Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov test — the first and only FDA-cleared test to confirm successful ovulation at home.
Written on 3/12/21
Keep reading to learn more about ovulation quality, the different ways you can ovulate, and how Proov helps you have the best ovulation each cycle.
Did you know that not all ovulation is created equal? And that it’s possible to ovulate well...and not so well?
That’s right — ovulation quality comes in many different forms. This means there’s actually more than one way to ovulate and that yes, some ovulation is better than others!
Keep reading to learn more about ovulation quality, the different ways you can ovulate, and how Proov can help you understand your ovulation quality as well as next steps on what to do about it.
Why is ovulation important?
Ovulation is a critical piece of the trying to conceive puzzle. Without a successful ovulatory event, it can be more difficult to get pregnant.
In fact, problems with ovulation are the leading cause of infertility. While many people believe “problems with ovulation” simply means lack of ovulation, you can actually have a “poor quality” ovulation. Poor quality ovulation can also be a cause of infertility.
So what is “high quality” ovulation?
We’re so glad you asked! We like to think of quality ovulation as a “successful” ovulation. You see, after an egg is released from a follicle, that empty follicle (also called the corpus luteum) produces progesterone.
Progesterone is the hormone that not only confirms ovulation, but is necessary for stabilizing the uterine lining and making it “sticky” enough for the implantation of an embryo. Progesterone is named for its vital role in conception and pregnancy (pro-gestation), so it’s no surprise that without enough progesterone following ovulation, it can be more difficult to conceive.
High quality or successful ovulation occurs when an egg is released and progesterone levels rise and remain elevated for long enough after ovulation to allow for the best possible chance at conception. A poor quality ovulation would occur if there is not enough progesterone present or progesterone levels drop too soon after ovulation.
Above all, a higher quality ovulation leads to a better chance at conception!
High quality or successful ovulation occurs when an egg is released and progesterone levels rise and remain elevated for long enough after ovulation to allow for the best possible chance at conception.
Can a progesterone blood test assess my ovulation quality?
By now you may be wondering, “Why test PdG in urine when you can test progesterone in blood?” Great question! While progesterone blood tests can confirm that you did or did not ovulate, they miss providing information about your ovulation quality.
This is because progesterone blood tests only show serum progesterone levels at one point in time. But we know that progesterone must rise and remain elevated in order to allow for the best possible chance at conception.
It’s entirely possible to have progesterone levels rise to an adequate level, yet drop entirely too soon, leading to a shortened luteal phase and poor ovulation. But, if you only tested progesterone levels on cycle day 21, you wouldn’t know if this were the case.
Additionally, serum progesterone levels have been shown to fluctuate. This means that in the same 24-hour period, your progesterone levels could be as low as 2.3 ng/ml or as high as 40.4 ng/ml. Depending on what time of day you test, you could get pretty different results, leading to inaccurate assumptions about your levels.
One way to address this is to get multiple blood tests over several days during your luteal phase and take the average of these results. But who wants to get poked with a needle more than necessary!?
The other solution? PdG tests!
The original Proov tests measure PdG (pregnanediol glucuronide), which is a urine metabolite of progesterone. After progesterone circulates through your blood, it is metabolized by your liver and expelled from the body as PdG in urine.
With PdG tests, not only can you non-invasively test levels multiple days in a row, but studies show that PdG levels in first morning urine (after at least a 6 hour hold) show an average of the previous day’s progesterone levels. Proov PdG tests make it easier to assess the overall quality of your ovulation.
How does Proov track ovulation quality?
With Proov, you can not only confirm that ovulation occurred but can also tell you how well you’re ovulating. Your Proov results give you powerful information to help you assess the overall quality of your ovulation to get pregnant faster.
The Proov protocol suggests taking 5 PdG tests throughout one cycle. First, you’ll want to take a baseline negative test the day after your period ends. You can take this test anytime between cycle day 5 and your peak fertility date. It will be negative but be sure to snap a picture of it between 5 and 10 minutes of processing as it comes in handy when reading test results later in your cycle!
