When does ovulation occur at 28. How to calculate the menstrual cycle and the date of ovulation? What does late ovulation mean?

Any woman needs to know what day of her cycle ovulation usually occurs. This will help plan your pregnancy. Moreover, you can try to choose the gender of the child if you know exact days for conception.

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It is ovulation that makes it possible to become a happy mother, so you should understand what day of the cycle it begins on. If female body healthy and working like clockwork, problems with calculations the right day will not arise. Otherwise, you will have to resort to the help of specialists.

It happens that a woman has calculated the day on which she should begin long-awaited ovulation, but she didn't come. This means that there is some kind of malfunction in the body and you need to urgently consult a doctor. Let's take a closer look at this issue.

Every woman needs to know

When to expect this phenomenon

After ovulation, a mature egg leaves the follicle to merge with a sperm. He, in turn, lives a maximum of 7 days, and usually no more than three. Life cycle eggs is 12-24 hours. Therefore, you need to calculate on what day of the menstrual cycle a woman ovulates.

There are several main points:

• menstrual cycle must be counted from the first day of menstruation of the past month to the first day of the next menstruation;
• the egg may not mature if there is any disruption in the woman’s orgasm, the problem will have to be solved by an experienced gynecologist;
• you can start counting on what day of your cycle the long-awaited ovulation should occur, but your period does not come, in this case you also need to contact a specialist.

If there is no suitable time

You can scrupulously calculate on what day ovulation will occur when the cycle lasts 27-29 days, but it never comes. This usually occurs due to problems in the hypothalamic-pituitary-ovarian axis. Dysfunction is caused by:

• genetic factor;
• inflamed genitals;
• stress.

It could also be due to any infection, affecting menstruation, or climate change when traveling on vacation. Research by scientists has led to an unexpected conclusion. It turns out that it doesn’t matter what day ovulation occurs, if the cycle is 25-26 days, the egg will be released from the ovary only if the woman has at least 18% body fat. Estrogen accumulates in them and the androgen hormone, which is responsible for the process, is converted. Thus, a lack of hormones leads to serious problems: absence of menstruation. However, a similar thing can happen if a woman has overweight bodies.

Testing for sexually transmitted infections

It also happens that a woman is confident in her health, so she calculates on what day of her menstrual cycle the long-awaited ovulation will occur, but it does not occur. There's nothing to worry about here, because this phenomenon happens even to absolutely healthy women. The number of such anovulatory cycles increases every year. For example, up to 30 years old their number is 2-3 per year, and for 40 years old it is already 4-8.

In any case, you need to find out the reason for what happened. It is necessary to undergo examination by an endocrinologist or gynecologist to get advice or competent treatment. Most likely you will have to:

• undergo an ultrasound examination of the ovaries, pancreas and thyroid gland;
• take tests for the presence of sexually transmitted infections, hormone levels;
• take blood and urine tests.

If ovulation is not observed for more than a year, although sex life occurs regularly, treatment is prescribed. Doctors usually prescribe the medication Clostilbegit. This medicine includes hormones that stimulate the desired process.

The medication is quite effective. According to statistics, 15% of women became pregnant during the first month, and another 50% in the second month.

You should not carry out treatment yourself. Therapy should proceed under the vigilant supervision of a physician so that he can monitor the body's reaction. Otherwise there is a risk of developing serious complications. Before prescribing a medication, a woman needs to undergo an examination and be sure to take several tests:

• blood test to check immunity to rubella;
• patency of the fallopian tubes;
• cultures to detect gardnerella, mycoplasma, trichomonas, ureaplasma, chlamydia, candida;
• smear for oncocytology;
• analysis for hepatitis group C, B;
• test for HIV, syphilis.

During the appointment, the doctor tells the patient on what day of the menstrual cycle the process of ovulation stimulation should begin. Usually the drug is taken from days 5 to 9 of the cycle. If additional stimulation is carried out using Puregon, then from 3 to 7 days.

Therapy with these drugs should not exceed 6 courses in a row. Otherwise, ovarian depletion may develop, which is dangerous. early menopause. When treatment does not bring the desired result after the third course, the doctor usually reconsiders the treatment methods.

Premature release of the egg

Sometimes ovulation occurs ahead of time. This happens for a number of reasons.

1. Various pathologies.
2. Strong physical activity.
3. Climate change, lifestyle change or severe stress.
4. Sudden weight gain or loss.
5. Drug treatment.

These factors are not always noticeable to a woman. She continues to live as before, but a hormonal imbalance begins in the body, which can affect the duration of her period, as a result of which the egg is released earlier than expected.

Long-awaited pregnancy

This shift in the body will not affect your health in any way unless you are planning to become pregnant and are not using calendar method for contraception. However, the early release of an egg can be a surprise in several cases:

• IVF is prescribed, so medications must be taken strictly after ovulation;
• you think it is impossible to conceive a child after menstruation.

If you have a cycle of 33 days or more, it is very important to calculate on what day ovulation begins so as not to miss so much an important event. To do this, you need to closely monitor your well-being and body signals. Need to.

1. Measure your basal temperature regularly. It is best to measure it at the same time and record the readings in a notepad.
2. Monitor vaginal discharge.
3. Conduct special tests that can detect a surge in luteinizing hormone.
4. Conduct an ultrasound examination to assess follicle growth (folliculometry).
5. Take tests to track hormone levels (FSH, LH, progesterone, estradiol).

