Ovulation: Myths and False Beliefs

When a woman wants to get pregnant, ovulation becomes a passionate matter. Something that wasn’t important, suddenly becomes a goal. “Am I certain that I ovulate? How do I know on which day I ovulate?” These are frequently asked questions.

That is why I would like to talk about some of the false beliefs we often encounter in our consultations.

Is it true that every month, ovulation happens in only one ovary?

Actually no, it isn’t, even though it is written in school text books.

The oocyte is a cell contained inside the follicle. Both develop simultaneously.

The follicles go through the following stages: primordial, primary, secondary and finally tertiary, when they have become mature.

The primordial follicles, during the first stage, lie in the ovary, until three months before the cycle in which ovulation takes place several start to grow and become primary follicles. This process is called recruitment.

Of all these follicles, only a few eventually become secondary, many atrophy and are left behind. This is called atresia process. Finally, only one among the secondary ones will become tertiary, measuring at that point 2 or 3 cm in diameter. If instead of being one they are two, the result is a twin pregnancy.

Throughout this process, the dominant follicle produces substances which inhibit the development of the other follicles. This occurs in all ovary tissue, it does not matter if it is on the right or left ovary. When a woman only has an ovary she always ovulates from this ovary. If she has two this process is randomized, which means she can ovulate from one ovary for several months in a row.

What if I don’t ovulate?

Many women fear not knowing whether they ovulate. I can tell you that, if menstrual cycles are regular, which means you have your period each month, it is certain that you ovulate.

Women who do not ovulate are those who don’t get their period, have it every several months, or have irregular cycles.

To know on which days you ovulate, it is enough to observe the usual length of your cycles. We know that 14 days go by from ovulation to the following period. Thus if your cycles are of 28 days, you will ovulate most likely on the 14th day of your cycle. And if they are of 27 days, you will ovulate on day 13th.

Although it is not always exact, you don’t need an ovulation test. It is more practical to have sexual intercourse between three days before and one day after you expect to ovulate. We know that sperm can remain alive, waiting for the oocyte for up to three days on the fallopian tubes, and that the oocyte can be fertilized within 24 hours (it degenerates one day after ovulation).

Ideally you should have sexual intercourse on these days, but not necessarily on all these days. Even if you have a mission, try to keep a bit of romance!

You should know that sperm moves from the vagina to the tube with a speed of 2-3mm a minute. Therefore, from the moment ejaculation occurs until the sperm reaches the oocyte, approximately 45-60 minutes go by… Only a few hours after sexual intercourse, you may already be pregnant!

Ovulating doesn’t mean you can get pregnant 

During the last years of menstruating, a woman cannot have healthy children. The physiological system which separates the chromosomes in the oocytes ages, and becomes ineffective. Thus, as time passes, the oocytes present alterations which prevent fertilization to take place, or which may lead to miscarriages.

This aging process is caused by the passing of time. Some believe that during pregnancy, or while taking contraception, oocytes are preserved, but this is not true. It is like thinking that while we sleep we do not age.

Another common misconception is believing that, if you have been taking contraceptive pills for a long time, you should wait several months before getting pregnant.

This is untrue, you can seek pregnancy from the moment you stop taking the pill. I guess this false belief is based on the fact that when ovulation does not occur over many cycles, it is frequent that it can be delayed.

What happens to the unfertilized oocytes?

The unfertilized eggs are microscopic cells that are eliminated by a type of white blood cells called macrophages, which are part of our cellular cleansing system. They are not eliminated throughout the period but recollected by these lymphocytes and brought to the blood stream.

Is fertility inherited? 

We know some aspects related to fertility are genetically determined and for this reason some families are more fertile than others. Therefore, the number of oocytes and of primordial follicles when a baby girl is born can be approximately 2 to 3 million. This is related to heredity linked to the X chromosome.

Our patients often tell us: I will probably start menopause at the same age my mother had it or a bit later. In industrialized societies this is changing. Since toxic substances, which are endocrine disruptors, get collected on the fat of the mother, the number of these cells is reduced along with the fertile age. This also occurs in men and for this reason male fertility decreases in areas contaminated by environmental toxics.

