulation, it is possible to track the long-awaited ovulation with a 100% guarantee. After all, it is on these days that the chance for successful conception is highest: there is ovulation - conception is possible.

Ovulation calendar

Using ovulation data from a basal temperature chart or tests for at least 3 months, you can create an ovulation calendar. The calendar allows you to predict the day of the next ovulation, so it is possible to plan conception and pregnancy.

Ovulation and pregnancy

In a woman, the few days before and after the moment of ovulation represent the fertile phase in which conception and pregnancy are most likely.

Different women have a noticeable difference in the timing of ovulation. And even for the same woman, the exact timing of the onset of ovulation fluctuates in different months. Menstrual cycles may be longer or shorter than average, may be irregular. In rare cases, it happens that in women with a very short cycle, ovulation occurs around the end of the period of menstrual bleeding, but still, in most cases, ovulation occurs regularly at the same time.

From the time of conception in relation to the time of ovulation, not only the actual conception of the child, but also its gender depends. Right at the time of ovulation, it is more likely to conceive a boy, while before and after ovulation, a girl is more likely to be conceived. This is explained by the fact that spermatozoa with the Y chromosome (boys) are faster, but live less and are less stable in an acidic environment before ovulation than with the XX set (girls). If the egg is already moving towards fresh sperm, the "boys" will reach it faster. If the sperm "waits" for an egg for a long time, most of the sperm remain in it to conceive a girl.

The probability of conception and pregnancy is generally maximum on the day of ovulation. and is estimated at about 33%. A high probability of pregnancy is also noted on the day before ovulation - 31%, two days before it - 27%. Five days before ovulation, the probability of conception and pregnancy is 10%, four days - 14% and three days - 16%. Six days before ovulation and the day after it, the likelihood of conception and pregnancy during sexual intercourse is very small.

Given that the average "lifespan" of spermatozoa is 2-3 days (in rare cases it reaches 5-7 days), and the female egg remains viable for about 12-24 hours, then the maximum duration of the fertile period is 6-9 days and the fertile period corresponds to the phase of a slow increase (6-7 days) and a rapid decline (1-2 days) before and after the day of ovulation, respectively. Ovulation divides the menstrual cycle into two phases: the follicle maturation phase, which, with an average cycle duration, is 10-16 days, and the luteal phase (corpus luteum phase), which is stable, independent of the duration of the menstrual cycle and is 12-16 days. The corpus luteum phase is referred to as the period of absolute infertility, it begins 1-2 days after ovulation and ends with the onset of a new menstruation. If, for one reason or another, ovulation does not occur, the endometrial layer in the uterus is thrown out during menstruation.

Stimulation of ovulation

Lack of ovulation is one of the common causes of infertility.

Violation of ovulation is due to dysfunction of the hypothalamic-pituitary-ovarian system and can be caused by inflammation of the genitals, dysfunction of the adrenal cortex or thyroid gland, systemic diseases, tumors of the pituitary and hypothalamus, intracranial pressure, stressful situations. Violation of ovulation may be hereditary in nature (first of all, it is a tendency to certain diseases that interfere with ovulation). Anovulation - the absence of ovulation in childbearing age - is manifested by a violation of the rhythm of menstruation by the type of oligomenorrhea (menstruation lasting 1-2 days), amenorrhea, dysfunctional uterine bleeding. Lack of ovulation is always the cause of a woman's infertility.

One of the common causes of infertility is the lack of ovulation, most often due to hormonal imbalance, which, in turn, can occur against the background of stress, brain injury, abortion, etc. To treat this condition, a complex of hormonal drugs is used that stimulates ovulation and causes superovulation, when several eggs mature in the ovaries at the same time, which increases the chances of fertilization, and is widely used in the IVF procedure.

Another cause of infertility may be, for example, luteal phase deficiency - NLF, when ovulation has occurred, and the concentration of progesterone in the second phase of menstruation is insufficient for implantation of the embryo into the uterus. In this case, treatment is carried out aimed at stimulating the function of the corpus luteum of the ovary and increasing the content of progesterone in the blood. However, the correction of NLF is not always successful, since this condition is often associated with other gynecological diseases and requires a thorough examination.