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Attention!

The information published on the website is for informational purposes only and is intended for informational purposes only. Site visitors should not use them as medical recommendations! The site editors do not recommend self-medication. Determining the diagnosis and choosing a treatment method remains the exclusive prerogative of your attending physician! Remember that only full diagnostics and therapy under the supervision of a doctor will help you completely get rid of the disease!

As you know, in the body of every healthy woman of childbearing age, a process such as ovulation occurs. Ovulation is the release of a mature egg from the ovary into the fallopian tube. Ovulation usually occurs in the middle , and lasts about several days, after which, in case of fertilization male sperm, the woman becomes pregnant, and if the egg is not fertilized, it “dies” and the woman begins menstruation. The ovulation cycle occurs according to the principle: “The longer the cycle, the later the ovulation.” But how can you correctly calculate your periods and the date of ovulation?

How to calculate your menstrual cycle and ovulation date?

It is believed that 4-5 days before ovulation and 1-3 after it are better days to conceive a child. Therefore, for some women this is a kind of “protection” from unwanted pregnancy, and for others who want to have a child, taking advantage of their chance at happiness.

The most the easy way Doctors usually call special ones for calculating the day of ovulation, which are sold in regular pharmacies. They must be done in the middle of the cycle, counting the first day of the cycle as the date of the start of menstruation. For example, if your last menstruation began on October 15, then starting from October 27-28, you should start doing these tests.

The principle of their “work” is the same as that of pregnancy tests - a woman dips a test strip into her morning urine and gets the result - tests must continue to be done until the second strip becomes as bright as the first. When both stripes become the same bright color- this means that ovulation has reached its peak, and it is important at this moment not to miss your chance.

The most budget-friendly, but also time-consuming way to calculate the ovulation cycle is to measure basal temperature. How to measure? Every morning, for at least three months, without getting out of bed, you must insert ordinary thermometer V anal hole, and when the numbers after 36.5-37 degrees on it show from 37.1 to 37.5, it means the day of ovulation has arrived. This ancient method is most suitable for women with an already regular menstrual cycle, and is not suitable for very young girls and those women whose cycle is regulated by various oral contraceptives.

And finally, the ultrasound diagnostic technique. Experienced doctor An ultrasound, even on an old machine, can easily determine the condition of the follicles in the ovary or corpus luteum, . However, it is not always possible to resort to this particular diagnosis.

The shortest cycles in women occur due to disorders hormonal levels, and average only 21-23 days. However, the longest ones - about 34 days - are also a kind of violation. Let's look at each menstrual cycle and ovulation cycle in detail.

The cycle is 22-23 days. When is ovulation?

A menstrual cycle that lasts only 22-23 days is considered lower limit norms in women, and is associated primarily with hormonal disorders or diseases of the pelvic organs that cause frequent bloody issues. But it also happens that for a woman this is a variant of the norm, however, it is not possible to conceive a child with such a short cycle, since for such a short time the embryo cannot fully form and attach to the wall of the uterus. With such a short cycle, ovulation usually occurs a few days after the end of menstruation.

Cycle 25 days. When is ovulation?

With a 25-day cycle, it is also difficult to get pregnant, since it takes about 14 days for the embryo to develop and attach. The day of ovulation in such a cycle should be counted as follows: 25 (duration of the entire cycle) - 14 (mid-cycle) = 11 (day of ovulation).

Ovulation in a 26-day cycle

If a woman with such a cycle wants to get pregnant, then she simply needs to measure her basal temperature for several months and buy tests, since “catching” the right moment is already more possible, but still difficult. However, you usually need to calculate the ovulation date using the same scheme. With a 26-day cycle, it occurs on days 14-16 of the cycle.

The menstrual cycle is 28 days. When is ovulation?

The menstrual cycle of 28 days is standard and most favorable for conception. In healthy women, such a cycle indicates that they are ready for pregnancy. Usually the ovulation cycle in this situation does not have “jumps”, and strictly three days before and after ovulation, that is, from days 11 to 17, a woman can safely become pregnant.

The cycle is 29 days. When is ovulation?

A 29-day cycle is also considered normal, and ovulation can also occur from days 11 to 17 of the menstrual cycle.

The menstrual cycle is 30 days. When is ovulation?

With such a long cycle, just like with a very short one, it is difficult to track ovulation, but it is possible. You need to rely on your feelings from the 14th to 20th days of the cycle, and when you feel an increase in libido, or there is a viscous, colorless discharge from the vagina and the stomach is stretched, it means that you can successfully conceive a child.

The cycle is 33-34 days. When is ovulation?

It is believed that with such a long cycle it is almost impossible to get pregnant, because there is too little time left for the development of the embryo. Ovulation in such a long cycle occurs approximately on days 20-25. Doctors unanimously say that this ovulation cycle needs to be corrected hormonal drugs. However, some women manage to “get” happy Days and conceive a baby.

Dear women! If you are planning a baby, then do not despair if your ovulation cycle is too long or too short. You just need to see a doctor who will correct this phenomenon with appropriate treatment, and everything should work out for you!

