Is there any way to be sure that I have ovulated? I use a fertility monitor and it has been telling me that I am ovulating on cycle day 21 or 22, but I would like to know for sure that I have ovulated. Is there a test that my doctor can run to confirm that everything is working properly?

They say that the only proof of ovulation is pregnancy, but that's not very helpful when you're trying to conceive! There are a few things you can do to help determine that ovulation has occurred.

First, a few rules: many women have different length cycles, some are 28 days, some 32 and some women vary a lot or a little from cycle to cycle. If you are very regular and consistent in your cycle it's a bit easier to figure out the day of ovulation. Take your cycle length and subtract 14 and that's your day of ovulation, give or take a day or two for margin of error. For instance, a woman with a 28 day cycle ovulates around day 14, one with a 32 day cycle around day 18 (ie: 32-14=18).  If you are irregular it can be very difficult to determine going into your cycle on what day ovulation will occur; it's a somewhat retrospective "diagnosis". If your fertility monitor is saying that ovulation is occurring on day 21 or 22 this is perfectly normal if your cycle is around 35 or 36 days in length. You can ask your doctor to send a blood Progesterone level one week after ovulation is thought to have occurred (for you day 28 or 29) and that will confirm ovulation most of the time.

Some women notice a change in cervical mucous around ovulation as well. Instead of thicker white secretions, the cervical mucous is more liquidy and "egg-white" like in its consistency and stretches out when placed between the fingers (don't say eewww!) This change is strongly suggestive of ovulation.

The ovulation predictor kit measure the surge in Lutenizing Hormone that precedes ovulation, but is not definitive proof; basal body temperatures can also be indicative of ovulation but are prone to error. The best bet is the blood progesterone level. If your doctor has access to an ultrasound machine, she can do a transvaginal ultrasound and look to see if you are making a good follicle in one of your ovaries. A few days after ovulation that follicle will be gone or collapsed on the ultrasound, so that's a good way to tell as well (although a bit more expensive).

One thing to be aware of: if you are ovulating on day 21 or 22 as confirmed by the blood level, make sure that your period is coming at least 12 days after ovulation. If your period is coming 11 or fewer days after your ovulation, this could be indicative of a condition known as a luteal phase defect (LPD) and could delay your getting pregnant. If you think you may have a LPD talk to your doctor, it's a relatively easy condition to address and correct. Good luck!

Answered by Dr. Lynn Friedman, M.D.