If the process of follicle maturation and, accordingly, ovulation is disturbed in a woman, ovulation is stimulated. For this, special medications are prescribed - ovulation inducers. Prescribing drugs leads to the stimulation of the development of one or more eggs in patients, which will then be ready for fertilization. Before the appointment of such a serious therapy, a whole range of tests is carried out, which allows you to determine the level of hormones in a woman. In addition to the use of ovulation stimulation, regular ultrasound diagnostics are also carried out. After the onset of ovulation, if it is still not possible to become pregnant naturally, the patient is given intrauterine insemination or IVF. There is a big difference in the method of ovulation stimulation for IVF and for natural conception: in the first case, they achieve the maturation of several eggs, in the second - 1, maximum 2.

Ovulation inducing drugs

The most commonly used drugs to stimulate ovulation are Clostilbegit and gonadotropic hormone preparations.

Preparations of gonadotropic hormones contain hormones of the endocrine gland of the pituitary gland - gonadotropins. These are follicle-stimulating hormone - FSH and luteinizing hormone - LH. These hormones regulate the process of follicle maturation and ovulation in a woman's body and are secreted by the pituitary gland on certain days of the menstrual cycle. Therefore, when prescribing drugs containing these hormones, the follicle matures and ovulation occurs.

These drugs include Menopur (contains the hormones FSH and LH) and Gonal-F (contains the hormone FSH).

The drugs are available in injectable form, administered intramuscularly or subcutaneously.

How is ovulation stimulated?

Various ovulation stimulation schemes are used depending on the type of ovulation disorder and the duration of the disorder. When applying the scheme with Klostilbegit, the latter is prescribed from 5 to 9 days of the menstrual cycle. A combination of this drug with gonadotropins is often used. In this case, Klostilbegit is prescribed from days 3 to 7 of the menstrual cycle with the addition of Menopur (Puregon) on certain days.

When conducting ovulation stimulation, a very important point is to conduct ultrasound monitoring, that is, control of the maturation of the follicle on an ultrasound machine. This allows you to make adjustments to the treatment regimen, in a timely manner to avoid such a side effect of stimulation as the growth of several follicles. The frequency of ultrasound examinations during the treatment program averages 2-3 times. During each examination (monitoring), the number of growing follicles is counted, their diameter is measured and the thickness of the uterine mucosa is determined.

When the leading follicle reaches a diameter of 18 millimeters, the doctor may prescribe the drug Pregnil, which completes the final process of egg maturation and causes ovulation (direct release of the egg from the follicle). Ovulation after the introduction of Pregnyl occurs within 24-36 hours. Depending on the type of marital infertility during the period of ovulation, either intrauterine insemination is performed with the husband's or donor's sperm, or the time of sexual intercourse is calculated.

Depending on the duration and cause of infertility, the age of the woman, the pregnancy rate per attempt is 10-15%.

Conditions for ovulation stimulation:

1. Examination of a married couple.
List of analyzes:
HIV (both spouses)
Syphilis (both spouses)
Hepatitis B (both spouses)
Hepatitis C (both spouses)
Cleanliness smear (female)
Bacteriological crops: chlamydia, mycoplasma, ureaplasma, trichomonas, candida, gardnerella (both spouses)
Pap smear for oncocytology (female)
Conclusion of the therapist on the possibility of carrying a pregnancy
Ultrasound of the mammary glands
A blood test for antibodies to rubella, that is, the presence of immunity (protection) in a woman

2. Passable fallopian tubes.
Since fertilization occurs in the fallopian tube ("Physiology of conception"), an important condition for the onset of pregnancy is passable fallopian tubes. Evaluation of the patency of the fallopian tubes can be carried out by several methods:

Laparoscopy
Transvaginal hydrolaparoscopy
Metrosalpingography

Since each method has its own indications, the choice of method is determined jointly by you and your doctor at the appointment.

3. Absence of intrauterine pathology
Any deviations from the uterine cavity prevent the onset of pregnancy ("Intrauterine pathology"). Therefore, if a woman has indications of trauma to the uterine mucosa (curettage of the uterine cavity during abortions and bleeding, inflammation of the uterine mucosa - endometritis, intrauterine device and other factors), hysteroscopy is recommended to assess the state of the uterine cavity ("Hysteroscopy").

4. Satisfactory sperm quality
Satisfactory quality of sperm is the absence of male factor of infertility. In the event that intrauterine insemination is not planned, a postcoital test (“Postcoital test”) is recommended before ovulation stimulation.

