Is Your BBT Spike Missing? Confirm Ovulation with Progesterone Testing!
November 5, 2020 | By: Dr. Patti Haebe, N.M.D
Basal body temperature (BBT) is a great way to help confirm ovulation by identifying temperature rises in your body, due to increased progesterone production after ovulation. But what happens if you aren’t seeing this spike? Or what if you missed your temp for a few days, and you can’t see your coverline? Having trouble being consistent with your temping? Or perhaps, you suffer from a thyroid imbalance that affects your basal body temperature.
Why Progesterone Testing?
All thanks to advancements in modern technology, we now have a convenient tool to confirm your ovulation at home!
The best way to confirm ovulation is to look at progesterone levels. Historically, BBT readings or a blood test were the only way to get an idea of adequate progesterone levels. Oftentimes doctors would draw a 21-day progesterone level in hopes of catching progesterone after ovulation. However, this process not only included a drive to the doctor’s office and an uncomfortable needle-stick, but also a potentially missed ovulation.
Ultrasound is another technique that reproductive endocrinology clinics use to visualize and track follicle growth and release. However, not only is this expensive, but it also requires frequent trips to the clinic throughout the menstrual cycle.
But what if you could confirm ovulation at home, cost-effectively, with nearly 100% certainty?
PdG Testing at Home
At home test strips can now test for a urinary metabolite of progesterone called pregnanediol 3-glucuronide, also known as PdG. This gives you the ability to confirm ovulation, regardless of BBT readings.
Research has demonstrated that PdG typically begins to rise 24-36 hours after ovulation. Furthermore, after LH has peaked, if urinary PdG test strips are positive for 3 consecutive days, it can be 100% confirmed that ovulation has occurred -- no more guessing!
These easy-to-use PdG test strips are just like LH and hCG test strips: you simply dip a test strip in a few milliliters of urine and read the results a few minutes later. All three types of fertility tests can be captured, stored and charted through the free Premom Ovulation Tracker app.
PdG strips have also been studied in association with fertile mucus tracking. You are able to simply begin using PdG test strips after the disappearance of highly fertile type mucus, in order to confirm ovulation. Positive PdG is typically detected either 5 days after LH peak or 3 days after the disappearance of fertile mucus.
A Deeper Dive into the Luteal Phase
The luteal phase is the second half of the menstrual cycle and is known to be dominated by the hormone progesterone, the hormone released with successful ovulation. Without ovulation, the presence of progesterone is highly unlikely. (However, this may also be due to other medical conditions.)
Progesterone is responsible for reducing cervical mucus production, increasing body temperature by 04.-1.0 degrees Fahrenheit, preparing the endometrium for fertilized egg implantation, decreasing uterine contractions, and supporting early pregnancy.
The luteal phase can be broken into three phases and is typically similar in length for most women, we can see increasing levels of progesterone through the first two phases of the luteal phase.
- Luteinization Process (early stage)
- Progestation Process (middle stage)
- Luteolysis Process (late stage)
With PdG testing, progesterone levels that are at least 5ng/mL can be detected. With this amount, one can the most confidently confirm ovulation. In research studies, values such as 3ng/ml or 7ng/ml were less likely to identify ovulation. These test strips were designed with research in mind, to get women results that accurately reflect their ovulation.
In general, you can expect PdG levels to be detected 3 days after peak and to be highest 7 days after LH peak. In summary, PdG can be present as early as 2 days after ovulation, but typically presents itself 4-5 days past the LH surge. Consider adding PdG testing into your cycle tracking regimen to help confirm ovulation.
Dr. Patti Haebe is a results-obsessed naturopathic doctor. She specializes in pre-conception preparation, fertility and hormone optimization. She is committed to root-cause healing through therapeutic supplementation as well as targeted diet and lifestyle modifications. Her virtual practice, Ocotillo Integrative Medicine, provides integrative consultations worldwide via webcam for those looking to incorporate natural, proactive approaches to their healthcare and fertility journey. Schedule a consultation with Dr. Haebe right through your Premom app!