Ovulation is the release of an egg from the ovaries, which usually occurs around the middle of the menstrual cycle. Women who dream of getting pregnant try different ways determine the most favorable period for this, and to do this correctly, you need to understand how many days ovulation lasts.

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What does the duration depend on?

As a rule, the egg leaves the follicle on days 13-17 of the cycle. These terms are individual for everyone, but in the absence of pathologies and diseases in each individual woman, the egg matures at the same time, with a difference of no more than a day.

As for how many days ovulation usually lasts, doctors do not have a clear consensus: some believe that its duration is only 24 hours, others claim that it lasts twice as long. Today it is customary to say that this process lasts approximately 24-36 hours.

During this period, a woman wants more tenderness and affection.

This is the period during which a mature female cell moves along the fallopian tube. However, for a girl planning a pregnancy, it would be more correct to ask the question how many days the possibility of conception remains.

The length of this period may be influenced by the following factors:

• duration of the menstrual cycle;
• stress;
• physical exercise;
• gynecological diseases;
• taking hormonal drugs.

It is very important to remember that it takes sperm some time to reach the fallopian tube and then fertilize the egg. In addition, they can remain viable for up to 5 days after intercourse. So, theoretically, conception is also likely 4-5 days before the release of the female cell, and for 2 days after it.

That is why, when determining the exact period, women are advised to try to conceive not only on this specific day, but throughout the whole week in the middle of the cycle.

How long does the ovulatory period last?

Despite the fact that ovulation itself lasts no more than 48 hours, it is very important for a woman to know not only the timing of its onset, but also the length of time favorable for conceiving a child. Also find out when it comes and everything about it.

The easiest way to find out the answer to the question is how many days does ovulation last in a 28-day cycle. This is considered the average statistical norm, therefore, when gynecologists say that the egg is ready for fertilization on the 14th day after the start last menstruation, they mean just such a cycle.

However, each body works in its own way, questions often arise as to how long ovulation lasts in a cycle of 26 days, 35 days, or even in general fickle cycle. You can find out the start and end date of the ovulatory period in the following ways.

1. Observation by a gynecologist. Upon examination, a doctor can determine the moment of release of a mature cell by the appearance of the genital organs. The specialist will see signs of egg release 2 days before and within 2 days after.
2. Ultrasonography. This is the most exact way diagnostics: in the middle of the cycle, the follicle increases significantly, it can be clearly seen on an ultrasound machine.
3. Blood chemistry. This method is usually prescribed in difficult cases, trying to figure out whether the female cell matures at all.
4. Measuring basal temperature. This home method diagnostics: by regularly measuring the temperature, a woman can see at what point it becomes 0.5 degrees higher and identify the beginning of the period.
5. Carrying out the test. Another way to self-determination the period suitable for conception has arrived. These tests are easy to use and also readily available.

Can be calculated approximate time by cycle duration - this method is imperfect and only works in the case of a regular cycle, but when planning a pregnancy in a healthy woman, it is quite possible. According to this method, you need to count not from the beginning of the previous menstruation, but the days until the onset of the next one.

The third phase of the cycle is the most constant, usually lasting no more than 14 days. Thus, to find out how many days ovulation lasts when regular cycle in 30 days, you need to subtract 14 days from the expected date of menstruation, and the result obtained will be the date of release of the mature egg.

Deadline calculation

Discharge during egg maturation

Sometimes discharge helps calculate how many days you remain fertile. By their nature, one can determine the phase, as well as the onset of a period favorable for fertilization. Let us consider the discharge characteristic of each period of the cycle.

1. In the first days after menstruation, the discharge is almost invisible.
2. With the onset of the ovulatory period, the amount of discharge increases, they become more liquid and sticky.
3. Immediately during the release of the egg, the discharge becomes mucous, similar to raw protein from an egg.
4. After ovulation is completed, the discharge again becomes viscous and sticky.
5. Before menstruation begins, the secretion becomes watery.

It is also worth paying attention to uncharacteristic discharges:

• for example, white curds may be a sign of thrush, especially if they are accompanied by itching;
• brownish secretion may be a sign of pregnancy, side effect hormonal contraception or a symptom of gynecological diseases;
• Yellowish or greenish mucus may appear with certain female or sexually transmitted diseases.

Having determined how many days the mucous membranes last transparent discharge, you will find out the duration and period during which pregnancy can occur.

Possible pathologies

When answering the question of how many days ovulation usually lasts, doctors, as a rule, give average statistical data. However, this process is not the same for everyone, so the deadlines may shift.

The reason for this may be various disorders woman's health, so if pregnancy does not occur for a long time, it is necessary to find out the exact timing of the release of the female cell, and if any failures are detected, identify the cause and possibly carry out some treatment. All this cannot be done on your own - only an experienced doctor can help here.

How does this moment happen?

Often women, knowing how many days the ability to conceive lasts after the onset of menstruation, use a calendar method of contraception or, on the contrary, plan to conceive a child in a strictly defined period. Any delays in timing can lead to unwanted pregnancy or the inability to become pregnant.

The egg can leave the follicle either earlier or later than the expected date. This can occur in completely healthy women, however, in some cases, factors that interfere with pregnancy may be the cause.