5. Absence of an acute inflammatory process
The absence of an acute inflammatory process of any localization. Any inflammatory disease is a contraindication for many diagnostic and therapeutic procedures in medicine, since it carries the risk of worsening the patient's condition.

Folk remedies to stimulate ovulation are best used only after consulting a doctor.

Photo of ovulation taken during IVF surgery

The 3rd photo shows that several eggs have matured (after preliminary stimulation of ovulation).

Ovulation- This is the physiological process of the release of a mature egg from the follicle shell into the area of the fallopian tube.

Follicle is the sac in the ovary that contains the egg. At the beginning of the cycle, several maturing follicles, approximately the same size, are almost always normally released in the ovary. Then, after a few days, one of the follicles becomes dominant - it begins to grow faster than the others. Its size increases gradually from 1 mm to 20 mm. When the follicle reaches its maximum size, an egg is released from it, that is, ovulation occurs.

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The concept of ovulation is closely related to the female menstrual cycle. The beginning and end of the cycle are counted from ovulation, taking into account that ovulation itself occurs in the middle of the cycle (normally 14 days before the start of menstruation).

Ovulation begins to occur in the female body almost from the beginning of the period of puberty, usually in adolescence, from 12-13 years. Ovulation stops with the onset of menopause.

How does ovulation happen?

Relatively recently, scientists for the first time captured the moment of ovulation on video using modern equipment during an operation for IVF. Previously, it was a complete mystery, and one could only guess about what was happening in the female body.

It turns out that the process of ovulation lasts only about 15 minutes. A hole is formed on the wall of the follicle, from which the cell emerges. By the way, the egg is the largest cell in the human body.

The photo shows how surgical instruments support the follicle, the arrow points to the emerging egg.

When does ovulation occur?

In women who do not have chronic inflammatory diseases of the ovaries and other organs of the reproductive system, on average, once a month, an egg is released from one ovary into the uterine cavity. In rare cases, ovulation occurs twice in one cycle, from both ovaries with a difference of several days. This is how multiple pregnancies happen, in which babies of different sexes.

Do you ovulate every month?

Girls are born with a certain supply of eggs, which are consumed with each ovulation. At birth, the reserve is about 400 thousand eggs. When their number comes to an end, menopause occurs.

On average, ovulation occurs monthly, in each menstrual cycle. Sometimes it happens that out of 12 cycles in a year, one or 2 will be anovulatory, that is, without ovulation. This is normal and cannot be treated. This process has nothing to do with age. In women with a healthy reproductive system, the release of the egg from the follicle occurs every month and in most cases without much disruption. But with age, the number of eggs becomes less and less, and over the age of 45, ovulation can occur with a break of 2-3 months.

What day to expect ovulation?

It is believed that on average ovulation occurs on the 12th-15th day of the menstrual cycle. To set the date as accurately as possible, it is necessary to maintain a special calendar. This is an approximate method, because there is some difficulty in calculating ovulation with the calendar method. If you have a 28 day cycle, you will ovulate around day 14 of your cycle. If you have a cycle of 32 days - on the 18th day of the cycle, and so on.

But if a woman has an irregular cycle, then its length changes every time, for example, from 30 to 40 days, and it is no longer possible to calculate ovulation in this way.

Sometimes, the basal temperature method is used to calculate the onset of ovulation. In the absence of inflammatory processes, it should be stable daily, and before ovulation, under the action of the hormone estrogen, it decreases by 0.1 or 0.2 degrees. This suggests that the egg is already formed and ready to leave the follicle. Then the temperature rises sharply and stays within 37.0 - 37.3 ° until the next menstruation. It is this temperature dip that indicates the onset of ovulation.

Signs of ovulation

Many women feel the approach of ovulation for certain signs that are associated with changes in hormonal levels. These include:

Pain in one side of the abdomen(associated with stretching of the ovarian capsule before ovulation and rupture of the capsule during ovulation). Pain can be of different intensity, but mostly pulling, sometimes given to the lower back. After ovulation, the pain completely disappears. If the pain in the middle of the cycle is very severe and radiates to the rectum, then this may be a symptom of ovarian apoplexy, and such a condition requires medical intervention.
Change in the nature of the discharge. In the first half of the cycle, whites are practically absent, but towards the middle of the cycle they begin to appear. A feature is that the discharge during ovulation becomes abundant and viscous. At the same time, in a healthy woman, they are completely transparent. During the examination, the gynecologist can assume the day of ovulation, as he sees the “pupil symptom” - the accumulation of mucus in the cervical canal.
Increasing sex drive. This is a natural reaction, as the body adjusts to pregnancy. A woman on a subconscious level becomes more attractive to men.

