Fertility tracking has been performed since the early 19th century when Henrik Van de Velde observed that a woman’s basal body temperature increased mid cycle and dropped at the time of her period. In the 30’s and 40’s, menstrual calendar tracking had become the norm.
When I started practicing medicine in the 60’s, the first thing patients received when they came in for a fertility evaluation was a basal body temperature (BBT) chart for them to take home and complete.
Since then, a large number of techniques have been developed to track fertility, including the following:
- Cervical mucus testing
- Evaluation of positions of the cervix
- Urinary luteinizing hormone (LH) testing
- Electronic fertility monitors
- Smart phone-based fertility apps
Ovulation usually occurs about 2 weeks into the cycle — typically on day 14 in a 28-day cycle. However, the best approach is to plan intercourse around ovulation and plot cycle days 12, 14 and 16 as target dates.
Does Fertility Tracking Work?
The importance of fertility tracking technique is to know the woman’s cycle, track when it starts and ends, and also figure out the fertile dates or “window” when the optimal time would be to have intercourse to create a baby. The question is, does it work?
When we look at statistics and science, very few studies have been performed to prove the effectiveness of fertility tracking. In a recent large study of over 6,000 patients who were just starting to think about getting pregnant, the participants were interviewed and asked the following questions:
- Do you track your fertility?
- Do you write down your menstrual cycles and calculate their length?
- Do you try to figure out when you ovulate and what the outcome is?
In the study, the most common testing was to chart and count the cycle days, followed by cervical mucus evaluation. The third most used technique was urinary LH testing.
The “fecundability odds ratio” (FR), which means the time it took to achieve a pregnancy, was quite a bit higher in the patients who tracked their cycles than it was for those who did not track their menstrual cycles. The technique used to track the cycle did not matter, and those who did track had a shorter time to pregnancy, indicating that this low-cost approach is quite valuable and works better than any of the high-tech procedures.
Reasons for Improved Pregnancy Rate with Fertility Tracking
The reason for the improved pregnancy rates in patients using fertility tracking was likely the increased number of intercourses performed at the time of the ovulation which was the purpose of the tracking in the first place. People who are using fertility tracking may be more motivated to conceive than those not using tracking. The study found it was also more common for these couples who used tracking to be taking prenatal vitamins and folic acid.
The important take home message from this study is that fertility tracking is low cost and effective and would be the first step a patient should take when they are attempting to become pregnant.
Next Steps in Fertility Evaluation
So what is the next step in the evaluation of your fertility?
When couples have tried fertility tracking for a few months to a year, no pregnancy has occurred, and your age is less than 35, it may be time to check in with a reproductive endocrinologist or your gynecologist to seek some advice.
If you are 35 years or older and a pregnancy has not occurred within 6 months, it is also time to see a professional about what to do.
Click here to learn more about fertility evaluation at Friberg Fertility.