An egg that has matured in the follicle, ready for fertilization, destroys the surface of the ovary and passes through abdominal cavity into the fallopian tube. This phenomenon is called ovulation. It happens in the middle menstrual period women, but can shift in one direction or another, occurring on the 11th – 21st days of the cycle.

Menstrual cycle

In a female fetus at 20 weeks intrauterine development there are already 2 million immature eggs in the ovaries. 75% of them disappear soon after the girl is born. Most women have reproductive age 500 thousand eggs are stored. By the beginning of puberty, they are ready for cyclical maturation.

During the first two years after menarche, anovulatory cycles are common. Then the regularity of the maturation of the follicle, the release of the egg and the formation of the corpus luteum is established - the ovulation cycle. A disruption in the rhythm of this process occurs during menopause, when the release of an egg occurs less and less and then stops.

When an egg moves into the fallopian tube, it can merge with a sperm - fertilization. The resulting embryo enters the uterus. During ovulation, the uterine walls thicken and the endometrium grows, preparing for implantation of the embryo. If conception does not occur, the inner layer of the uterine wall is rejected - menstrual bleeding occurs.

On what day after menstruation does ovulation occur?

Normally, this is the middle of the cycle, taking into account the first day of menstruation. For example, if 26 days pass between the first days of each menstruation, then ovulation will occur on the 12th – 13th day, taking into account the day the period begins.

How many days does this process take?

The release of a mature germ cell occurs quickly, hormonal changes in this case, they are registered within 1 day.

One of the misconceptions is to believe that if you have periods, then the cycle was necessarily ovulatory. Thickening of the endometrium is controlled by estrogen, and ovulation is caused by the action of follicle-stimulating hormone (FSH). Not every menstrual cycle is accompanied by the process of ovulation. Therefore, when planning pregnancy, it is recommended to monitor the precursors of egg release and use additional tests to determine it. If anovulation lasts for a long time, you should consult a gynecologist.

Hormonal regulation

Ovulation occurs under the influence of FSH, which is synthesized in the anterior lobe of the pituitary gland under the influence of regulators formed in the hypothalamus. Under the influence of FSH, the follicular phase of egg maturation begins. At this time, one of the follicle vesicles becomes dominant. As it increases, it reaches the preovulatory stage. At the moment of ovulation, the wall of the follicle ruptures, containing mature sex cell leaves the ovary and penetrates the uterine tube.

What happens after ovulation?

The second phase of the cycle begins - the luteal phase. Under the influence of the luteinizing hormone of the pituitary gland, a peculiar endocrine organ- yellow body. This is a small round formation yellow color. The corpus luteum secretes hormones that cause the endometrium to thicken and prepare it for implantation of the embryo during pregnancy.

Anovulatory cycle

Menstrual-like bleeding may recur regularly after 24-28 days, but the egg does not leave the ovary. This cycle is called . In the absence of ovulation, one or more follicles reach the preovulatory stage, that is, they grow, and a germ cell develops inside. However, the follicular wall does not rupture and the egg does not come out.

Soon after this, the mature follicle undergoes atresia, that is, reverse development. At this time, estrogen levels decrease, which leads to menstrual-like bleeding. By external signs it is practically indistinguishable from normal menstruation.

Why is there no ovulation?

It could be physiological state during puberty or premenopause. If a woman is in childbearing age, rare anovulatory cycles – normal phenomenon.

Many hormonal disorders lead to an imbalance of the “hypothalamus-pituitary-ovary” system and change the timing of ovulation, in particular:

• hypothyroidism (lack of thyroid hormones);
• hyperthyroidism (excess thyroid hormones);
• hormonally active benign tumor pituitary gland (adenoma);
• adrenal insufficiency.

Lengthen ovulatory period Maybe emotional stress. It leads to a decrease in the level of gonadotropin-releasing factor, a substance secreted by the hypothalamus and stimulating the synthesis of FSH in the pituitary gland.

Other possible reasons for which there is a lack or delay of ovulation associated with hormonal imbalance:

• intense sports and physical activity;
• rapid weight loss of at least 10%;
• chemotherapy and radiation for malignant neoplasms;
• taking tranquilizers, corticosteroid hormones and some contraceptives.

Basic physiological reasons lack of ovulation – pregnancy and menopause. During premenopause, women may continue to have more or less regular periods, but the likelihood of anovulatory cycles increases significantly.

Symptoms of egg release

Not all women experience signs of ovulation. At this moment, hormonal changes occur in the body. By carefully observing your body, you can detect a period best ability to fertilization. It is not necessary to use complex and expensive methods for predicting egg release. It is enough to detect natural symptoms in time.

• Change in cervical mucus

The female body is preparing for probable conception, producing cervical fluid suitable for the transfer of sperm from the vagina to the uterine cavity. Until ovulation, this discharge is thick and viscous. They prevent sperm from entering the uterus. Before ovulation glands cervical canal begin to produce a special protein - its threads are thin, elastic and similar in properties to protein chicken egg. Vaginal discharge becomes transparent and stretches well. This environment is ideal for sperm to penetrate into the uterus.

• Change in vaginal moisture

Discharge from the cervix becomes more abundant. During sexual intercourse, the amount of vaginal fluid increases. A woman feels increased humidity throughout the day, which shows her readiness for fertilization.

