September 30, 2020 | By: Dr. Patti Haebe, N.M.D
Interpreting chart information, made easy!
When you first sit down to look at a Premom chart it can look a bit overwhelming, but together we are going to discuss how each of the pieces fit together to provide you with your fertile picture! You’ll learn how to use LH strips, take your basal body temperature, look for fertile mucus and time intercourse.
For starters, it’s essential that you are tracking your symptoms each day -- the more information you can record and the more consistent you are, the better the information you can glean from the chart.
The app will help you track the following information throughout your cycle:
- Ovulation Tests / LH Strips
- Basal Body Temperature (BBT)
- Cervical Mucus
- Symptoms you may have experienced
Premom LH Strips - Purple Handle
This is what makes Premom uniquely effective compared to other fertility apps and ovulation test strips!
Quantitative Premom LH Strips test your urine for something called Luteinizing Hormone (LH), which is secreted by your brain and triggers follicle maturation and release from the ovary. These strips are different from others, in that they show a quantitative level of LH, meaning it tells us the quantity of LH that is present each day, going beyond just identifying its presence. Keep reading to learn why this unique quality is so important for conception!
What are we looking for?
LH begins to rise over the course of a few days and finally surges drastically 24-36 hours before you actually ovulate. This is what makes this hormone a good indicator that ovulation is about to occur and allows you to time intercourse accordingly!
We are looking for the darkest, positive ovulation test over a series of days to help zero in on your most fertile window. When you are using your Premom test strips, they are QUANTITATIVE, meaning we can keep an eye on the increasing quantity of luteinizing hormone that is present. This variation in LH levels allows us to be more targeted in identifying ovulation!
Ensure that you have good, consistent lighting when taking photos of your LH strips with your phone. Use your best judgement when comparing test strips and retake photos as necessary to ensure the photos accurately reflect the color variations that you are seeing. Learn more tips for the best picture-taking results here.
The strips will begin to darken as the presence of LH hormone increases, so begin testing about 5-7 days before estimated ovulation. (See chart below in Tips For Success: LH Strips to ID what day you should begin testing, dependent on your cycle length).
When trying to conceive, you are looking for the darkest test line in a series of strips, which indicates your LH surge (often around 25-65 miU/mL) and tells you ovulation should occur in the next 24-36 hours. See below for timing intercourse!
After the darkest strip, you will notice a quick decline (lightening) in LH levels. If LH strips are lighter and lighter 2 days in a row, you know that you’ve already had your peak and have likely already ovulated, missed your ovulation or perhaps did not ovulate this cycle. Use a confirmatory method along with your ovulation testing to confirm ovulation has occurred.
Cervical Mucus (CM)
It may sound strange but, your vagina is just like your nose! It creates mucoid secretions just like your nose does. This mucus can tell us a great deal about what is going on with your hormones! Cervical mucus is greatly affected by hormonal changes, and when we know what to look for, it can provide us information about our fertile window.
What are we looking for?
Cervical mucus ranges from dry, to white/sticky, wet like a drop of water and slippery like raw egg whites. Egg white consistency, slippery, stretchy mucus is what we are looking for to indicate ovulation is near! This is a great sign of fertility and indicates elevated estradiol levels prior to an LH surge which means ovulation is just a few days away!
When you pinch egg white cervical mucus between your thumb and pointer finger, it will stretch in a thin strand between the two fingers! This mucus creates a physiological ladder for sperm to easily swim up through the cervix, and deep into the uterus/fallopian tubes where it will hopefully unite with an egg. Track your cervical mucus at least once each day and record in the Premom app. It’s easiest to check by taking a peek at your panties or taking a look at the toilet paper after wiping post-urination.
When you feel that slippery cervical mucus, it’s a great time to begin intercourse to ensure sperm are present before ovulation! Learn more about cervical mucus here.
Basal Body Temperature -- Blue Line
What are we looking for?
Progesterone is the hormone secreted by the ovaries (corpus luteum) AFTER an egg has been released. When progesterone levels increase, we can feel confident that you ovulated (released an egg). Progesterone increases body temperature; we are looking for this increase in temperature as depicted in your chart to confirm ovulation. Your temperature will likely increase at least 0.2 degrees Fahrenheit (0.11 in Celsius) higher than the past 6 days, after you ovulate. This temperature increase is what we are looking for to confirm ovulation.
Your temperature will also likely remain high throughout early pregnancy due to the presence of progesterone. When the temperature remains at that elevated level after ovulation, it is often a good indicator of early pregnancy. If a pregnancy did not occur -- or progesterone levels were insufficient -- you will see it slowly trickle back down to baseline by the time your period begins. (Learn more here.)
Putting It All Together!
Fertile Window- Light Purple Circles
Through all of your diligent tracking and our application’s mapping, you can now see your fertile window as evidenced by the light purple area. Refer to the timeline highlighted in light purple to see when you are most likely fertile. It’s important to have intercourse within this timeline.
By performing intercourse prior to ovulation, it allows the sperm time to swim through the cervix, up to the top of the uterus so that they can be present for fertilization when an egg is released! So when you feel that slippery cervical mucus and notice your LH strips beginning to darken, it’s a great time to begin intercourse. Be sure to have intercourse as you see your LH strips darken during the LH surge!
