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 11/24/20
What is ovulation and when does it typically occur?
If you’re familiar with Proov, you may have heard us use the term “successful ovulation.” While successful ovulation is a fairly new concept, it can make a huge difference when it comes to getting pregnant. This is why confirming successful ovulation is so important! Let’s dive in.
Ovulation is the release of a mature egg from a follicle in the ovary. The egg travels to the uterus through the fallopian tubes. An egg is only viable for approximately 12 to 24 hours, and if it meets sperm and fertilizes, conception has occurred.
Ovulation should happen each cycle. We start every cycle with a certain number of antral follicles. Under the influence of follicle stimulating hormone (FSH) some of these antrals start to grow, with the ovary recruiting the “best egg” from the lead follicle.
As it grows and matures during the first half of your cycle, the egg produces estrogen — the hormone responsible for stimulating the follicle so the egg is released, also called a luteinizing hormone (LH) surge. Once the egg is released from the follicle, progesterone is produced from the same follicle and nourishes and prepares the uterine lining for implantation.
In an average 28-day cycle, ovulation usually occurs around day 14. But every woman and cycle is unique, so tracking LH and determining your peak fertility day can give you a better understanding of exactly when you ovulate!
Ovulation is critical when trying to conceive because irregular or absent ovulation is one of the most common causes of female infertility.
Why is ovulation important?
Ovulation is a sign of health because it implies proper endocrine function. Unless pregnancy, lactation, or menopause are in the picture, irregular ovulation patterns may signal a greater health disorder. If you suspect you have irregular ovulatory patterns, we recommend consulting your doctor.
Ovulation is critical when trying to conceive because irregular or absent ovulation is one of the most common causes of female infertility. In fact, ovulatory disorders are the cause of infertility in about 25% of all infertile couples. Without the presence of an egg, conception is not possible. But even if ovulation is occurring, if it’s not doing so successfully, it can still be very hard to conceive.
What is successful ovulation?
Ovulation is considered “successful” when an egg is released and PdG (pregnanediol glucuronide), otherwise known as a progesterone metabolite, levels remain elevated for long enough to allow for the best possible chance at conception. Progesterone is the hormone responsible for stabilizing the uterine lining and making it receptive to an embryo.
After the ovary releases the egg, the corpus luteum (also known as the empty follicle), produces enough progesterone to support the implantation and development of the fertilized embryo.
How do I know if ovulation was successful?
To make sure your ovulation has been successful, you first need to test your LH levels so that you can predict when ovulation is going to occur. You then need to make sure your progesterone stays at an optimal level throughout your luteal phase, the second part of your cycle.
One of the most common fertility myths is that progesterone levels should be tested only on cycle day 21. However, cycle day 21 progesterone tests assume that a woman ovulates exactly on day 14. Since every woman and cycle is different, we know more often than not this doesn’t hold true!
Cycle lengths may vary anywhere between 21 to 40 days and we know that progesterone levels rise 7 days past peak fertility day. Therefore the best way to test these levels is to first make sure you have had a positive LH test, then wait 7 days, then test for progesterone.
Progesterone testing through blood draws doesn’t give you the full ovulation picture.
How do I test my progesterone levels?
There are a few ways you can find out if progesterone levels are high enough to support implantation. The most well-known method is to measure serum level progesterone by taking a blood draw in a doctor’s office.
However, studies have found that the corpus luteum actually secretes progesterone periodically. Progesterone levels can fluctuate up to 8 times in just 90 minutes and range anywhere from 2.3 to 40.1 ng/mL during a 24-hour period. This means that you could get very different results if you were to test progesterone at 8 am versus 3 pm, which could give you an inaccurate assumption about your levels.
So is there a better way to confirm successful ovulation?
Enter Proov and its inventor, Dr. Amy Beckley!
Being aware of serum levels fluctuations, and having dealth with a luteal phase defect and early miscarriage herself, Amy thought women would benefit more from being able to check their progesterone levels several times during the luteal phase, to make sure they stay above the adequate level (5ug/mL or 10ng/mL) in order to confirm successful ovulation.
But for many of us, visiting a lab for blood tests twice a day, several days in a row is not only invasive, but also unrealistic logistically and financially. This is why Proov was invented! Proov measures PdG, a progesterone metabolite that is metabolized by the kidneys and releases into urine. For more reading, you can check out this study on how PdG and serum progesterone levels correlate.
Proov allows you to test PdG levels in the comfort of your home with results in just 5 minutes. Testing on days 7, 8, 9, and 10 past peak fertility can let you know if you’ve successfully ovulated, which is critical when trying to conceive. Using first morning urine for testing gives you an average reading on your PdG levels, which gives you a more complete picture of your progesterone levels compared to a blood draw.
How common are problems with ovulation?
Sadly, too common! The failure to ovulate occurs in just under 40% of women. And even when ovulation occurs, if progesterone levels are low, luteal phase defect can be responsible for up to 10% of infertility cases and as much as 25% of early miscarriages.
Using Proov to help answer your ovulation questions
Tracking with LH and PdG levels with tests like Proov is a reliable way of understanding when you are most fertile and the overall success of your ovulation. With Proov’s Predict & Confirm kit, you can finally get the full ovulation picture with just one test kit.
The Predict & Confirm kit comes with 15 LH strips so you can test twice a day in order to track your peak fertility day more frequently to make sure you catch your LH surge. It also comes with 5 PdG test strips so you can confirm if you’ve successfully ovulated. Testing PdG, a progesterone metabolite, on days 7, 8, 9, and 10 past peak fertility can give you a better picture on ovulation and potentially rule out — or address — an ovulatory disorder that may be an issue for why you may not be conceiving!
At Proov, we are passionate about providing important information and essential education so women can be empowered to have better conversations with their doctors and ultimately reach their fertility goals faster.