• Breast tenderness

After ovulation, progesterone levels increase. If a woman keeps a chart, she will see that her basal temperature has risen. It is caused precisely by the action of progesterone. This hormone also affects the mammary glands, so at this moment they become more sensitive. Sometimes this soreness resembles premenstrual sensations.

• Changing the position of the cervix

After the end of menstruation, the cervix is ​​closed and low. As ovulation approaches, it rises higher and softens. You can check this yourself. After thoroughly washing your hands, you need to place your foot on the edge of the toilet or bathtub and insert two fingers into the vagina. If you have to push them deep, it means your cervix has risen. It is easiest to check for this symptom immediately after menstruation, so that you can then better determine the change in the position of the cervix.

• Increased sex drive

Women often notice stronger sexual desire in the middle of the cycle. These sensations during ovulation are of natural origin and are associated with changes in hormonal levels.

• Bloody issues

Sometimes in the middle of the cycle, small bloody discharge from the vagina appears. It can be assumed that this is the “residue” of blood leaving the uterus after menstruation. However, if this sign appears during suspected ovulation, it indicates rupture of the follicle. In addition, some blood may also be released from the endometrial tissue under the influence of hormones immediately before or after ovulation. This symptom indicates high ability to conception.

• Cramp or pain on one side of the abdomen

20% of women experience pain during ovulation, which is called pain. It occurs when the follicle ruptures and contracts fallopian tube when the egg moves into the uterus. A woman feels pain or spasm on one side of her lower abdomen. These sensations after ovulation do not last long, but serve quite a long time. exact sign fertilization ability.

• Flatulence

Hormonal shifts cause slight bloating. It can be detected by the fact that it has become a little tight clothes or belt.

• Mild nausea

Hormonal changes may cause mild nausea, similar to pregnancy-like symptoms.

• Headache

In 20% of women, before or during menstruation, headache or migraine. The same symptom in these patients may accompany the onset of ovulation.

Diagnostics

Many women are planning their pregnancy. Conception after ovulation gives best chance for fertilization of the egg. Therefore, they use additional methods to diagnose this condition.

Tests functional diagnostics during the ovulatory cycle:

• basal temperature;
• pupil symptom;
• study of cervical mucus extensibility;
• karyopyknotic index.

These studies are objective, that is, they show the phase quite accurately and regardless of the woman’s feelings. ovulatory cycle. They are used when normal hormonal processes. With their help, ovulation is diagnosed, for example, in an irregular cycle.

Basal temperature

Measurements are taken by placing the thermometer in anus by 3-4 cm, immediately after waking up. It is important to perform the procedure at the same time (a half hour difference is acceptable), after at least 4 hours of continuous sleep. You need to take your temperature every day, including on menstruation days.

The thermometer should be prepared in the evening so as not to shake in the morning. In general, it is not recommended to make unnecessary movements. If a woman uses mercury thermometer, after it is inserted into the rectum, she should lie still for 5 minutes. It is more convenient to use an electronic thermometer, which will give sound signal about completion of the measurement. However, sometimes such devices give erroneous readings, which can lead to misidentification ovulation.

After the measurement, the result must be plotted on a graph, divided by vertical axis by tenths of a degree (36.1 – 36.2 – 36.3 and so on).

In the follicular phase, the temperature is 36.6-36.8 degrees. Starting from the second day after ovulation, it rises to 37.1-37.3 degrees. This rise is clearly visible on the chart. Just before the release of the egg, the mature follicle secretes maximum amount estrogen, and on the graph this may appear as a sudden decrease (“recession”), followed by a rise in temperature. It is not always possible to register this sign.

If a woman irregular ovulation, constant measurement of rectal temperature will help her determine the most favorable day for conception. The accuracy of the method is 95%, subject to the rules for performing measurements and interpreting the results by a doctor.

Pupil symptom

This sign is detected by a gynecologist when examining the cervix using vaginal speculum. During the follicular phase of the cycle, the external uterine os gradually increases in diameter, and cervical discharge becoming more and more transparent (+). Outwardly, it resembles the pupil of an eye. By the time of ovulation, the uterine os is maximally dilated, its diameter reaches 3-4 cm, the pupil symptom is most pronounced (+++). On days 6-8 after this, the external opening of the cervical canal closes, the pupil symptom becomes negative (-). The accuracy of this method is 60%.

Extensibility of cervical mucus

This sign, which can be noticed independently, is quantified using a forceps (a type of tweezers with teeth on the edges). The doctor grabs mucus from the cervical canal, stretches it and determines maximum length the formed thread.

In the first phase of the cycle, the length of such a thread is 2-4 cm. 2 days before ovulation it increases to 8-12 cm, starting from the 2nd day after it decreases to 4 cm. From the 6th day the mucus practically does not stretch. The accuracy of this method is 60%.

Karyopyknotic index

This is the ratio of cells with a pyknotic nucleus to total number superficial epithelial cells in vaginal smear. Pyknotic nuclei are wrinkled and less than 6 µm in size. In the first phase, their number is 20-70%, 2 days before ovulation and at the time of its onset - 80-88%, 2 days after the release of the egg - 60-40%, then their number decreases to 20-30%. The accuracy of the method does not exceed 50%.