Finally, it is very typical to hear: “I had my first period at a very young age so this means I will reach menopause early”. This is not true. The age of menopause is not linked to the age of the first menstruation.

122 Comments

  1. Pauline Achieng Reply

    Not true all ovaries are released in 28 or 30days but only right side overy comes out because they are large,while left are very small cannot flow ,but both can be fertilised

    • Dr. Marisa López-Teijón Reply

      Dear Pauline,

      I’m sorry but I don’t understand the point of your question. Both ovaries work together as a unique ovary, so usually only one of hem will produce a mature oocite in every ovarian cicle. They don’t alterante.

      Yours,

      • Terri Reply

        Hi , I don’t know if you can help but , I had an eptopic pregnancy on my right Fallopian tube and they removed my whole tube , Iv gone for some tests to see if I have any problems , she done a scan and said I haven’t got a right Fallopian tube but I’m ovulating from my right ovary, and not my left where I have my only Fallopian tube , what I’m asking is will I ovulate on the left side next month ??? Also Iv read that in some cases the Fallopian tube can still pick up the egg from the opposite side of there isn’t a Fallopian tube ???

        • Dr. Marisa López-Teijón Reply

          Dear Terri,

          Contrary to what many people think, the side of ovulation is random and the ovaries not necessarily alternate each month. However, as you well said, the remaining tube can pick up the egg from the other side and therefore you still have high chances of getting pregnant.

          Kind regards

          • Aiza

            Hi. I have a question. I had a hysteroscopy last year because I had something that blocked my uterus. After that I started taking Clomid for ovulation. My period has been irregular since I had it the first time. My Obgyn told me that the result of my blood test taking clomid for ovulation is just 0.29 she already increase the dosage for me. My question is , is there any medication I can take for me to ovulate and what are the chances of me getting pregnant if I dont ovulate at all? Is the IUI an option for me to do if I dont ovulate at all? Please I need to Know. My husband and I are trying to concieve for four years now. I would appreciate any information about my situation. Thank you! God bless

          • Dr. Marisa López-Teijón

            Dear Aisa,

            Thank you for your e-mail.

            We have other medicines which can stimulate your ovulation. Please, you have to talk with your Doctor about some options for your specific case and clinical history.

            Best regards

  2. Clare Horan Reply

    I have always had regular periods but after trying to conceive for a year, tests showed I wasn’t ovulating. I have had friends who have also experienced this so I am confused that you state you must ovulate if you have regular periods. Please can you explain this.

    • Dr. Marisa López-Teijón Reply

      Dear Clare,

      Generally speaking, if a woman has regular periods less than 35 days long, she is ovulating. Regular periods accompanied by other signs such as breast tenderness or ”egg white” cervical mucus appearance strongly suggest that too. Although ovulation kits can be useful for reassurance, it might prove to be challenging to know the exact day when to test, so a positive test is indicative of ovulation but a negative one can be due to wrong date. To know when to test, from ovulation to the next period is generally 14 days so if you have 28 days cycle, you count back 14 days which means you myth have ovulated around day 14. If you have a 30 days cycle, counting back 14 days, your ovulation was around day 16 of your cycle. I hope this is helpful.

      Kind regards

  3. Stacey Reply

    Hi
    I feel I ovulate on the right side each month as that is where I get pain around ovulation. But I have also heard that having pain on a certain side doesn’t mean that you have actually ovulated on that side? Is this true?

    Thanks

    • Dr. Marisa López-Teijón Reply

      Dear Stacey,

      Having pain on a certain side doesn’t mean that the ovulation is happening on this side.

