Ovulation: Interpreting Basal Body Temperature and Test Strips

There are basal body temperature measurements and ovulation test strips?

My last menstrual period was from November 5 to November 10.
I was diagnosed with severe polycystic ovary syndrome (PCOS) two years ago, and I have lost 8 kilograms since then.
After the examination, my PCOS has improved significantly.
This year, I have been taking traditional Chinese medicine to regulate my menstrual cycle, but my periods are still sometimes irregular, and I even experience premenstrual spotting.
I have been trying to conceive for three years.
This month, I started using ovulation test strips on the 14th, and both lines appeared, with the second line being faint.
On the evening of the 19th at 7 PM, the test line darkened a bit, but it was still lighter than the control line.
An hour and a half later, the test line became faint again.
On the morning of the 21st, the test line darkened a bit again, but afterward, it remained faint.
My basal body temperature readings started on the 16th: 16th: 35.93, 17th: not measured, 18th: 36.02, 19th: 35.82, 20th: 35.89, 21st: 36.09, 22nd: 35.99, 23rd: 36.12, 24th: 36.47.
I am unsure if I have ovulated because the test lines did not darken significantly, and this is my first time measuring my basal body temperature, so I'm not sure if I did it correctly.
I would appreciate your guidance, thank you.

Ting, 20~29 year old female. Ask Date: 2023/11/24

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, ovulation is likely around November 20, but it's not easy to assess accurately.
Wishing you good health.

Reply Date: 2023/11/24

More Info

Understanding ovulation can be a complex process, especially for those dealing with conditions like polycystic ovary syndrome (PCOS). Your situation, involving irregular menstrual cycles and the use of ovulation test strips alongside basal body temperature (BBT) monitoring, is quite common among women trying to conceive. Let's break down the information you provided and interpret what it may mean regarding your ovulation status.

Basal Body Temperature (BBT)
BBT is a method used to track ovulation by measuring your body temperature at rest, typically first thing in the morning before any activity. After ovulation, a woman's BBT usually rises by about 0.5 to 1 degree Fahrenheit (approximately 0.3 to 0.6 degrees Celsius) due to increased progesterone levels. This rise in temperature can help confirm that ovulation has occurred, but it does not predict it.

From the data you provided:
- 16th: 35.93°C
- 18th: 36.02°C
- 19th: 35.82°C
- 20th: 35.89°C
- 21st: 36.09°C
- 22nd: 35.99°C
- 23rd: 36.12°C
- 24th: 36.47°C
The temperatures show a slight increase towards the end of your tracking period, particularly on the 24th, which could suggest that ovulation may have occurred around that time. However, BBT alone cannot confirm ovulation without a clear pattern of sustained temperature rise.

Ovulation Test Strips
Ovulation test strips detect the surge in luteinizing hormone (LH) that occurs 24-48 hours before ovulation. The presence of two lines indicates that LH is present, but the darkness of the test line compared to the control line indicates the strength of the surge.
You mentioned:
- Starting from the 14th, you observed two lines, with the second line being faint.

- On the 19th, the test line deepened slightly but was still not as dark as the control line.

- The line continued to fluctuate in darkness, indicating varying levels of LH.

The fact that you saw a faint line suggests that your body was gearing up for ovulation, but the lack of a consistently dark line may indicate that the LH surge was not strong enough to trigger ovulation or that it was a short surge.

Interpretation and Recommendations
Given your history of PCOS and the irregularities in your menstrual cycle, it is not uncommon to experience fluctuations in both BBT and LH levels. Here are some considerations:
1. Confirming Ovulation: To confirm ovulation, look for a sustained increase in BBT for at least three consecutive days after the suspected ovulation date. If your temperature remains elevated, it is a strong indicator that ovulation has occurred.

2. Using Test Strips: Continue using the ovulation test strips daily around the expected ovulation window (typically 12-16 days before your next expected period). A positive result (a test line as dark as or darker than the control line) is a good indicator of an imminent ovulation.

3. Consulting a Specialist: Given your history with PCOS and the challenges you are facing with conception, it may be beneficial to consult with a fertility specialist. They can provide more personalized insights and may suggest additional tests or treatments to help regulate your cycles and improve your chances of conception.

4. Lifestyle Factors: Maintaining a healthy weight, as you have been doing, can significantly impact ovulation and fertility in women with PCOS. Regular exercise, a balanced diet, and managing stress are also crucial components of improving reproductive health.

5. Tracking Symptoms: Besides BBT and ovulation tests, pay attention to other ovulation signs such as changes in cervical mucus, which becomes clear and stretchy like egg whites during ovulation.

In conclusion, while your BBT and ovulation test results suggest that you may be approaching ovulation, further monitoring and possibly medical guidance may be necessary to achieve your goal of conception. Keep tracking your cycles, and don't hesitate to seek professional advice tailored to your specific situation.

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