More exact method ovulation determination – hormonal studies. The disadvantage of this method is the difficulty of using it with an irregular cycle. The level of luteinizing hormone (LH), estradiol, and progesterone is determined. Typically, such tests are prescribed without taking into account individual characteristics, on the 5th – 7th and 18th – 22nd days of the cycle. Ovulation does not always occur during this period, with more long cycle it happens later. This leads to unfounded diagnosis of anovulation, unnecessary tests and treatment.

The same difficulties arise when using drugs that are based on changes in the level of LH in the urine. A woman must either accurately guess the time of ovulation, or constantly use rather expensive test strips. There are reusable test systems that analyze changes in saliva. They are quite accurate and convenient, but the disadvantage of such devices is their high cost.

LH levels may be persistently elevated in the following cases:

• severe stress due to the desire to become pregnant;

Ultrasound detection of ovulation

The most accurate and cost-effective method is diagnosing ovulation using ultrasound (). With ultrasound monitoring, the doctor evaluates the thickness of the endometrium, the size of the dominant follicle and the corpus luteum formed in its place. The date of the first study depends on the regularity of the cycle. If it has the same duration, the study is carried out 16-18 days before the start date of menstruation. If the cycle is irregular, an ultrasound scan is prescribed on the 10th day from the beginning of menstruation.

At the first ultrasound it is clearly visible dominant follicle, from which a mature egg will subsequently be released. By measuring its diameter, you can determine the date of ovulation. The size of the follicle before ovulation is 20-24 mm, and its growth rate in the first phase of the cycle is 2 mm per day.

A second ultrasound is prescribed after the expected date of ovulation, when a corpus luteum is detected at the site of the follicle. At the same time, a blood test is performed to determine progesterone levels. The combination of increased progesterone concentration and the presence of a corpus luteum on ultrasound confirms ovulation. Thus, a woman undergoes only one test for hormone levels per cycle, which reduces her financial and time costs for the examination.

When examining in the second phase, changes in the corpus luteum and endometrium can be detected, which can prevent pregnancy.

Ultrasound monitoring confirms or denies ovulation even in cases where data from other methods turned out to be uninformative:

• an increase in basal temperature in the second phase due to a decrease in the production of hormones by the atretic follicle;
• increased basal temperature and progesterone levels with low endometrial thickness, which prevents pregnancy;
• no changes in basal temperature;
• false positive ovulation test.

An ultrasound examination helps answer many of a woman’s questions:

• does she ever ovulate?
• whether it will happen in the current cycle or not;
• On what day will the egg be released?

Changes in the timing of ovulation

The release time of the egg may vary by 1-2 days even with a regular cycle. Permanently shortened follicular phase and early ovulation may lead to problems with conception.

Early ovulation

If the release of the egg occurs 12-14 days after the start of menstruation, there is no reason to worry. However, if the basal temperature chart or test strips show that this process occurred on the 11th day or earlier, then the released egg is not developed enough for fertilization. At the same time, the mucus plug in the cervix is ​​quite dense, and sperm cannot penetrate through it. Insufficient increase in endometrial thickness, caused by a reduction in the hormonal influence of estrogens in the developing follicle, prevents implantation of the embryo, even if fertilization has occurred.

Still being studied. Sometimes it happens accidentally, in one of the menstrual cycles. In other cases, pathology may be caused by the following factors:

• severe stress and disruption of the relationship between the hypothalamus and pituitary gland in nervous system, which leads to a sudden premature increase in LH levels;
• a natural aging process in which the body produces more FSH to support egg maturation, which causes excessive fast growth follicle;
• smoking, overuse alcohol and caffeine;
• gynecological and endocrine diseases.

Can ovulation occur immediately after menstruation?

This is possible in two cases:

• if menstruation lasts 5-7 days, and against this background a hormonal imbalance occurs, early ovulation can occur almost immediately after its completion;
• if two follicles mature at different times in different ovaries, then their cycles do not coincide; in this case, ovulation of the second follicle is timely, but occurs in the first phase in the other ovary; This is associated with cases of pregnancy during sexual intercourse during menstruation.

Late ovulation

For some women, from time to time the ovulatory phase occurs on the 20th day of the cycle or later. Most often this is caused by hormonal disorders in the complex balanced system “hypothalamus - pituitary gland - ovary”. Usually these changes are preceded by, caused by stress or taking certain medicines(corticosteroids, antidepressants, antitumor agents). increases the risk chromosomal disorders in the egg, fetal malformations and early termination of pregnancy.

If two follicles in each ovary do not mature at the same time, ovulation is possible before menstruation.

The cause of such a failure may be breastfeeding. Even if a woman regains her period after childbirth, she experiences a long follicular phase or anovulatory cycles for six months. This normal process, laid down by nature and protects a woman from re-pregnancy.

During breastfeeding Often both menstruation and ovulation are absent for some time. But in certain moment The maturation of the egg, nevertheless, begins, it is released, it enters the uterus. And only 2 weeks after this, menstruation begins. This is how ovulation is possible without menstruation.

Often late ovulation occurs in women who are too thin or who have lost weight quickly. The amount of fat in the body is directly related to the level of sex hormones (estrogens), and a small amount of it leads to delayed egg maturation.

