In the world of NFP and Fertility Awareness we are focused on one main event, the day of ovulation. Here's how it happens, what to look for and why it's such a big deal.
It's kind of a big deal.
Ovulation is when you ovulate! You can only get pregnant if there is an egg to fertilize, which is only possible when the egg is released from the ovary. Ovulation is one essential ingredient to your fertility because it sets your body up for optimal health before and after the egg is released. It is more than just an egg popping out of your ovary, it's the story of your entire cycle. What goes into that one event is magical, yet scientific.
It starts in the Ovary...
Each ovary has hundreds of thousands of undeveloped little eggs, each living inside a follicle. A follicle is a cyst-like structure full of fluid and a little egg inside.
Each month or so, the pituitary gland in the brain sends a signal to the ovaries for some of those follicles to mature and grow.
As the follicle (or follicles) grows, it makes estrogen.
Once estrogen has risen to a high level and the follicle is fully grown, it ruptures in what we know as ovulation!
After ovulation the follicle changes and becomes the corpus luteum.
The corpus luteum produces progesterone.
The two possible outcomes from ovulation are pregnancy or period.
Seriously, that's your fertility in a nutshell.
Read on for more detail...
Step One: Follicle Stimulating Hormone
This actually happens about three months before you ovulate. YEP! The pituitary gland in your brain tells some follicles in your ovary to start growing. The selected follicles grow in response, but the real fun starts in that third month, the one where the follicle releases the egg.
Step 2: Estrogen
In the final stretch of that follicle's life, the month it releases an egg it does some cool things. First, the follicle makes a lot of estrogen. The follicle itself makes estrogen and releases it into the bloodstream. Blame all estrogen on the ovaries (and a little on the adrenals). Estrogen has many effects on the body, which I will explain in another post, but pertaining directly to fertility, it tells the uterine lining to grow. It also starts preparing our breast tissue for pregnancy. Tender boobs? Blame your ovaries. Logic follows that as the follicle grows it makes more and more estrogen every day so our blood levels go up. When it reaches a certain threshold and that is detected by your brain, it signals the next hormone in this relay: LH or Luteinizing Hormone.
Step 3: Luteinizing Hormone
Luteinizing Hormone or LH is the trigger for ovulation. It doesn't leave the pituitary gland until estrogen has risen high enough. It travels via the bloodstream and sends a message to the ovaries. It is detectable via urine metabolites 24-36 hours before ovulation. LH tells the follicle to rupture and then starts the change of cells of the follicle to transform into something else.
Step 4: Ovulation
The mature follicle ruptures! The egg is released! The fimbria at the end of the fallopian tubes sweep it up and carry it to and through the fallopian tubes, where fertilization can happen. While this step is short and sweet, it took a lot to get here. What it means for the rest of the cycle is crucial as well.
Step 5: Corpus Luteum Formation=Progesterone
After the release of the egg, the follicle remains on the ovary and the cells of the follicle change. It now becomes the Corpus Luteum. Corpus Luteum means "Yellow Body" because it forms a yellow colored structure on the outside of the ovary. The Corpus Luteum does a very important thing: it makes progesterone. Progesterone, like estrogen, has many functions in the body, but in terms of our fertility, it keeps the uterine lining intact, tells the cervix to make a mucus plug and promotes the growth of a baby. The placenta also makes progesterone once it is formed around 12 weeks after conception. The Corpus Luteum has all the progesterone making responsibility up to that point. If pregnancy does not occur, progesterone keeps the uterine lining intact until the brain detects that conception and implantation did not occur and then the corpus luteum starts to shrink and we produce less and less progesterone. Once progesterone levels are low enough, we release the endometrial lining and have what we know as a menstrual period.
Step 6: Pregnancy or Period
The only two outcomes after ovulation are period or pregnancy. If you do not get your period and you are not pregnant, you did not ovulate. Read that again. Maybe once more just to let it sink in. The menstrual period happens if pregnancy does not occur, because progesterone levels drop and the endometrial (uterine) lining sheds. If pregnancy does occur, progesterone rises and we do not bleed. The endometrial lining stays intact because a baby is growing there and we also make a good mucus plug to seal off the uterus with the help of progesterone. A good time to take a pregnancy test is about 2 weeks after ovulation (generally when women notice their expected period did not come).
How to detect ovulation:
To quote Dr. Ann Church from my FertilityCare Practitioner training, "Ovulation can only be confirmed 2 ways, either by ultrasound at the exact time of ovulation where you watch it happen or pregnancy."
Since most of us do not have an ultrasound machine at our disposal several days a month, and might want to confirm ovulation without becoming pregnant, we have Fertility Awareness.
Fertility Awareness and Natural Family Planning are how you detect ovulation. Using various signs like cervical mucus, basal body temperature (BBT), cervical position, urine hormone tests and monitors, there are methods that can catch when ovulation is about to happen and confirm that it did. All of those signs detect the rise in estrogen, some detect LH and then the rise in progesterone. Check out my post on the 3 Main Methods of NFP + FA to see what is out there and what could work for you!
It's a big deal if you aren't ovulating.
Anovulation is simply not ovulating. There are many reasons this can happen. Some may be very natural (the postpartum period or menopause) and not pose a health threat, but many underlying conditions that would prevent ovulation do pose a threat to your long term health. Polycystic Ovary Syndrome, Hypothalamic Amenorrhea, autoimmune conditions, hormone imbalance and inflammatory conditions are examples of underlying conditions that need attention.
If you have been practicing Fertility Awareness or Natural Family Planning, and are not able to detect any signs of ovulation, you can seek help. Either finding a new method that might detect hormone levels more appropriate to your body and lifestyle or seek medical attention to address the root cause of anovulation. Anovulation is one of many issues that can show up on a Natural Family Planning or Fertility Awareness chart, stay tuned for how to chart for health reasons in the future.
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