"You’re ready to start a family. Maybe you have a partner, maybe you don’t, but you’re ready. You just don’t know exactly where to start. Do you just start trying? Do you immediately make an appointment with a fertility expert? What’s a gal to do? Ultimately, this sort of thing can be sort of daunting, as anything new or different can be. Whether you’ve made the decision that you really want to start a family and are ready to do so right this second or you’ve been sort of trying to start a family for awhile and haven’t gotten pregnant yet, then you might consider tracking your cycle to get a better understanding of what’s going on in your body. But now that you know where to start, you need to know where to start with that.
Step 1: Start tracking your cycle.
“You can track your menstrual cycles on a paper calendar, a spreadsheet on your computer, or via an app on your smartphone,” Dr. Kate O’Connell White, MD, MPH, the director of the fellowship in family planning in the department of obstetrics and gynecology and Boston University / Boston Medical Center, says. “If you create a calendar or sheet yourself, keep track of the first and last days of each period, as well as any spotting that you have in-between periods. If you are using a smartphone app, you can input as much or as little data as you want — the important pieces of information are the first and last days of your period.”
READ: The Fertility Apps You Need to Have in Your Arsenal
Step 2: Watch for dips in your basal body temperature.
If you’re already tracking your menstrual cycle, you’re already on your way. Once you’ve got your menstrual cycle tracking down, consider tracking things like your basal body temperature or your cervical mucus — things that you’re probably not already tracking.
“The basal body temperature must be recorded from bed before you get up for the day,” Dr. Jane M. Nani, a double board-certified reproductive endocrinologist with Fertility Centers of Illinois, says. “Your temperature will remain consistent, but right before ovulation it will go down, then dip back up – a sign that ovulation is beginning.”
That means that in order for your basal body temperature to give you an indication that ovulation might be headed your way, you probably need to track your temperature for a little while so that you have an idea of what’s normal, because, though you probably learned that 98.6 Fahrenheit is considered “normal,” it can actually vary from person to person (and over the course of the day).
Step 3: Notice the consistency of your cervical mucus (aka discharge).
Another thing that you can track is your cervical mucus. There are a few ways that you can do this. One way is to take a look inside your underwear. “If you notice a thick, slippery mucus similar to an egg white in your underwear or when you go to the bathroom, that is your cervix releasing a mucus, a sign that ovulation is near or occurring,” Nani explains.
The other way allows you to more proactively track what’s going on in your body. “With clean hands, place one finger into your vagina as far up as you can reach, until you feel your cervix,” White explains. “Remove your finger and roll the secretions between your finger and your thumb. Record if the discharge is sticky, wet and watery, creamy, or wet and stretchy like a raw egg white.”
Step 4: Be strategic about when you have sex.
That being said, tracking your cycle doesn’t necessarily mean it’s a sure thing. “Accurate prediction of ovulation can be challenging,” Dr. Barry Witt, medical director with WINFertility and Greenwich Fertility, says. “Since the chance of getting pregnant increases with the frequency of intercourse during the fertile window, increasing the frequency of intercourse beginning soon after the end of the menses and continuing to ovulation is recommended. The chance of pregnancy is highest when intercourse occurs every one to two days. Thus, the only real utility of ovulation detection devices is for those couples that have infrequent intercourse (like once or twice a month), in which case these devices may reduce the time to conception.”
Step 5: Consult an ovulation kit.
If you’re planning to use an ovulation kit to help you determine whether or not you’re truly ovulating, there are a few things you should know. “Some women may be ovulating but the test doesn’t detect the [hormonal] surge — so don’t get too concerned if you have regular monthly menstrual cycles and the kit is never positive,” Dr. Beth W. Rackow, MD, a fertility specialist at Columbia University Fertility Center, says. “But it is definitely worth discussing this with a provider — they can check an ultrasound and blood work to see if ovulation is really happening.”
Additionally, the test may not be fully accurate. “Ovulation detection devices, including kits for monitoring urinary luteinizing hormone (LH) and electronic monitors, are promoted as being helpful to determine the fertile window,” Witt says. “Ovulation usually occurs anytime within two days of a detected LH surge. However, about 7 percent of these detected surges have been found to be false positives that do not actually reflect a true LH surge. These devices tend to be expensive and have not been demonstrated to predict ovulation any better then cervical mucus tracking, and don’t increase the chance of pregnancy over frequent intercourse in the fertile period.”
However, once you think you’ve determined when you might be close to ovulating, “having regular intercourse every other day over the days prior to ovulation is ideal – since identifying the exact timing of ovulation can be difficult, and since sperm can live inside the female reproductive tract for 48 to 72 hours — this way, there are always sperm around in the event that ovulation occurs,” Rackow explains. “And having intercourse with the positive surge and for the next one to two days is also helpful.”
You don’t have to wait to track your cycle until you’re ready to get pregnant.
Just because you’ve not been tracking your cycle before doesn’t mean that it’s too late to start. Nor do you have to wait until you’re at a point where you’re hoping to get pregnant. “There’s no time like the present to start tracking! If you’ve never tracked your body’s signs of fertility, I would recommend using either an app that can organize all the information, or my favorite book Taking Charge of Your Fertility by Toni Weschler, for detailed instructions and pages that you can copy for tracking,” White says. “The more information you record, the better you’ll understand your cycles. You can’t improve your fertility by tracking, but you’ll have good information that you can discuss with your doctor or midwife.”
Ultimately, what tracking gives you is more insight and information about you – and what’s going on in your body. It’s information that then can become talking points with your health care providers, particularly if things don’t seem to be as they should be. And sometimes, just knowing what’s going on can give you serious peace of mind.