Treatment for ovulatory cycle disorders

Anovulation for several cycles throughout the year is normal. But what to do if there is no ovulation all the time, and a woman wants to get pregnant? You should be patient, find a qualified gynecologist and contact him for diagnosis and treatment.

Reception oral contraceptives

Usually, a course of oral contraceptives is first recommended to cause the so-called rebound effect - ovulation after discontinuation of oral contraceptives. high probability will happen in the first cycle. This effect persists for 3 consecutive cycles.

If a woman has taken these medications before, they are discontinued and ovulation is expected to resume. On average, this period takes from 6 months to 2 years, depending on the duration of treatment birth control pills. Conventionally, it is believed that for every year of using oral contraceptives, 3 months are required to restore ovulation.

Stimulation

In more severe cases, after excluding diseases of the thyroid gland, adrenal glands, pituitary tumors and other possible “external” causes of anovulation, the gynecologist will prescribe medications for. At the same time, he will monitor the patient’s condition, conduct ultrasound monitoring of the follicle and endometrium, and prescribe hormonal tests.

If there has been no period for 40 days or more, pregnancy is first ruled out, and then progesterone is administered to induce menstrual-like bleeding. After an ultrasound and other diagnostics, medications for ovulation are prescribed:

• clomiphene citrate (Clomid) is an anti-estrogenic ovulation stimulator that increases the production of FSH in the pituitary gland, its effectiveness is 85%;
• gonadotropic hormones (Repronex, Follistim and others) are analogues of one’s own FSH, causing the egg to mature, their effectiveness reaches 100%, but they are dangerous for the development of ovarian hyperstimulation syndrome;
• hCG, often used before the IVF procedure; HCG is prescribed after the release of the egg to maintain the corpus luteum, and subsequently the placenta, and maintain pregnancy;
• leuprorelin (Lupron) is an analogue of gonadotropin-releasing factor, which is produced in the hypothalamus and stimulates the synthesis of FSH in the pituitary gland; this drug does not cause ovarian hyperstimulation syndrome;

Self-medication with these drugs is prohibited. When strictly following the doctor's recommendations and treatment in accordance with internationally recognized rules, most women manage to become pregnant in the first 2 years after starting therapy.

Auxiliary reproductive technologies

In the event that ovulation disorders cannot be corrected, assisted reproductive technologies come to the woman’s aid. However, they are associated with strong hormonal influence on the body to obtain a normal mature egg. Are used complex circuits medications. Such procedures should only be performed in specialized medical centers.

One of the indicators normal operation reproductive system– regular maturation of the egg, so many women have a question about what day of the cycle ovulation occurs. It is easiest to accurately calculate the period suitable for conception with an average regular cycle. But there are certain methods that will help girls with any cycle length make calculations.

What day is it on?

Ovulation is the release of an egg (oocyte) from the ovary. Tearing the walls of the follicle, it comes out into fallopian tubes. If there are active sperm in them at this moment, there is a high probability of fertilization.

When does ovulation occur? In women with a normal and regular cycle of 28–30 days – on days 14–15. But the body cannot work like a machine, so deviations occur - the egg can leave the follicle for 11-21 days.

Important! The duration of ovulation is 12–48 hours, sperm can remain viable for 3–7 days. These factors should be taken into account by girls who do not plan to become a mother in the near future. 5 days before and after the expected release date of the egg should be used barrier means contraception.

The release of the egg from the ovary is accompanied by certain hormonal changes. You can determine ovulation by a number of characteristic features, which manifest themselves equally in women with any length of the menstrual cycle.

Main symptoms of ovulation:

1. Change in appearance and consistency vaginal discharge– during ovulation, the cervical fluid becomes viscous and transparent, which facilitates the movement of the egg and sperm. The color of mucus can be white, yellow, pink.
2. The amount of natural lubrication during sexual intercourse increases.
3. The mammary glands slightly increase in volume, hurt, and their sensitivity increases.
4. The position of the cervix changes - it rises higher and becomes softer.
5. Increased libido against the background of a hormonal surge, the body gives signals of readiness for conception.
6. Minor spotting discharge - appears after follicle rupture.
7. Pain, spasms in lower area abdomen, most often on one side - occur when the walls of the follicle rupture, contraction of the fallopian tube, during the movement of the egg. Fine discomfort are of a short-term nature.

Among additional symptoms at the end of ovulation, bloating, upset stool, increased appetite, headache, and mood swings most often occur.

Long cycle

Long menstrual cycle – 35–45 days. Since the stage of the corpus luteum is approximately the same for all women, to determine ovulation with a long cycle you need to subtract 14 from its duration.

For example, with a cycle of 35 days, the calculation scheme is as follows: 35 – 14 = 21, ovulation should occur on the 21st day.

The average menstrual cycle lasts 28–32 days, while menstrual flow observed for 3–5 days. Ovulation occurs after 12–15 days, with a 32-day cycle - after 18 days, but it all depends on the individual characteristics of the body.

How many days after ovulation will the test show pregnancy? A faint second line may appear on the test 6–12 days later when the embryo implants. Exactly on what day this will happen depends on your hormonal levels.