      Kind regards

  4. Nisssooo Reply

    Hi
    I am 24 F
    Have low amh 0.8 ng/ml
    Fsh 8.3
    Lh 4.8
    I was given benforce m ebexid for 1 month
    Ovulator tablet for 5 days.
    Please provide ur suggestions. Am i on the right track?
    Last month i took siphene 100 2 times a day for 5 days. Got 25 mm follicle. But ended up negative. Got bleeding on and off no continuous flow. Is it due to tablet side effects

    • Dr. Marisa López-Teijón Reply

      Dear Nisssooo,

      If you don’t have regular periods, the medication you mention might help you to ovulate. The 25mm follicle shows that you responded to the treatment but ovulation doesn’t guarantee prenancy as it might take few cycles before you achieve one. Your AMH is showing a low ovarian reserve so you should consider soon to move to other treatments if induction of ovulation is not successful after 6-12months.

      Kind regards

  5. Hi Dr. Marisa,
    I have been surfing online many hours lately, yet I by no means found any interesting article like yours. Thanks for elaborating on the fact that ovulation has no relationship with neither pregnancy nor inheritance. I’ve had friends who had regular periods but after trying to get a baby, they found out that they were not ovulating. You stated that ovulation and periods go hand in hand. Please elaborate that further, help a friend to help a friend. Thanks.
    Best Regards,
    Julia Morales.

    • Dr. Marisa López-Teijón Reply

      Hi Julia,

      Thank you very much for your kind words. It’s a great pleasure for me to know that my medical experience can helps.

      Warm rega

      • Paty Reply

        Hi Dr,I am 28 yrs old, I was having a lot of pains during menstruation, I went for a pelvic scan and I was told it was ovarian cyst, went again after a year and I was told that the ovary is stuck to the uterus. I have regular menstrual period . can this affect my fertility or chances of ovulating,pls help me with a solution

        • Dr. Marisa López-Teijón Reply

          Good morning.
          I can tell you there are 2 kinds of cysts, functional and organic. The first ones disappear when taking birth control pills after two of three monts, so that your ovaries can rest and discard them. The second ones could even need a surgical procedure if they were endometric cysts, which can affect fertility but not ovulation.

          I hope yours will be a functional cyst that can be solved in a short time.

          Best regards.

  6. Carly Reply

    Hi Dr Marisa,

    I have a unicornuate uterus, with 2 functioning ovaries, although my right ovary is very high the doctors don’t believe my only fallopian tube will be able to retrieve the egg from this ovary. We have been trying for almost 2 years and have completed 1 round of IVF, unsuccessfully. I now want to get scanned to see if I am ovulating from my left ovary each month, but the doctors say this is a whole monitoring cycle and will cost £500 every month! Is there any other way to know when I am ovulating from my left ovary, so I know I have the potential to get pregnant?
    Regards,
    Carly

    • Dr. Marisa López-Teijón Reply

      Hi Carly

      The only way to assess which side you are ovulating from, would be by doing regular scans and check which side is producing a dominant follicle. Apart from ovulation, other factors need to be taken into account to know if you are fertile (like tubal patency, sperm quality). If you already have a history of 2 years of infertility, IVF might be the best way to go but your doctor is the best person to assess this by taking into account your previous response to IVF
      Yours sincerely,

  7. Maaza Reply

    Hi..
    I am 27yrs old.. planning for a baby but not getting pregnant. My husband and I had few tests and results were positive..My doctor suggested to have only folic acid tablets and said everything is good and pregnancy Wil happen naturally.. But my concern is my egg s getting released only on the right side for consecutive 4 months and I am having slight pain on my left side.. tis pain lasts hardly for 3 to 4 seconds but comes often…is it normal or something to worry?? Please suggest..thanks..

    • Dr. Marisa López-Teijón Reply

      Hi Mrs Maaza,

      This pain you explain does not suggest anything to worry about. If all the investigations came back normal, your chances of spontaneous pregnancy are high given your age.

      Yours sincerely,

      • Maaza Reply

        Thank you so much Dr.Marisa..good to hear from you..one last question for my satisfaction please..Is it normal that the egg is getting ruptured only from the right side continuously??