How to determine ovulation?

In order to obtain the most accurate information about the movement of the egg through the fallopian tubes, you should, of course, contact a gynecologist. It has all the necessary medical equipment that allows you to fully examine all the female reproductive organs. It is also possible to determine this process at home, but for this you will need to apply the following methods:

use the above basal temperature measurement, the deviation of which is even half a degree, indicates that there is a healthy egg inside the uterus, waiting in the wings;
buy at the pharmacy ovulation test, which works exactly on the same principle as the strips for determining pregnancy. With a positive test result, ovulation will begin in 16 - 26 hours;
regularly count 14 days from the last date of menstruation, after which the probability of ovulation is extremely high;
listen to the signs of your body, because in 85% of women during the movement of the egg into the uterine cavity, the hormonal background rises sharply, pulling pains appear in one of the ovaries and sexual attraction to the opposite sex increases (if you mark such days monthly, you can eventually trace the pattern that such a condition organism falls on the same dates, which are essentially the days of ovulation).
Ultrasound allows you to visually assess the processes occurring in the ovaries. This method is used quite often in order to identify signs of ovulation. It's called folliculometry.
Microscopic examination of saliva to determine ovulation. The changes that occur during ovulation affect the entire body. The microscopic method is based on the detection of the "fern" pattern in the study of saliva. You can also use the discharge during ovulation, which by this time becomes more viscous and thick.

Having this information, a woman, having spent a small amount of time, will be able to independently determine the cycle of passage of a mature egg and plan a long-awaited pregnancy, or avoid an unwanted conception.

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Normally, the egg is released from the ovary in the middle of the menstrual cycle. If this occurs prematurely, early ovulation is observed.

What does this term mean

It is believed that with a 28-day cycle, the release of a mature germ cell develops on the 14th day. This is what happens to most women. However, in some cases, ovulation with a 28-day cycle may occur on the 12th day or even earlier.

Women with this form of cycle disorder have a short follicular phase. This is the time from the beginning of menstruation to the release of the egg from the ovary. Usually its duration is 12-16 days. During this phase, the egg is protected by the follicle, where it grows and matures.

If the duration of the follicular phase is less than 12 days, early ovulation occurs, and pregnancy in this case is less likely. The egg in this situation is not fully mature and not ready for fertilization.

Can this condition occur normally?

This can happen to any woman. But the constant premature rupture of the follicle can be the cause of infertility.

On what day of the cycle does early ovulation occur?

It occurs before the 12th day after the onset of menstruation. In the period of 12-16 days, the egg is ready for fertilization with a cycle of 25 days.

Why is this happening

The main causes of early ovulation:

time before the onset;
short follicular phase;
smoking, alcohol and caffeine abuse;
stress;
sudden weight loss or sudden weight gain;
early ovulation may occur after the abolition of OK (oral contraceptives);
sexually transmitted diseases;
abrupt change in normal daily activities;
irregular menstrual cycle caused by gynecological hormonal diseases.

Any hormonal imbalance can disrupt the length and staging of the menstrual cycle. The maturation of the egg in the ovarian follicle is stimulated by follicle-stimulating hormone (FSH), and its release is associated with the action of luteinizing hormone (LH). Both of these substances are produced in the pituitary gland under the control of the hypothalamus. A change in the level of these hormones leads to a violation of the ovulatory mechanism.

The premature onset of the ovulatory phase is associated with high levels of FSH.

A decrease in ovarian activity inevitably occurs with age. At birth, a girl has about 2 million eggs. During each menstrual cycle, hundreds of them die, and only one matures. The exception is hyperovulation, when more than one egg matures in one cycle.

By the age of 30, a woman has lost more than 90% of all eggs. As menopause approaches, the pituitary gland begins to feed back more and more FSH to compensate for the lack of ovulating follicles. This leads to menstrual irregularities.

The consequences of constant early ovulation are the release of immature eggs and infertility.

According to studies, smoking causes disruption of the ovulatory cycle and affects female fertility. When a woman smokes more than 20 cigarettes a day, the full maturation of the egg is almost impossible for a woman. The same can be said about the effects of alcohol and caffeine.

