SYMPTOMS

Anovulation is when egg or "oocyte" is not released from the ovary. Normal ovulation occurs monthly from alternating ovaries. The oocyte develops in a small fluid collection in the ovary called a "follicle" and ovulation occurs when this follicle ruptures. Usually one oocyte is released every month. A small gland in the base of the brain called the "pituitary gland" regulates ovulation.

DIAGNOSIS

You may be slightly confused by the outcome of your self-assessment of ovulation. Do not despair even your doctor may be uncertain when you show him the results of especially the basal body temperature chart. Special investigations will shed more light in doubtful cases.

1. Serum progesterone assessment
   The pathologist takes blood on request from your doctor approximately 7 days after ovulation for progesterone assessment. There are different views on what the minimum normal ovulatory levels are. Usually a level of more than 30 nmol/l is regarded as an optimal result.

2. Ultrasound evaluation
   Examination of your ovaries before and after ovulation to detect the presence of a follicle and its subsequent disappearance is the best way of assessing ovulation since ovulation day can be accurately predicted once the size of the follicle is known. However, you will only find adequate ultrasound equipment for this purpose at Infertility Clinics and some Gynaecologists' consulting rooms.

3. Endometrial biopsy
   This relatively painful procedure is only rarely performed by your doctor to identify subtle hormonal disorders associated with ovulation abnormalities. A small sample of the uterine lining is obtained by means of a thin plastic needle and is assessed by a Pathologist.

IMPORTANT FACTS

1. Ovulation does not equal pregnancy. If everything is normal and you have intercourse at exactly the right time the chance of pregnancy is roughly 25%!!!

2. The best way for you to determine the optimal time for conception is by evaluating your cervical mucus by means of the Billings method. Your finger is placed through the vagina until the cervix is touched (feels like the tip of your nose). The mucus is then examined by rolling your forefinger and thumb together and stretching the mucus as far as possible. When the mucus is clear, stretchable and slippery ovulation is close.

3. Sperm will survive for approximately 12 hours and the oocyte 48 hours. It is therefore advisable to have intercourse every 2nd day during the fertile period.

4. Do not think that by abstaining in order to “get the sperm build up” will improve your chances. Indeed, abstinence for more than 2 – 3 days may be disastrous for sperm quality in certain circumstances.