Expert: Debbi Craig - 3/1/2004

Question
Hi Debbi,
 This is absolutely fabulous that I can ask a question to someone who is knowledgeable without having to call my doctor.  Let me give you a little bit of my history, I had an ectopic pregnancy in April 2003, saved both tubes.  I ovulate naturally, but my OB gave me a perscription for clomid to "boost" my ovulation.  I got pregnant on my second cycle of clomid in November 2003 and had a missed miscarriage on 12/20/03, no heart beat seen on ultrasound, all my hormone levels were great.  
   After all of that my OB still thinks things are ok and gave me another perscription of clomid. I just took the first round and had a positive LH test on Friday 2/26/04, so we had sex both Friday and Saturday.  My concern is this, my temperature was low on Thursday, but no positive LH, so we didn't have sex, then friday my temperature went even lower and we had a positive LH test, Saturday morning, my temp shot up to 98.2, which I think indicates ovulation has occurred.  I am wondering if I ovulated on the same day that I had the positive LH surge and possibly missed getting sperm up there before the egg was released as I have read it is best to have sperm waiting.... I thought the LH surge indicated that ovulation was going to happen in the next 24 hours..., not that same day.  I am worried that I missed ovulation as Friday I took the LH test at 4pm but had some ovary aching at work in the morning.
  As you can probably read, my anxiety is pretty high also....  but I am disappointed if we possibly wasted one of the months I can be on clomid because I ovulated the same day as the LH surge.
  All of this to say what do you think?  Did i ovulate that Friday if my temp shot up Saturday?  The LH surge line was very dark when I took it at 4pm on Friday afternoon.  It would be great to get your opinion if any of this makes sense to you.  Thanks again for volunteering on this site, I think it is wonderful.  Heidi

Answer
Hi Heidi,

Thank you for giving me the opportunity to help you by answering your question. I am deeply saddened by your losses, and sincerely hope that it will not happen again.

In order to answer your question, please let me explain what happens to trigger ovulation. First, is the LH surge. This hormonal surge happens about 36 to 48 hours prior to ovulation and is the "trigger" that signals the body to "prepare" for possible fertilization. It takes about 6 hours for the LH to show up in a woman's urine, but will continue to show up in the urine for about 12 to 24 hours. The LH surge also seems to cause a temp drop in some women, but not in all.

36 to 48 hours after the LH surge, a woman should ovulate. Up to 12 hours after ovulation, fertilization can take place. Because you "caught" the LH surge on Friday afternoon, and also "felt" some aching Friday morning. This aching that you felt may not have been the actual ovulation, but was related in some way I am sure. My best guess, and that is all it can be, is that you probably actually ovulated late Friday night, or very early Saturday morning. The resulting release of progesterone from the corpus lutem (the "sac" that held the ovulated egg) caused your temp to increase.

There could be other reasons for the temp increase, so the only way to "confirm" that ovulation did happen between Friday and Saturday is by continued charting. Because you did have sex within 12 hours of the release of the egg, your chances of getting pregnant are "normal" at about 20% to 25%.

Another thing to remember, and this may or may not help to reduce any anxiety you are feeling. Even if everything is "perfect", timing is perfect, ovulation was perfect, sperm were there at the "perfect" time, and so on, you only have at best a 25% chance of getting pregnant.

If you do not conceive this cycle, please remember that.

I hope that I have been able to answer your questions and helped to put your mind at ease. If you have any other questions or concerns, please let me know.

Best Wishes,
Debbi Craig