Ep.1 The Fertility Series: How ovulation and the fertile window work

00:00 - Introduction

00:45 - What ovulation actually is

03:18 - How do I know when I'm ovulating?

05:05 - Should I use an app to track my cycle?

06:55 - Understanding cycle length

07:38 - When am I most fertile?

08:29 - When should I have sex?

09:19 - The importance of progesterone

12:20 - Fertility myth busting

13:51 - Outro

Transcript:

Thalia: You can only get pregnant on ovulation day. True or false?

Gail: That one is false.

Thalia: So we know that a short luteal phase can impede conception. And that's
because of the role of progesterone.

Gail: If you're someone who's been trying for a long period of time, I'd say ditch the apps.

Thalia: Ovulation is probably
the most misunderstood part of the cycle.

Gail: If you're trying to conceive, this one window matters more than anything. I'm Gail Madalena, a registered nutritional therapist with over eight years specialised experience in fertility and preconception health.

Thalia: Fertility is all about timing and most people are working with the wrong assumptions. My name is Thalia Pellegrini. I'm a registered nutritional therapist specialising in women's hormonal health, and I've got more than 15 years experience. Ovulation is probably the most misunderstood part of the cycle, so let's break it down and explain exactly what goes on.

Gail: Yes. So our menstrual cycle is classified as two different phases. In the first part pre-ovulation, you have the follicular phase. This is where your immature follicles in the ovaries are maturing. When you get to the point of ovulation, you'll have a surge of something called LH(luteneising hormone). This is when the more dominant egg will ovulate. Once this has happened you then move into your luteal phase which is the second half. And this is really important when we're thinking about conception. In the luteal phase progesterone is dominant which is a key hormone to support the lining of your uterus, to help with implantation, but also tonmaintain a pregnancy. So it's really, really important to have a balance. And for these two parts of your cycle to be functioning optimally.

Thalia: So we'll talk more about luteal phase later because it's so important. And actually what we see a lot clinically is different lengths of luteal phase which is really normal. So length variation is perfectly normal and we'll talk about how to optimise that luteal phase. But definitely when we think about the whole cycle there are certain nutrients we need to optimise a healthy menstrual cycle.

Gail: Absolutely. We want to be having a balanced diet so we're getting good diversity of these nutrients. But key things to focus on are things like B6 which is fantastic for hormone balance and modulation and making sure that the levels of progesterone and oestrogen are optimal. Zinc is also really important for ovulation. You also want to think about your B vitamins, specifically Folate and Choline, which are really, really important for early foetal development in pregnancy.

Thalia: Absolutely. And that's why we always recommend if you're trying to conceive, always think about a specifically designed pre-conceptual multi nutrient which will be different to a standard multi.

Gail: Absolutely. A fertility specific multi is going to be higher in certain nutrients like Folic Acid. It's also more targeted to support egg health and hormonal health which are all fundamentally important for preconception. Also a multi is really there to plug any gaps from a diet. You might not be getting all of these key nutrients in enough levels and quantities to really support the foundations of preconception.

Thalia: And those are all the nutrients that sit at the core of our Fertility Support for Women. So let's talk about the best ways to track ovulation. So the key one, the big one, the shining light is...?

Gail: Well, I think most people will know about is ovulation sticks - a dipstick in urine that tests for LH, and that's that surge hormone that promotes ovulation to occur. And that typically will happen about 12 to 24 hours before ovulation actually happens. So it's a really good indicator that it's coming and that's a great time to have intercourse. There are lots of other ways to establish what's going on with your body.

Thalia: So in terms of what the body's doing, that you can see, the key one is cervical mucus.

Gail: Absolutely. And this is one where once you tune into it you really can start to identify it. I don't know about you, but in my youth I never knew what it was. I didn't know. And it does change throughout your cycle. Typically after your period you're much drier. And as you move closer to ovulation it will go to a more creamy consistency. And then just before ovulation, it's that clear, egg white consistency. And that's what we're really looking for as a clear clue that ovulation start to happen.

Thalia: And other ways you can track your ovulation include taking your temperature.