Next, you’ll want to test for peak fertility using the ovulation prediction method of your choice. If you choose Proov LH tests, you’ll want to start testing 18 days before your next suspected period. As you near your suspected ovulation day, you may want to start testing twice a day in order to catch the LH surge.
After you observe peak fertility (i.e. get a positive LH test), you’ll want to count out 7 days and test with Proov PdG on days 7, 8, 9, and 10 past peak fertility. After getting results from the whole testing window, you can understand your ovulation status:
- Successful Ovulation: 4 positive Proov tests during the 7-10 days past peak (DPP) window or 3 out of 4 positives with a positive on day 10 past peak.
- Weak Ovulation: 7-10 DPP test lines lighten vs. the baseline test but never disappear, or only 1-2 positives during the testing window.
- No Ovulation: 7-10 DPP tests are negative with no change vs. baseline.
After getting your Proov results from the whole 7-10 days past peak testing window, you can understand your ovulation quality.
**Please note that the above chart is not representative of all possible Proov outcomes.
How do I interpret my ovulation quality?
Ideally, you’ll want to see 4 positive Proov PdG tests during the 7-10 days past peak fertility testing window. We consider this a successful ovulation.
However, sometimes it takes until day 8 past peak fertility to get a positive result. If you get positive PdG tests on days 8, 9, and 10, but day 7 was negative, we still consider this a successful ovulation.
Additionally, some women may experience small dips in PdG levels that result in a slightly negative Proov PdG test on day 8 or 9. As long as just one of those days is negative (meaning you still have three positives), we also consider this a successful ovulation.
Ideally, you’ll want to see 4 positive Proov PdG tests during the 7-10 days past peak fertility testing window to confirm successful ovulation has occurred.
How do I increase my ovulation quality?
The most important part of tracking consistently days 7, 8, 9, and 10 past peak is understanding the quality of your ovulation so that you can make improvements. First and foremost, we recommend taking your Proov results to your doctor.
These are some of our favorite ways to improve ovulation quality:
1. Functional foods
While foods don’t directly contain progesterone or PdG, there are some that can help increase production and improve ovulation quality, including:
- Brussel sprouts
- Whole grains
Additionally, the practice of seed cycling is a great way to naturally balance hormones and improve ovulation quality. Seed cycling involves eating certain seeds during certain phases of your cycle to promote hormone balance. During your follicular phase, flax and pumpkin seeds help promote estrogen production, while sesame and sunflower seeds promote progesterone production during the luteal phase.
Many vitamins contain micronutrients that can help improve ovulation quality, such as B vitamins (including 1, 2, 3, 5, 6, and 12), vitamin D, vitamin E, folate, magnesium, zinc, and copper. If you have specific questions about which vitamins you should be taking, we recommend consulting your doctor.
Many herbal supplements have been shown to increase progesterone levels and ovulation quality. Some of our favorites include vitex (chaste tree berry), maca, and ashwagandha.
Sometimes, supplements that support healthy estrogen levels can be helpful as well. These include wild yam, red clover, and antioxidants like pomegranate, grape seed, cinnamon, and black currant extracts. Before adding supplements, we always recommend consulting your doctor.
4. Prescription-level progesterone support
If you have poor ovulation or are not ovulating at all, we recommend consulting your doctor. He or she should be able to work with you to find an effective treatment, whether that be a prescription-level progesterone supplement or ovulation inducing medication. Luckily, your Proov results contain powerful information that you can share with your doctor to ensure you get the best possible treatment!
After or as you continue to make changes to improve your ovulation, we recommend continue to test with Proov PdG tests to see if your efforts are working. Please note that baseline tests are good for up to 6 cycles, so no need to take one every cycle.
We are so excited to support you throughout your journey to YOUR best ovulation! Feel free to reach out with any questions at firstname.lastname@example.org or join our private community of Proovers like yourself.