Signs and symptoms

To determine the premature appearance of an egg, it is necessary to track the cycle for at least 3 months. With a 28-day cycle, ovulation should be expected on the 12-16th day, with a 30-day cycle - on the 13th - 17th day.

If a woman begins to feel the following symptoms shortly after menstruation, most likely, she has come into the ovulatory phase earlier than usual:

increased viscosity of cervical mucus;
soreness of the mammary glands;
increased sexual desire;
aching pain in the abdomen.

Signs of premature egg release can be tracked by determining the level of LH in the urine using.

How else can you determine early ovulation?

Questions about pregnancy with this condition

Is it possible to get pregnant with early ovulation?

Yes, it is possible, but the probability of such an event is less than normal. With a premature ovulatory process, an immature egg is released from the follicle. It may not be fertilized or not develop further. Such an egg is hardly implanted in the wall of the uterus, so even the onset of pregnancy is interrupted at an early stage.

Early onset of ovulation is a sign of a decrease in the reserve capacity of the ovaries. The lower they are due to the woman’s age or illness, the earlier she releases the egg from the follicle.

An ovulation test performed early in pregnancy can instead determine the amount of hCG (these hormones have a similar chemical structure) instead of LH levels, and thus give false information about premature rupture of the follicle and the absence of pregnancy.

Another obstacle to pregnancy, for example, with a long cycle: a woman expects ovulation in the middle of the cycle, and the release of a mature egg has already occurred, and all attempts to get pregnant are unsuccessful.

Can there be a cycle failure after an abortion?

Yes, this happens quite often. You need to wait at least one full cycle after that, so that the ovulatory function is restored.

In some women, after a miscarriage, ovulation consistently occurs earlier than usual, leading to infertility. The reason for this may be stress or hormonal imbalance. In this case, you must consult a doctor.

Treatment

Most infertility problems in women are caused by ovulation disorders. Therefore, before starting treatment, you need to consult a doctor and check the hormonal background.

First of all, it is recommended to reduce the consumption of alcohol, caffeine and smoking. In addition, it is better to sleep in complete darkness. This helps to restore the FSH level responsible for the first phase of the cycle. In this way, the normal cycle is regulated and fixed, which facilitates the conception and implantation of the embryo.

Other measures to restore reproductive function:

a complete fortified diet;
auto-training techniques to cope with stress;
sleep at least 7 hours a day;
hardening, physical activity in the fresh air.

Drug treatment includes the appointment of drugs that stimulate the maturation of the egg and its timely release - FSH and LH (Cetrotide). They are administered subcutaneously from the first days of the cycle until the period of normal ovulation. Self-administration of such funds is strictly prohibited.

To normalize ovulation, glucocorticoids are often prescribed, mainly against the background of hyperandrogenism. It is not recommended to suddenly stop taking them. In this case, early ovulation may occur due to Metipred, Prednisolone or other glucocorticoid drugs. Their cancellation is carried out only by a doctor according to a certain scheme.

If a woman constantly ovulates early on the 8th day of her cycle or a little later, she needs to see a doctor. This is especially important with a short menstrual cycle - 24 days, since the ability to conceive in this case is sharply reduced.

Sometimes, to restore hormonal levels, for example, when women take various dietary supplements. Their effect on hormone levels is unknown. Therefore, it cannot be said whether there can be early ovulation from Ovariamin or some similar means.

Self-restoration of timely ovulation is a complex process, which is difficult to influence only on your own. Therefore, all recommendations for treatment come down to general health promotion, restoration of the functions of the neurohumoral system. This should cause the restoration of hormonal levels in a physically healthy woman.

The use of progestogens (Dufaston) is aimed at maintaining an already formed pregnancy, that is, at stabilizing the second phase of the cycle. Progestogens do not affect the first half of this period and cannot cause early ovulation. The same applies to the popular drug Utrozhestan.

The use of Cetrotidne to prevent early ovulation

This process is most dangerous for women who plan to use assisted reproductive technologies. Indeed, with early ovulation, the eggs may be immature, which means that their suitability for artificial insemination may decrease.

Cetrotide blocks the action of the gonadotropin-releasing factor, secreted by the hypothalamus and stimulating the production of FSH. Thus, through a chain of chemical reactions, the early release of FSH, which is responsible for the premature release of the egg, stops. During ovarian stimulation, which serves as an indispensable link in preparation for, early ovulation is a frequent occurrence. For its prevention, this drug is used.

