How to Know If You Are Ovulating Regularly With PCOS

Many women who have difficulty conceiving would probably agree: Finding out the reason is crucial to ending the frustration.

Polycystic ovary syndrome (PCOS) can make it difficult to conceive by affecting your menstrual cycle and ability to ovulate. But rest assured: There are ways to check if you are ovulating.

Learn more about how PCOS can disrupt the menstrual cycle and how to tell if or when you are ovulating.

PCOS and Ovulation

The menstrual cycle begins when a particular hormone is secreted in the brain. This ultimately causes an egg follicle in the ovary to begin growing.

Two main hormones are involved in this process. The first is follicle stimulating hormone (FSH), which stimulates the maturation of an egg. The second is luteinizing hormone (LH), which triggers ovulation, or the release of the egg.

A woman with PCOS tends to produce excess androgens, or male hormones. As a result, a woman's menstrual cycle and ovulation can be affected.

Her cycles may be irregular or longer than normal. Or they may not occur at all. She may or may not ovulate in a given cycle. These irregular cycles make it difficult to know when ovulation is occurring, if at all.

This will affect a woman's ability to conceive. And in the United States, this is a common problem. Nearly 19% of women between the ages of 15 and 49 are infertile, the Centers for Disease Control and Prevention says. (Infertile is defined as being unable to conceive after a year of trying.)

About 26% of women in the same age group have trouble getting pregnant or carrying a fetus to term. This condition is called "impaired fecundity."

Signs That You Are Ovulating

Having regular periods is one sign of ovulation. You can find out if and when you are ovulating to maximize your chance of conceiving a baby by:

• Purchasing an ovulation prediction kit. It can detect elevated levels of LH, which surges right before ovulation. Women with PCOS tend to have high levels of LH. So a kit may not be as reliable for them as they are for other women.
• Taking your basal body temperature: Another way to determine whether you're ovulating is to measure your temperature while at rest. Between one and three days after ovulation, your basal body temperature will increase by around one degree due to a surge of progesterone. To ensure accurate results, use a digital thermometer as soon as you wake up and before you get out of bed.
• Checking your cervical mucus: A woman's cervical mucus changes throughout the course of her monthly menstrual cycle. At the start of her cycle, her cervical mucus will be dry. When cervical mucus is wet or the consistency of raw egg whites, ovulation may be approaching. 
• Determining your cervical position: Your cervix also goes through changes throughout the course of your monthly menstrual cycle. You can reach inside your vagina to feel your cervix. If you are able to feel your cervix fairly easily, you're usually not close to ovulating.

Using one or more of these techniques can help you know when to time sex properly if you are trying to conceive. The "fertile window" typically begins five days before ovulation and lasts for about a day after. However since ovulation timing may vary you may want to start trying about a week before you ovulate and continue trying a few days after you think you ovulated.

Get to know your body each month and try these techniques. They can maximize your chance of conceiving.

If You're Not Sure

If you don't get clear signals that you're ovulating, see a doctor and get an evaluation. You may need help regulating your menstrual cycles or getting pregnant.

Typically, a fertility specialist or a reproductive endocrinologist will do a full hormonal workup, gather a detailed medical history, and possibly do an ultrasound. These steps can help determine if and when you are ovulating.

Summary

Polycystic ovary syndrome causes hormonal changes that can make your menstrual cycle irregular and interfere with ovulation. This can make it hard to know if and when you are ovulating.

There are certain tests you can do yourself to try to predict ovulation, so you can time sex appropriately for the best chances at conception. If you're still having trouble, a fertility specialist or your obstetrician-gynecologist can help.