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   Ovulation and Fertility frequently asked Questions and Answers
             
  What is the difference between the menstrual cycle, uterine cycle and the ovarian cycle?  
 
 
           
 
 
The menstrual cycle is the rhythmic female reproductive cycle characterized by physical changes in the uterine lining. The reproductive cycle can be divided into an ovarian cycle and a uterine cycle. The length of the menstrual cycle is 28 days on average. However this can vary from cycle to cycle and is different for every woman. The length of the cycle is determined by the day of ovulation.
 
The uterine cycle is the first phase of the reproductive cycle, the time when the endometrial lining builds up and the follicles develop. Other terms used for this phase are follicular or oestrogenic phase. This part of the cycle lasts from Day 1 of menses to ovulation and its length can vary considerably.
 
The ovarian cycle is the second or last phase of the reproductive cycle. If no implantation occurs, it causes the breakdown of the endometrial lining and causes menstruation. Other terms used for this phase are luteal or progestational phase. This part of the cycle lasts from ovulation to the last day before the new period begins. It usually has a limited lifespan of 12-16 days.
             
  Menstruation or menses is the discharge of blood and tissue from the uterus at the end of the menstrual cycle. Menstruation or menstrual period
 forms a normal part of a natural cyclic process occurring in healthy women between puberty and the end of the reproductive years.
             
  What is ovulation? Why is FSH (Follicular Stimulating Hormone) and LH (Luteinizing Hormone) levels important?
 
             
  During every cycle, under the influence of FSH (Follicular Stimulating Hormone) about 15 -20 eggs start to mature in each ovary. Each egg is
encased in its own follicle. The follicles produce oestrogen, the hormone necessary for ovulation to occur.
   
  These follicles develop and mature during the uterine cycle and within a few days’ one dominant egg or fertile ovum are released by bursting of
a follicle. Ovulation is the rupture of an ovarian follicle with the release of a fertile ovum.
   
  The primary factor that determines how long it will take before you ovulate is how soon your body reaches an oestrogen threshold. High levels
of oestrogen will trigger an abrupt surge of LH (Luteinizing Hormone). It is the LH surge that causes the egg to literally burst through the ovarian
wall, usually within a day or so after the LH surge.
   
  After ovulation the second phase, ovarian cycle, starts when the egg enters the fallopian tubes in preparation for fertilization and implantation,
under the influence of progesterone.
   
  Following the release of the egg, the burst follicle that held the egg, collapses on itself becoming a yellow body called the “corpus luteum”.
The corpus luteum starts releasing progesterone. Progesterone stops the release of any other eggs until the next cycle.
   
  The corpus luteum has a limited life span of about 12 to 16 days with an average length just over 12 days. This is the luteal phase.
  In summary:
 
  • The uterine cycle is the first phase of the reproductive cycle, the time when the endometrial lining builds up and the follicles develop. Other terms used for this phase are follicular or oestrogenic phase. This part of the cycle lasts from Day 1 of menses to ovulation and its length
    can vary considerably.
  • In the follicular phase the follicles develop and the dominant follicle is selected to develop to full maturity. This is the pre-cursor for ovulation. Follicles themselves secrete FSH (Follicular Stimulating Hormone) and oestrogen, and these two hormones stimulate follicular growth and development.
  • The ovarian cycle is the second or last phase of the reproductive cycle, if no implantation occurs it causes the breakdown of the
    endometrial lining and causes menstruation. Other terms used for this phase are luteal or progestational phase. This part of the cycle lasts from ovulation to the last day before the new period begins. It usually has a limited lifespan of 12-16 days.
  • Approximately every 28 days, during ovulation, an ovary sends a tiny egg into one of the fallopian tubes. Unless the egg is fertilized by a sperm while in the fallopian tube in the two to three days following ovulation, the egg dries up and is excreted by the body about two
    weeks later through the vagina. This process is called menstruation.
  • Ovulation marks the beginning of the luteal phase. The ruptured follicle is turned into a gland (corpus luteum) that secretes progesterone. Ovulation is marked by a surge in plasma LH (Luteinizing Hormone) levels.
  • The length of the menstrual cycle is 28 days on average. However this can vary from cycle to cycle and is different for every woman.
    The length of the cycle is determined by the day of ovulation.
  How do rapid diagnostic tests assist you in getting pregnant?    
 
 
             
  Rapid diagnostic ovulation screening tests such as U-Test Ovulation can predict when there is a LH (Luteinizing Hormone) surge and in turn
when a woman is likely to ovulate (ovulation) and when you are likely to conceive.
             
  U-Test Ovulation test detects LH at levels of 20 mIU/ml. This means that the U-Test Ovulation test is a very sensitive rapid diagnostic test for predicting ovulation. This test is very helpful in family planning.
             
  FSH (Follicular Stimulating Hormone) stimulates follicle development. A rapid diagnostic fertility screening test such as U-Test Fertility will
indicate that the FSH levels are high which indicates possible menopause or declining fertility.
   
