What does it mean to be fertile and how do you know if you are?

Are you a “fertile Myrtle” or someone who will have trouble getting pregnant? Unfortunately, this information is not tattooed on your body for you to know off hand. And, many women don’t think about their fertility until they feel ready to start a family. It’s at this time that you are desperately searching for signs of whether you are fertile or not.

But what does “being fertile” mean, exactly? Scientific definitions of human fertility include a person’s physical capability of reproducing and producing offspring. For a woman, this would be the ability to regularly ovulate an egg and for the uterus to be able to carry a baby. Unfortunately, we cannot know these things just by looking at you. Ovulation can’t be seen with the naked eye. And you may not know whether your uterus is suitable to carry and deliver a child until you actually get pregnant.

In the absence of this, we look for signs of fertility throughout your cycle that you may be ovulating. In addition, your doctor can conduct medical tests for fertility that look at your hormone levels, ovaries and uterus.

Physical signs that you are ovulating

What should you be on the lookout for to give you hints at being fertile or not? There are many physical signs that you can be aware of throughout the month that give an indication of whether or not you are ovulating.

• Regular menstrual cycles: Having regular menstrual cycles every 21-35 days apart can be a sign that you are ovulating.
• Cervical mucus changes: During the nonovulation phase of your cycle, your cervical discharge may appear sticky, cloudy or fairly minimal. But as you get closer to ovulation your produce more estrogen. This increase in estrogen causes changes in your cervical mucus. It becomes clearer and more stretchy, similar to egg whites.
• Basal body temperature (BBT) increase: BBT is your lowest body temperature recorded after a period of rest. Tracking your BBT before getting out of bed in the morning may show a slight rise after ovulation. A sustained increase in BBT for several days can indicate ovulation.
• Mid-cycle spotting: After ovulation, your estrogen levels drop significantly before rising again. This short-lived drop in estrogen may trigger some mid-cycle spotting in some women.
• Breast tenderness: Right after ovulation, your body produces the hormone progesterone which, in turn, can cause your breasts to be sore or have a heavy feeling.
• Increased libido: When you enter your most fertile window right after ovulation, your sexual desire rises due to the jump in hormones in your body.
• Lower abdominal pelvic pain: Some women can actually “feel” when the ovary releases an egg. A sharp, lower abdominal cramp or pain during the middle of your cycle can mean you ovulated.

Tests that can indicate fertility

Aside from the often-subtle physical signs that you may feel around ovulation, there are several tests, over-the-counter or at your doctor’s office, that can help you determine if you are fertile.

• Ovulation predictor kit (OPK): Luteinizing hormone (LH) spikes just before ovulation. When used correctly, over-the-counter OPKs are generally reliable for detecting this LH surge and your fertile window over the next few days. However, OPKs only test your urine for LH and cannot confirm that you actually ovulated.
• Blood tests: Your gynecologist or infertility specialist can conduct several blood tests critical for fertility. These include anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), and progesterone.
• Transvaginal ultrasound: Ultrasound imaging of the uterus can check for fibroids or ovarian cysts as well as count the number of small follicles on your ovaries (antral follicle count).
• Saline ultrasound or hysteroscopy: These procedures can provide more in-depth views of the inside of the uterus, detecting fibroids and determining the shape of the uterus.
• Hysterosalpingogram (HSG): This X-ray test uses special dye to check the shape of your uterus and if the fallopian tubes are open.

Our fertility specialists often combine multiple tests to get a complete picture of your fertility. Having this information helps them determine the next steps and the best treatment options should you have difficulty getting pregnant. Contact us if you are ready to learn more about your fertility.