Women who get their periods every 24 to 35 days are probably ovulating normally, says Lynn Westphal, MD, a reproductive endocrinologist and an associate professor at Stanford University School of Medicine. "A regular cycle is one of the clearest signs that your hormones are working properly and releasing an egg each month," she says.
Aside from cycle length and predictability, being able to detect your body's subtle clues that ovulation is actually occurring each cycle is a good sign. (Plus, knowing the exact window of time when you ovulate is the best way to time your babymaking sex to boost your pregnancy odds.) Most women ovulate 14 days before their next period. (In a 28-day cycle, that means day 14. In a 32-day cycle, that means day 18.) But unless your cycle's totally regular from month to month, it's hard to know for sure.
Using an ovulation predictor kit (OPK) or charting your basal body temperature is a better way to determine when you actually ovulate. OPKs work by detecting levels of luteinizing hormone (LH) in your urine (this hormone surges one to two days before you ovulate). Since your body temperature spikes very slightly around ovulation, tracking your temperature first thing in the morning is also another, though less precise, way to pinpoint ovulation.
Weighing too much or too little can make you more likely to have fertility problems (although heavy and thin women do get pregnant all the time). In overweight and obese women, excess body fat can disrupt the delicate balance of hormones needed for ovulation and helping a new embryo develop and thrive into a healthy pregnancy. On the flip side, women with too little body fat may have difficulty getting pregnant because their bodies are conserving energy to keep the rest of the body functioning properly; this can shut down ovulation.
In many cases, having a normal menstrual cycle is the most important clue you're fertile, regardless of what you weigh. But losing or gaining weight to reach a healthy body mass index (ideally 20-24) before you start trying to get pregnant is a smart move when done in a healthy way and will help you have a healthier pregnancy, labor and postpartum recovery too.
Symptoms like pelvic pain or extremely painful, heavy, or long periods are often the main signs of fibroids or endometriosis, although many women don't discover these conditions until they run into difficulty getting pregnant. While having fibroids or endometriosis may increase your risk of fertility problems, having them is no guarantee you won't be able to conceive eventually.
Fibroids are benign tumors in the uterus that affect 20 to 40 percent of women, but their size and location are what have the biggest impact on fertility problems. Fibroids that jut out into the uterus may disrupt the embryo from implanting and developing properly; other growths may not have any impact at all. If fibroids are uncomfortable or affecting your fertility, they can be removed with outpatient surgery.
About five million women in the U.S. have endometriosis, in which the uterine lining grows on organs outside of the uterus, such as the fallopian tubes or ovaries. This can lead to scar tissue that prevents your egg from being released or getting fertilized normally. Taking birth control pills or having outpatient surgery may reduce endometriosis.
Certain bacterial infections, like chlamydia and gonorrhea, can spread to organs throughout the reproductive tract, causing pelvic inflammatory disease (PID). This infection can cause serious damage to your ovaries, fallopian tubes, and other organs, significantly increasing your risk of infertility. While PID may have symptoms like fever, vaginal discharge, pain during sex and urination, and irregular menstrual bleeding, the infection goes unnoticed by women and their doctors about two-thirds of the time, according to the Centers for Disease Control and Prevention. If you've never been tested for these STDs, ask your ob-gyn to screen you now. Antibiotics can treat the infection and prevent further damage.
We don't need to tell you that a cigarette habit is bad for your health, but you should know that smoking can damage your eggs and derail ovulation, increasing the time it takes you to get pregnant and the risk of miscarriage if you do. Those odds go up even more if your partner smokes too.
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