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When It's Time for Fertility Testing

Charting Your Cycle

After going through your medical history and having a physical examination, your healthcare provider will sit down with you to discuss the next step. The tests are done in phases, usually starting with the least expensive and possibly the one that may be specific to what your healthcare provider suspects is going on. Although these phases may come in a different order for each woman, the safer, simpler, and least expensive ones usually come first.
If you haven't already been charting your cycles, your healthcare provider may ask you to chart your basal body temperature and use an ovulation detection kit. Fertility testing will largely be timed based on your menstrual cycle. One of the simplest ways to monitor your cycle is by charting your basal body temperature (BBT), which is your body's lowest temperature of the day. So why would you need to check your BBT?
Basically, after a woman ovulates, her body temperature increases by one-half to one degree due to the secretion of progesterone. This small change in body temperature is most evident by measuring your BBT. Measuring this temperature helps to estimate if and when you have ovulated and can also help to estimate the length of each phase of the cycle.
You can measure your BBT by using a good-quality thermometer that reads to at least a tenth of a degree. You do not necessarily have to invest in a "basal thermometer," although those are also available. To chart your BBT, you will want to start on the first day of your period (day 1 of your chart). Take your temperature first thing in the morning, as soon as you wake up and before you get out of bed (this is your true basal body temperature). Keep the thermometer by your bed and record your temperature every morning as soon as you wake up. Record your BBT on a chart, along with the date.
After charting your BBT for at least a couple of months, your healthcare provider will be able to review your chart and determine whether you are ovulating and if you are having intercourse at the appropriate time in your cycle to maximize your chance of conceiving. This chart can also help to determine whether there was enough time following ovulation for an embryo to implant before your period started again.
Not all healthcare providers will recommend charting your BBT, as it does have some disadvantages. One of the biggest disadvantages is that the temperature shift does not predict ovulation, as it occurs after ovulation has already happened. In some cases, your healthcare provider may recommend using a kit to better predict when ovulation is about to occur.
These kits monitor for an increase in luteinizing hormone (LH), which briefly and dramatically surges in the middle of your cycle, causing the ovary to release an egg. Conception is mostly likely to occur within 36 hours following the LH surge. Using the ovulation kits to test for this can help you time sexual intercourse at the optimal time.
Last reviewed by: Arthur Schoenstadt, MD
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