Gonadotropin releasing hormone stimulates the release of LH and FSH from pituitary cells under the influence of estradiol, the content of which increases towards the middle of the cycle. As a result, a surge in LH levels is formed, which causes normal ovulation of the dominant follicle.

The drug is administered subcutaneously. There may be short-term soreness or redness at the injection site. Other side effects include nausea and headache. It can not be used during pregnancy, with renal and hepatic insufficiency, in postmenopausal women. The drug is dosed individually and is prescribed only by an experienced doctor in the center of assisted reproductive technologies. Self-administration of such hormonal agents can cause a serious failure at the level of the hypothalamic-pituitary system.

One of the indicators of the normal functioning of the reproductive system is the regular maturation of the egg, so many women have a question on what day of the cycle ovulation occurs. It is easiest to accurately calculate the period suitable for conception with an average regular cycle. But there are certain methods that will help girls with any cycle length make calculations.

What day is coming

Ovulation is the release of an egg (oocyte) from the ovary. Tearing the walls of the follicle, it goes into the fallopian tubes. If active spermatozoa are present in them at this moment, the probability of fertilization is high.

When does ovulation occur? In women with a normal and regular cycle of 28-30 days - for 14-15 days. But the body cannot work like a machine, so deviations occur - the egg can leave the follicle for 11-21 days.

Important! The duration of ovulation is 12–48 hours, spermatozoa are able to remain viable for 3–7 days. These factors should be considered for girls who do not plan to become a mother in the near future. 5 days before and after the expected date of release of the egg, you should use barrier contraceptives.

The release of the egg from the ovary is accompanied by certain hormonal changes. You can determine ovulation by a number of characteristic signs that are the same in women with any length of the menstrual cycle.

The main symptoms of ovulation:

Change in the type and consistency of vaginal discharge - during ovulation, the cervical fluid becomes viscous and transparent, which facilitates the movement of the egg and sperm. The color of the mucus can be white, yellow, pink.
Increases the amount of natural lubrication during sexual contact.
The mammary glands increase somewhat in volume, hurt, their sensitivity increases.
The position of the cervix changes - it rises higher, becomes softer.
Increased libido against the background of a hormonal surge, the body gives signals of readiness for conception.
Minor spotting of a smearing nature - appear after the rupture of the follicle.
Pain, cramps in the lower abdomen, most often on the one hand - occur when the walls of the follicle break, contraction of the fallopian tube, during the movement of the egg. Normally, discomfort is short-lived.

Among the additional symptoms at the end of ovulation, bloating, stool disorder, increased appetite, headache, and mood swings most often occur.

long cycle

Long menstrual cycle - 35-45 days. Since the stage of the corpus luteum is approximately the same for all women, to determine ovulation with a long cycle, you need to subtract 14 from its duration.

For example, with a cycle of 35 days, the calculation scheme is as follows: 35 - 14 = 21, ovulation should occur on day 21.

The average is called the menstrual cycle, which lasts 28–32 days, while menstrual flow is observed within 3–5 days. Ovulation occurs after 12-15 days, with a 32-day cycle - after 18 days, but it all depends on the individual characteristics of the organism.

How many days after ovulation will a pregnancy test show? A faint second line may appear on the test 6 to 12 days after the embryo is implanted. On what day exactly this will happen depends on the hormonal background.

Short

The duration of a short cycle is less than 25–26 days. To calculate the day of release of the egg, you need to subtract 14 from the length of the cycle, for example, 25 - 14 = 11. The favorable period for conception will come on the 11th day after menstruation.

If the menstrual cycle constantly lasts less than 21 days, the gynecologist can diagnose polymenorrhea, in such cases ovulation often occurs immediately after menstruation, on the 7-8th day.

irregular cycle

To calculate the favorable period for conception with an irregular cycle, it will take a lot of effort - to maintain a schedule, measure basal temperature regularly throughout the year.

To calculate the ovulation period, it is necessary to subtract 11 from the longest cycle, and 18 from the shortest. The values obtained will show the interval in which conception can occur, but with an irregular cycle, these figures can be a week or more.

Estimated ovulation date table

Cycle change

Quite often, early or late ovulation is observed. Most often, such deviations are associated with hormonal failure, which causes disturbances in the hypothalamus-pituitary-ovarian ligament. Permissible deviations in the timing of ovulation - 1-3 days.