  U-Test Fertility test detects FSH at levels of 25 mIU/ml. This means that U-Test Fertility test is a very sensitive rapid diagnostic
 test for indicating fertility. This test is very helpful in family planning.
   
 
 
  What are the signs of ovulation and how do you test for ovulation or know when you will ovulate?  
 
 
                     
  Rapid diagnostic ovulation screening tests such as U-Test Ovulation can predict when there is a LH (Luteinizing Hormone) surge and in turn
when one is likely to ovulate.		  
     
  U-Test Ovulation test detects LH at levels of 20 mIU/ml. This means that the U-Test Ovulation test is a very sensitive rapid
diagnostic test.		  
     
  In addition to a LH surge, the female body produces outward signs that can easily be recognized at the time of ovulation. The two main signs
 are changes in the cervical mucus and a slight change in body temperature.		  
     
  Changes of the cervical mucus  
Cervical fluid is to a woman what seminal fluid is to the man. Since men are always fertile, they produce seminal fluid continually. Woman, on the
other hand, are only fertile for the few days around ovulation.
     
  Cervical fluid provides an alkaline medium to protect the sperm from the acidic vagina provides nourishment for the sperm to survive for up to 5
days and functions as a medium to move in. Without cervical fluid sperm will die!		  
     
  After menstruation and just before ovulation, a woman will experience an increase of cervical mucus. At first, it will be thick and yellowish in colour
 and will not be plentiful. Leading up to ovulation, it will become thinner and clearer. On or around the day of ovulation, the cervical mucus will be
very thin, slippery, clear and stretchy. The most fertile cervical fluid can be compared to the consistency of raw egg whites. The most important
 feature of extremely fertile cervical fluid is the lubricate quality.		  
     
  Fertile cervical fluid may leave a symmetrical, round pattern of fluid on your underwear due to its high water content.  
     
  Temperature change  
     
  A woman can also tell the time of ovulation by taking her basal body temperature daily.  
     
  The temperature is taken with a very sensitive thermometer first thing in the morning before the woman gets out of bed. The temperature is then
tracked to show any changes. In the uterine cycle, a normal temperature will be around 36.1° – 36.7°C. The day of ovulation the temperature
spikes downwards, usually to the 35.6° – 36.1° range. The next morning it will rise up to normal of around 37° and stay in that range until
menstruation begins.		  
     
  Temperatures typically rise within a day or so after ovulation and are the result of the release of progesterone. By definition, the rise in
temperature signifies that ovulation has already occurred.		  
     
  What are the limitations of an ovulation predictor diagnostic test?  
 
   
                     
 
  • Rapid diagnostic screening tests for ovulation should be used in conjunction with the visible signs the female
    body produces at the time of ovulation – changes in the cervical fluid and basal temperature – as part of detecting
    the most fertile time in the reproductive cycle.
  • The test tests for Luteinizing Hormone (LH) surge that precedes ovulation. It does not indicate whether you
    have ovulated or not.
  • Woman with PCOS (Polycystic Ovarian Syndrome) may produce false LH surges that are not indicative of impending
    ovulation. PCOS is a common endocrine disorder that usually leads to irregular cycles and hormonal problems,
    during which developing follicles often remain
    trapped inside the ovary, later becoming cysts.
  • The test is only accurate when used correctly. Read and follow all the instructions carefully.
    Always store and transport the tests at the correct temperature as indicated on the package insert and packaging.
    Excessive heat can damage the test.
  • The recommendation for testing on day 3, 4 and 5 is based on the average female cycle of 28 days.
    Woman with irregular cycles or long cycles should not start testing their urine for ovulation until they
     notice a rise in the excretion of their cervical fluid. This will ensure that the
    test is done at the most appropriate time around ovulation.
  • Women over 40 and women approaching menopause might have elevated levels of Luteinizing Hormone (LH) that are
     not indicative of ovulation. It is recommended that the LH test should be done in conjunction with FSH testing for
     fertility or menopause.
  • If you happen to be pregnant at the time of testing for ovulation (LH), the test will indicate that you are not ovulating,
     and will give a negative result.
  • Some fertility medications such as Pergonal and injections containing hCG (human Chorionic Gonadotropin)
    will invalidate the results of
    these tests. Clomid, however, does not have this effect.
  
  When is a FSH test useful?        
 
           
 
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  Follicle Stimulating Hormone (FSH) tests can provide useful information to women seeking pregnancy or who are concerned about their fertility,
ovarian health and function.		  
     
  It is recommended for women experiencing irregular menstrual cycles or finding it difficult to conceive to determine if this is related to elevated FSH levels or not.  
     
  FSH tests are commonly used to evaluate a woman’s egg supply, assist in evaluating menstrual problems, irregular or absent menstrual periods
 and to evaluate fertility, peri menopause and menopause.		  
     
  FSH testing for fertility should be carried out on Day 3 of the menstrual cycle (two days after the onset of menstruation).  
 
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