Short

Duration short cycle– less than 25–26 days. To calculate the day the egg is released, you need to subtract 14 from the length of the cycle, for example, 25 – 14 = 11. The favorable period for conception will occur on the 11th day after menstruation.

If the menstrual cycle consistently lasts less than 21 days, the gynecologist can diagnose polymenorrhea; in such cases, ovulation often occurs immediately after menstruation, on the 7th–8th day.

Irregular cycle

To calculate the favorable period for conception with an irregular cycle, a lot of effort will be required - keeping a chart, measuring basal temperature regularly throughout the year.

To calculate the ovulation period it is necessary from the long cycle subtract 11, from the shortest – 18. The resulting values ​​will show the interval during which conception can occur, but with an irregular cycle these indicators can be a week or more.

Table of approximate ovulation dates

Cycle change

Early or late ovulation is quite common. Most often, such deviations are associated with hormonal imbalance, which causes disturbances in the hypothalamus-pituitary-ovary ligament. Permissible deviations Ovulation dates are 1–3 days.

Late ovulation - the release of the egg occurs later than the 20th day of the cycle, often observed before the onset of menopause. This pathology increases the risk of chromosomal abnormalities, birth defects a child has a miscarriage.

Why does the ovulatory period lengthen:

• hypothyroidism, hyperthyroidism;
• benign neoplasms in the pituitary gland;
• adrenal insufficiency;
• severe stress;
• physical fatigue, intense training;
• a sharp decline or weight gain of more than 10%;
• chemotherapy;
• long-term use of hormonal drugs.

Late ovulation also occurs during natural feeding. When menstruation returns after childbirth, a long follicular phase can be observed for six months. This phenomenon is considered normal, as the body prevents repeat pregnancy.

Early ovulation

Early ovulation - the egg is released when normal cycle leaves the follicle before the 11th day, it is not suitable for fertilization. Additionally, there is a mucus plug in the cervix, which prevents the penetration of sperm; the endometrium is still too thin, high level estrogen interferes with the implantation of the embryo.

Reasons for early ovulation:

• stress, nervous tension;
• natural aging – a high level of FGS is observed in the body, which provokes active growth follicles;
• smoking, alcohol abuse, coffee;
• endocrine and gynecological diseases;
• recent abortion;
• cancellation oral medications contraception.

Important! On average, for each year of taking OCs, it takes 3 months to restore the normal ovulatory period.

Atypical cases of ovulation

Can you ovulate twice in one cycle? IN in rare cases 2 eggs are released into the fallopian tubes at once. Follicle rupture occurs in one of the ovaries with a difference of several days, or in both ovaries simultaneously.

Ovulation occurs immediately after the end of menstruation - this happens if menstruation lasts more than 5 days, which provokes hormonal imbalance. The reason may also be the non-simultaneous maturation of follicles in two ovaries; this pathology often causes pregnancy after sex during menstrual periods.

Important! The anovulatory cycle is observed in adolescence, before menopause. In women over 30 years of age, 2–3 such cycles per year are allowed. If the egg does not release in a timely manner - this is one of the main signs of pregnancy, it is necessary to determine the level of hCG.

Diagnosis of ovulation

Not all women show clear signs of egg release, so it is necessary to use additional methods definitions favorable period for conception.

How to determine ovulation:

1. Basal temperature - the most accurate data can be obtained by measuring in the rectum. This should be done at the same time immediately after waking up, without getting out of bed. It is better to use a mercury thermometer; the procedure lasts 5–7 minutes. In the first half of the cycle rectal temperature is 36.6-36.8 degrees. Immediately before the follicle breaks through, there is a sharp decrease in indicators, then they increase to 37.1–37.2 degrees. The accuracy of the method is more than 93%.
2. Pupil syndrome is a gynecological term that indicates the condition of the cervical pharynx. During the follicular phase, the pharynx expands, opens to its maximum just before ovulation, and on the sixth day it narrows. The reliability of the method is about 60%.
3. Condition of mucus - using serrated tweezers, you need to take a small amount of discharge from the cervical canal and stretch it. 2 days before ovulation, the length of the thread is 9–12 cm, gradually it decreases, after 6 days the mucus completely loses its viscosity. The accuracy of the method is more than 60%.
4. Home tests to measure LH levels in urine - this method is only suitable for women with a regular cycle, otherwise you will have to use it constantly. There are also reusable systems for saliva analysis, but they are expensive. If your LH level is high all the time, it could be a sign of stress or PCOS. When to take the test? 14–16 days before the expected date of your period.
5. Ultrasound is the most accurate method to find out the day of ovulation. With a regular cycle, diagnosis is carried out on days 10–12 of the cycle, with an irregular cycle - 10 days after the start of menstruation.

To independently determine the date favorable for conception, you need to keep a diary. It should record the indicators of rectal and normal temperature, condition of the cervix and vaginal discharge, general state, when signs of ovulation appear, do tests.

Important! There is a theory that if there was sex before the release of the egg, then when it is fertilized, there is a high probability of having a girl. If sexual intercourse occurs immediately during ovulation, boys are more likely to be born.

Every girl needs to know the day of ovulation. This data will help avoid unwanted pregnancy or increase the chance of a long-awaited conception. Help determine the day the egg is released specific symptoms, changes in the amount and structure of vaginal discharge, tests, basal temperature indicators.