Ovulation and Conception


Dear Midwife,
I had intercourse two days before my ovulation temperature rise. I have a 28-day cycle and have been using the ovulation predictor digital tests since day 10. It's day 18 and I still haven't gotten a positive LH surge indicator from the test. Could this mean that I'm pregnant (if conception took place before the LH surge, would there be no LH surge?). Or just that I didn't ovulate this month? Also, how early would one notice the signs of pregnancy?

Also, I generally have very little cervical fluid, and some months I don't notice any egg-white fluid. Could this make it harder for me to get pregnant? Finally, I have very, very light periods, with only one day of real bleeding and then one day before of spotting and two days after of spotting. Could this have any impact on my ability to conceive? I'm a healthy, fit, 30-year old.


The best person to answer your questions would be someone who has checked your hormone levels, just to be sure. If you miss a period, do take a pregnancy test, of course. But the LH surge is associated with the release of the egg, and you can't get pregnant before that! so I would be a little concerned about whether you are ovulating. The temperature rise is a good sign, and I may just be being over-cautious, but I think it would be good to check.

It's good to be fit, of course, but over-doing it can reduce your body fat below the levels needed to conceive (your body thinks you're starving and it's not a good time . . .). If you think that might be true for you, you might consider gaining 5-10 pounds (add an Ensure or the like morning and afternoon to your usual diet) and see if that makes a difference.

As for when you notice the signs of pregnancy, some women with perfectly normal pregnancies never do, so it's hard to go by that. Hopefully, all these suggestions will be unnecessary and you'll be pregnant soon! Good luck.

--Cynthia, CNM

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.