Gail: This one's a bit more challenging. Youreally have to make sure you're doing it first thing in the morning. So very easy to forget if you're in a rush. It's also quite variable, you know, if you are sick or you haven't had a great night's sleep, it can feed into it. But this coupled with, tracking apps, for instance, can be a really good way to pinpoint ovulation. It gives you a bit more data and a bit more information to look at what's going on, cycle to cycle.

Thalia: I think you mentioned apps there, which is really useful, and I think so many women use apps to track their cycle. And what we always say in clinic is that apps predict but bodies confirm. So if you're new to an app, there's not that much data in there that you've recorded so far. So just be aware that it may not be 100% accurate. So really tuning into your body and paying attention to what your body is telling you is arguably as valuable or more valuable.

Gail: I think the key thing with the apps is it's an algorithm. It's using past data. So the more data you give it, the more accurate it will become. But it's never 100% accurate. So it can give you an idea, an indication. And if you're using it alongside things like your cervical mucus, for instance, that can be a really useful tool. But there's a danger with apps to become too obsessive,they can really take over your life and dictate what's going on in terms of your fertility journey. So if you're someone who's been trying for a long period of time, I'd say ditch the apps. If you know your cycle, then it's much better to put that to one side because it can become a bit overbearing, it can add stress, and it can also add a lot of stress to your partner as well.

Thalia: It's so valuable to tune in as a woman to what your cycle is doing and just being aware of it, because your cycle will not be the same every month, and not every woman has a 28 day cycle. There might be a difference of a couple of days each month, and that can affect ovulation. so actually things like that, cervical mucus signs are so important to tune in to.

Gail: Yeah. And I think a lot of women will also get, you know, some twinges some some light pain cramping very normal. And that's also another sign that you're ovulating. So there are definitely subtle things when you're looking that you can tune into.

Thalia: So we often get asked if I've got so 26 or 28 day cycle, when should I expect to be ovulating?

Gail: Yeah, it is a really good question. And I think as we've mentioned, it's highly variable. We want to be ovulating somewhere at the midpoint. So if we've got, you know, a 28 day cycle, then we're hoping somewhere around day 14, day 15. If you've got a slightly longer cycle, you know, something like 32 days, then you know, it moves just a little bit. So day 16, day 17. As long as it's somewhere in that midpoint and your luteal phase, so day of ovulation up to the day your period begins. As long as that's over ten days, then that would still be in the realms of being a normal cycle and consistent for fertility.

Thalia: So if we, as we've just discussed, the time in the month when we are most fertile is around the middle. So depending on the length of cycles, probably somewhere between 14 and 16 days. But there are other considerations and variations to that, which just complicates things a little bit. So that would probably be, um, how long your period is, for example, and a few other things as well.

Gail: Yeah. I think, you know, the key thing is your cycle length. You know, if you're someone who's got a very short cycle, so 22 days, for instance, you may be ovulating at day ten. And if you think the lifespan of sperm is about five days, if you're having sex, you know, very shortly after your period, during your period, even then, you could get pregnant, you know, right off the bat of having your period. But that's quite a small minority of people, you know. Most people, it's about two weeks after they've had their period.

Thalia: So in consultations, we're often asked, when is the best time to have sex if we're trying to get pregnant?

Gail: Yeah, probably one of the most, most asked questions. Um, and I think, again, obviously once we've identified ovulation, which we've spoken about. Really, we're looking at the kind of four days prior and the day of ovulation as our peak fertile window. As mentioned, you know, sperm, typically healthy sperm will live up to five days. And if you've got really good cervical mucus as the woman, that can mean that that has a higher chance of getting to the egg alive and functioning. So really you're looking at those four days prior and the day of ovulation. I would say that, you know, the day before is your optimal peak day. You really want the sperm to be up there waiting when that egg matures and ovulates.

Thalia: So in consultations, one of the key things we're going to ask a woman is when we're looking at her menstrual cycle is how long is her luteal phase? So we know that a short luteal phase can impede conception. And that's because of the role of progesterone. So let's talk about how important progesterone is for a healthy menstrual cycle. And when we're trying to conceive.

