Ovulation is the most important piece to the getting pregnant puzzle

The Physiology of Ovulation

Prior to Ovulation, each egg cell is housed inside of a protective sheath called a follicle. The follicle-stimulating hormone and luteinizing hormone, both produced by the pituitary gland, stimulate the development of the egg within the follicle. This growth takes place in several follicles at the same time. Over the course of several days, one follicle will develop further than the others and become the dominant follicle. As this follicle grows in size, it migrates from deep within the ovary until it reaches the ovarian wall. Once there, the walls of the follicle thin and fluid develops. Mounting pressure from a both the fluid and egg within the mature follicle cause bulging along the border of the ovary. The thinning follicular wall will rupture resulting in ovulation as the egg is released from the ovary.

What is ovulation tracking?

Ovulation Tracking is the use of diagnostic ultrasound to image the development and rupture of a dominant follicle. Ovulation Tracking requires several appointments per menstrual cycle. At these appointments, women will have a transvaginal ultrasound which will be interpreted by board certified, Massachusetts licensed radiologists who are accredited by the Joint Commission.

Women often spend a lot of time trying to prevent pregnancy not realizing how much time it actually takes to successfully become pregnant. There is a lot of misconception surrounding the female menstrual cycle and the most fertile days for conception. When a couple makes the decision to start a family, ovulation prediction is a big deal. If you don’t know when you’re ovulating, it is impossible to know when it is likely to become pregnant. Nothing can make you more obsessed with science and technology than the biological urge to reproduce. Unfortunately, nothing makes fulfilling this desire more difficult than your own body. You’re most fertile in the two to three days before ovulation. By timing intercourse around ovulation, couples can exponentially increase their odds of bringing a sperm and an egg together when conception is most likely to occur. Cue the invention of the ovulation predictor kits (OPKs)!

Why Ovulation Predictor Kits are Frustrating

In a perfect world, these kits would infallibly detect ovulation and ovulation would inevitably lead to pregnancy! The reality is much more complicated. OPKs indicate a surge of a hormone that is present in the body prior to ovulation. It does not, however, indicate that ovulation actually occurred. Many women find themselves in a frenzy peeing on a stick, often timing bathroom breaks at work to try to catch that elusive hormone surge, which can occur anywhere from 10 hours to 8 hours after day 10 of your menstrual cycle! The fertile window that these kits hint at is sometimes just too vast!

The Centers for Disease Control and Prevention reports that about 7.3 million women in the United States aged 15–44 years have difficulty getting pregnant[1] That means that the market is wide open for something that will make the technology of this frustrating, anxious process a bit further into the 21st century. OPKs are a $40 million dollar business in the United States, so if you are having difficulty tracking ovulation, you are not alone! Often times there is nothing “wrong” with couples that are having trouble conceiving. Many couples simply struggle with timing. We are here to be the bridge for couples trying to conceive before they are referred to IVF or reproductive endocrinology.


Let’s break it down in terms of the percentages….

Serial ultrasound imaging in the early to mid or late follicular phase can map the fate of a follicle as it grows. At any given time during a menstrual cycle, the chances to conceive are between 20-22%. With ultrasound guided ovulation tracking, the percentage of successful conception leaps to 76% in just one cycle of ovulation tracking! The numbers increase to 98% at 6 months of ovulation tracking[2].

Irregular or abnormal ovulation accounts for 30% to 40% of all cases of infertility[3]. Some women ovulate much later in their cycle than day 14, which is considered to be the most common cycle day for ovulation. “The most common cause of late ovulation is a luteal phase defect indicated by poor follicle production, failure of the uterine lining to respond to normal levels of progesterone, or premature demise of the corpus luteum. Stress, illness, or excessive exercise can also be a cause for some women. This is most commonly the cause of sporadic lateness or the occasional missed egg”[4]. At Perfect Timing Ultrasound we do not diagnose fertility. We simply help to narrow down your fertile window so your chances for successful conception are greatly improved! If you or someone you know is having difficulty trying to conceive, but do not qualify to see a specialist, Perfect Timing might be able to help!


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[1] https://www.cdc.gov/features/7things-womens-health/index.html


[3] https://www.webmd.com/infertility-and-reproduction/irregular-periods-and-getting-pregnant#1

[4] https://www.wisegeek.com/what-is-late-ovulation.htm