Late ovulation - the release of the egg occurs later than the 20th day of the cycle, often observed before the onset of menopause. This pathology increases the risk of chromosomal abnormalities, birth defects in a child, miscarriage.

Why is the ovulatory period lengthened:

hypothyroidism, hyperthyroidism;
benign neoplasms in the pituitary gland;
adrenal insufficiency;
severe stress;
physical fatigue, intense training;
a sharp decrease or increase in weight by more than 10%;
chemotherapy;
long-term use of hormonal drugs.

Late ovulation also occurs during breastfeeding. With the restoration of menstruation after childbirth, a long follicular phase can be observed for six months. This phenomenon is considered normal, so the body prevents re-pregnancy.

early ovulation

Early ovulation - the egg, during a normal cycle, leaves the follicle earlier than day 11, it is not suitable for fertilization. Additionally, there is a mucous plug in the cervix, which prevents the penetration of spermatozoa, the endometrium is still too thin, high levels of estrogen prevent the embryo from fixing.

Reasons for early ovulation:

stress, nervous strain;
natural aging - a high level of FGS is observed in the body, which provokes the active growth of follicles;
smoking, alcohol abuse, coffee;
endocrine and gynecological diseases;
recent abortion;
cancellation of oral contraceptives.

Important! On average, for each year of OC use, it takes 3 months to restore the normal ovulatory period.

Atypical cases of ovulation

Is it possible to ovulate twice in one cycle? In rare cases, 2 eggs are released into the fallopian tubes at once. The rupture of the follicle occurs in one of the ovaries with a difference of several days, or in both ovaries at the same time.

Ovulation occurs immediately after the end of menstruation - this occurs if menstruation lasts more than 5 days, which provokes hormonal imbalance. The reason may also be the non-simultaneous maturation of follicles in two ovaries, such a pathology often causes pregnancy after sex during critical days.

Important! The anovulatory cycle is observed in adolescence, before menopause. In women over 30, 2-3 such cycles per year are allowed. If there is no timely release of the egg - this is one of the main signs of pregnancy, it is necessary to determine the level of hCG.

Ovulation diagnostics

Not all women show signs of egg release clearly, so it is necessary to use additional methods to determine the favorable period for conception.

How to determine ovulation:

Basal temperature - the most accurate data can be obtained by measuring in the rectum. You need to do this at the same time immediately after waking up, without getting out of bed. It is better to use a mercury thermometer, the duration of the procedure is 5-7 minutes. In the first half of the cycle, the rectal temperature is 36.6-36.8 degrees. Immediately before the breakthrough of the follicle, there is a sharp decrease in indicators, then they increase to 37.1–37.2 degrees. The accuracy of the method is more than 93%.
Pupil syndrome is a gynecological term that indicates the condition of the cervical os. During the follicular phase, the pharynx expands, opens as much as possible immediately before ovulation, and on the sixth day it narrows. The reliability of the method is about 60%.
The state of mucus - with the help of serrated tweezers, you need to take a small amount of discharge from the cervical canal, stretch it. 2 days before ovulation, the length of the thread is 9-12 cm, it gradually decreases, after 6 days the mucus completely loses its viscosity. The accuracy of the method is more than 60%.
Home tests to measure the level of LH in the urine - this method is only suitable for women with a regular cycle, otherwise you will have to use it constantly. There are also reusable systems for saliva analysis, but they are expensive. If your LH is high all the time, it could be a sign of stress or PCOS. When to do the test? 14-16 days before the expected date of menstruation.
Ultrasound is the most accurate method to find out the day of ovulation. With a regular cycle, the diagnosis is carried out on the 10-12th day of the cycle, with an irregular one - 10 days after the start of menstruation.

To independently determine the date favorable for conception, it is necessary to keep a diary. It should record the indicators of rectal and normal temperature, the condition of the cervix and vaginal discharge, the general condition, and if signs of ovulation appear, do tests.

Important! There is a theory that if there was sex before the release of the egg, then when it is fertilized, the probability of having a girl is high. If sexual intercourse was directly at the time of ovulation, boys are more often born.

Every girl needs to know the day of ovulation. This data will help to avoid unwanted pregnancy or increase the chance of a long-awaited conception. Specific symptoms, a change in the amount and structure of vaginal discharge, tests, and basal temperature indicators will help determine the day the egg is released.