Gail: I mean it's fundamental. It's the hormone really. Whilst others play a role. Progesterone is the key driving factor of thickening the uterine lining and really providing that environment that's supportive of implantation and also supportive of maintaining a pregnancy. If someone's going on to have multiple miscarriages and early miscarriages, I would especially be looking at progesterone levels and making sure that that's sufficient. And when it comes to luteal phases, you know, we touched on ideally being longer than ten days. So anything shorter than ten days. Again, I would be worried that progesterone might be the driving factor.

Thalia: So when we're looking for indications from menstrual cycle, the progesterone might be a little low. One of the key ones for us would be spotting for your period. So if you're spotting for your period starts, that can be maybe an indication that your progesterone is a little low at the end of your cycle. And that might have implications if you're trying to conceive.

Gail: Yes, absolutely. That is a fundamental one. And also, you know, irregular cycles and changes, variability in cycle length, can also be a factor of low progesterone as well.

Thalia: So we talked a little bit earlier about nutrients that support that luteal phase. So the key one that I always go to is vitamin C. So we know that vitamin C can be really helpful for supporting that progesterone in the second half of your cycle. So from a dietary perspective that is, you know, fresh fruits and vegetables, lots of antioxidants. But that's one of the reasons that vitamin C is key in a pre conceptual multi.

Gail: Yes absolutely. And alongside you know progesterone whilst it is very important and the hormone we're really looking at. You do also have to factor in oestrogen levels as well throughout your cycle because it's also that ratio, you know, looking at the balance between oestrogen and progesterone. So still thinking about nutrients like B6 which is going to modulate the two. You know, we still want to be supporting things like our energy metabolism. So our B vitamins and things like choline are still really important. And so it's not any one thing in isolation.

Thalia: And it's not just about we always say food first. It's not just about your supplements. So in terms of food we've met, you know, fruit and vegetables for your vitamin C, whole grains for your B vitamins, nuts and seeds.

Gail: Green leafy veg you know, really important.

Thalia: So the foundation is your healthy diet and making sure you're getting all those nutrients where you can through your food.

Gail: Yeah. But I think, you know, we're all human and you can't have a balanced diet 100% of the time. And that is where a preconception supplement really supports and can just aid alongside what you're eating.

Thalia: So the fertility support for women has all those nutrients really targeting that healthy menstrual cycle across the whole cycle, including the luteal phase.

Gail: Yeah, 100%.

Thalia: We hear a lot of myths about trying to conceive in consultations. What's the one you hear most? 

Gail: I mean, there are there are a few, but I'd say definitely, you know, do I ovulate on day 14? Because that's what the GPS will say. Day 14. Day 14. The answer is no. That is a myth. Women are hugely individual and variable, so absolutely not. It can be individual to that person.

Thalia: So I get asked a lot. You can't get pregnant on your period. Isn't that right? And it's a tricky one because it's really unlikely. But theoretically you could if your cycle is short, you ovulate very early, so and you have quite a long bleed. So yeah, if all of these things in perfect combination, you could, but it's really rare.

Gail: Very rare. But you're right, there could be someone out there that has.

Thalia: What about regular cycles mean perfect timing? I hear that a lot.

Gail: Yes. Now, having a very, very similar cycle length each month. It's great. That's a really healthy sign. But actually what we want to know is, are you ovulating and how long is that luteal phase? You know, because you might be having a 28 day cycle, but if you're ovulating on day 21, 22 or much later in your cycle, that's not ideal for fertility.

Thalia: And you can only get pregnant on ovulation day. True or false?

Gail: That one is false. There is our fertile window. And really it's that five day period. And so four days pre ovulation and then the day of ovulation.

Thalia: So to wrap up this segment, what we'd really love you to take away is the fact that there's no such thing as a perfect cycle. And also tuning into your body is very important. So you can understand what your body is telling you. And that's going to really help optimise your chances of conception.

Gail: We speak to over 1200 women a month, so we're also here for you. And you can book a free consultation via our website at Wild Nutrition. In our next episode, we're going to get into the gritty details of laying the foundations for preconception.