Track that ovulation cycle, but make sure it’s accurate.
Here’s how doctors assess fertility: There’s your basic physical exam, including blood tests to check your hormone levels and screen for STIs. According to where you are in your menstrual cycle, there might also be tests for follicle stimulating hormone (FSH), and luteinizing hormone (LH),which regulates the menstrual cycle and egg production as well as progesterone and estradiol levels. Depending on the situation, your doctor might order a transvaginal ultrasound, an endometrial biopsy, or a hysterosalpingogram (it checks out your fallopian tubes).
You can study your own fertility at home, in the form of ovulation predictor kits, which allow you to see when you’re ovulating so you can determine the best time to conceive.
“For the most part, these are reliable,” says Dr. Wendy Chang, an OB-GYN fertility specialist with the Southern California Reproductive Center. “But you get what you pay for. Ovulation predictor kits will vary, with many kinds missing the most crucial window if they are not sensitive enough. While good hydration is important, occasionally we encounter women who drink far more than 2 1/2 liters of water per day. They may be more prone to get a false negative on their ovulation predictor kit testing.”
“Ovulation tests are great if your menstrual cycle is regular,” says Josie Bouchier, Holistic Health Coach for The Whole Woman and Expert at The Tot. “But if you have PCOS, or a short ovulation window, or you’re over 40, your LH surges vary, and therefore the test could be inaccurate.”
Bouchier recommends the fertility awareness method, a scientifically valid way to track your menstrual cycle. The method involves taking your basal body temper, evaluating your cervical fluid, and being aware of the position of your cervix, Regardless of whether or not you’re trying to get pregnant, Bouchier urges learning fertility awareness.
“Knowing that you ovulate on day 19 versus day 2 of your cycle takes the guesswork out of it,” she says. “It’s the difference between looking at a blinky smiley face on a test and understanding what’s actually going on in your body. Once you know what’s going on, you’re in a much better position to be an advocate for yourself.”
There are a few at home fertility tests Bouchier and her colleagues suggest. If you’re super serious about testing (as opposed to just learning about your cycle), Clearblue Advanced Digital Ovulation Test looks for LH and estrone-3-glucuronide to give you a wider range of days when you might try to conceive. If you only want to test your LH levels, WondFo offers an ovulation test that’s inexpensive and turns results around in five minutes.
Wendy Chang notes that some folks opt for saliva ferning tests, like Fertile-Focus, an ovulation predictor that detects the estrogen spike that precedes ovulation, known as ferning. Chang advises using a urine test to check for the presence of LH along with the salivary test, if you’re going to go that route, to see if the results are consistent.
Fertility tests, when accurate, give you a read on how you’re doing right now in terms of ovulation and hormones, and suggest when you might proceed with attempts at conception. But if pregnancy is further down the road for you, there’s an at home test that can help you learn what your fertility looks like at the moment.
Modern Fertility founders Afton Vechery and Carly Leahy developed their at home fertility test after realizing for themselves how complicated fertility is. The test gets you out in front, so to speak. The test allows you to “check in” on your fertility, so you can know what you’re dealing with before you try to get pregnant.
As Vechery learned when she went to get fertility testing herself, blood tests render the most accurate assessment of what’s happening now, and what might happen in the future. She and Leahy are “building the test we want,” in order to bridge the knowledge gap about fertility before thinking about pregnancy begins to happen. The test, which is personalized according to your birth control method, provides information about ovarian reserves (the capacity of your uterus to produce eggs), ovulation, and hormone levels. You order the test, send in your samples, and receive results in a few days in the form of a “fertility score,” as well as lab results you can share with a doctor.
“It’s a tool for thinking about your reproductive timeline more broadly,” says Vechery. “You can get access to information now that you might not uncover until later.”