Fertility research most conclusively supports intercourse every single day for a 6 day period ending on the day of ovulation. So, dependent on your cycle, it is advisable to begin intercourse when you notice a darkening of your Premom ovulation tests and to continue at least one day past your darkest strip!
You may also be noticing that you are actually considered “fertile” before you’ve ovulated!
This may be earlier than you had thought. However, it’s important for sperm to be present ahead of time in the uterus, as they survive 4-7 days, while an egg may only leave 24-36 hours.
Concerned about having intercourse too often?
Research suggests no negative correlation on successful conception when engaging in daily intercourse during your fertile window!
A Few Things To Note
As you’ve discovered, the female menstrual cycle is quite complex, and things can get confusing when BBT and LH strips don’t seem to follow the above pattern. Using period start and stop dates are a great place to start in predicting your fertile window, but it’s important to rely on your quantitative LH strips, cervical mucus changes and BBT to confirm that ovulation is actually occurring. This is what makes Premom more advanced than other cycle tracker apps and gives you confidence in what is actually occurring in your body.
It is possible that you do not ovulate some cycles. This is consistent with LH that never peaks, no slippery mucus or BBT that never spikes. Also, be aware it is possible to have a period without ovulating. So, if there aren’t signs of ovulation but you still get a period, a period alone does not confirm that you ovulated.
If this is the case, and you aren’t seeing a pattern in your testing, you’ll need to do some work to get your hormones cycling properly and investigate what the cause of your imbalance is. Could it be stress? PCOS? Overexercising? Excess alcohol consumption? Inflammation? Or just an anovulatory cycle?.
It takes time to get to know your menstrual cycle, so the sooner you can begin tracking, the better. It often takes about 1-3 cycles to get accustomed to your cycle and uncover your fertility pattern.
EXTRA TIPS AND TRICKS FOR SUCCESS:
Tips For Success: BBT
1. Keep your thermometer on your bedside on top of an alarm or on top of your phone or glasses. This way, you will feel the thermometer before you get out of bed and hopefully use it.
2. Don’t brush your teeth or drink coffee until you’ve taken that temperature.
3. If you miss a day, don’t stress; just pick right back up the next day. It takes some getting used to.
Tips For Success: LH Strips
Step 1: Determine your cycle length: Day one of bleeding during your period is considered “Day 1” of your cycle. Use the chart below to figure out which day to begin testing dependent on your cycle length.
Step 2: Begin testing your afternoon urine starting on the designated day: Test every day until you see a significant darkening of the strip! Use the “automatic” camera setting in the Premom app to record your ovulation test results; simply tap the camera icon on your homescreen. Enter your strips everyday; you are looking for a light rose-colored line to turn into a darker more intense rose-colored line. The darkest line shows us when the LH “spikes,” triggering ovulation 24-36 hours later.
When you get this significant darkening of the strip, it’s a great day to have intercourse. If you haven’t already, you are likely ovulating in the next 24 hours, and it’s important sperm are already present when the egg is released. Do your best to keep water intake consistent while testing; over-hydration and dehydration can effect results.
HCG Pregnancy Testing: How and When Will I Know I am Pregnant?
HCG (Human Chorionic Gonadotropin) is a hormone produced by the developing placenta shortly after conception and is secreted in the urine. HCG levels are detectable on a pregnancy test around 10 mIU/mL . This means you need to wait about 10-14 days post ovulation for hCG levels to develop enough to show positive on a pregnancy test. 10-14 days after ovulation you may perform a urinary hCG pregnancy test; use the FIRST urination of the morning, as it is most concentrated, and the test will be more likely to pick up on the hCG.
If You Get A NEGATIVE Pregnancy Test
Keep testing every 2 days until you get a positive or until you get your period. You may get a negative one day and then a positive the next day -- that just means you tested too early to demonstrate adequate hCG levels for the test to pick up.
If no color appears and your period comes, don’t be discouraged. Even with perfect conditions, pregnancies are only likely to occur around 30% of the time. Try, try again!
If You Get A POSITIVE Pregnancy Test
Any pink is positive! HCG does not exist without a pregnancy. A double pink line no matter how faint, can be considered positive with any color change. Keep testing, and the line will darken as HCG levels continue to increase. Be sure to record your test result into the Premom app and switch over to our pregnancy mode to track your pregnancy week by week.
Congratulations! Time to call your OB and make an appointment.
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.
Godbert, Sonya, et al. “Comparison between the Different Methods Developed for Determining the Onset of the LH Surge in Urine during the Human Menstrual Cycle.” Archives of Gynecology and Obstetrics, vol. 292, no. 5, 2015, pp. 1153–1161., doi:10.1007/s00404-015-3732-z.
Wilcox, Allen J., et al. “Timing of Sexual Intercourse in Relation to Ovulation — Effects on the Probability of Conception, Survival of the Pregnancy, and Sex of the Baby.” New England Journal of Medicine, vol. 333, no. 23, 1995, pp. 1517–1521., doi:10.1056/nejm199512073332301.