  8. Laney Reply

    Hello Dr.,
    Thank you for this article. I have another question on ectopic pregnancy. I only have my left tube and was wondering when I do finally conceive should I request to be checked on earlier to make sure I don’t risk have another one and lose this tube as well? I’m so scared it will happen again. Anything you could recommend to do would be great. Thank you for your time.

    • Dr. Marisa López-Teijón Reply

      Dear Laney.
      If you have a history of an ectopic pregnancy, this could be due to tubal disease and is some cases both tubes are affected.. As you well mention, it is advisable to do an early pregnancy scan to rule out an ectopic pregnancy in the remaining tube but remember ectopic pregnancies are not that frequent so you could still have a perfectly ongoing intrauterine pregnancy
      Best regards

  9. Aiza Reply

    Hi. I had a hysteroscopy last year because I had something that blocked my uterus. After that I started taking Clomid for ovulation. My period has been irregular since I had it the first time. My Obgyn told me that the result of my blood test taking clomid for ovulation is just 0.29 and it has to be double digit to say that I ovulate with the dosage of Clomid I’m taking, she already increase the dosage for me. My question is , is there any medication I can take for me to ovulate and what are the chances of me getting pregnant if I dont ovulate at all? Is the IUI an option for me to do if I dont ovulate at all? Please I need to Know. My husband and I are trying to concieve for four years now. I would appreciate any information about my situation. Thank you! God bless

  10. shariff Reply

    Dear

    My wife suffered from tuberculosis when she was 3 month pregnant,after we made abortion
    After several months she had ectopic pregnancy for this reason doctor removed left fallopian tube .

    After we trying but nothing will be happen

    Now i am diceded to make IUI plz give me a suggetion

    I am really confusion and unhappy plz plz help me.

    regards
    shariff

    • Dr. Marisa López-Teijón Reply

      Dear shariff,

      It is posible to proceed with an IUI but you have to be sure that your wife is ovulating in the right ovarian and her right tube is patent.

      Kind regards

  11. Wenda Reply

    Hi there,
    Thank you, im glad to hear that cervical mucus changes (egg white ) and regular menstruation mean your ovulating,I have been searching for that answer.
    My main question today is being an old bird can I conceive at 44yrs or older?
    I’ve always had longer than 28 day cycles (31/32 days), however I had four back to back 28 day periods just before turning 40 yrs old, I felt normal! Then when my fortieth birthday came I actually conceived that month but miscarried at almost 12 weeks.
    We tried on and off and luckily we got pregnant a year on and I gave birth to a gorgeous healthy little man at 42. Im 44 now and my cycles still average around 32 days,some less,with egg white mid cycle ,so what do you think? Is it still possible ?
    Much appreciated.

    • Dr. Marisa López-Teijón Reply

      Dear Wenda,

      At this age we strongly recommend to proceed with an egg donation treatment due to the poor chances of success using your own eggs.

      Kind regards

    • Mildred Garcia Reply

      Don’t get discorage. I am 45 years old and my last baby was conceived naturally at 43, born when I was 44. She is 16 months. I am trying to give her a sibling but I found out That my left fallopian tube is blocked now. I just went for a sonogram and they told me that I had just ovulated from the left side (the one that is closed) As soon as I get my period , I will start clomid 100 mg from day 2-6, praying to ovulate from my right ovary . Go to your doctor and get tested for everything so you know where are you standing. Good luck

  12. Amy Reply

    Dear Dr Marisa,

    I have been told that I have a low ovarian reserve (I am 36). I started doing scans every period to track my antral follicle count. Last 2 periods at my day 5 scan I already had dominant follicles. This month on day 6 the biggest one was only 6 mm 🙁 does this mean they will not be growing this month, or is there still hope? I should mention that my period is nornally 26 days.
    Thank you so much for tour help!

    • Dr. Marisa López-Teijón Reply

      Dear Amy,

      Having no dominant follicle on your day 6 scan can be still be normal. Cycles length might vary from cycle to cycle and the dominant follicle might be more visible from day 9 onwards.

      Kind regards

  13. Rachel Reply

    Very informative article, thank you. My question is in regards to hyper-ovulation. I have regular cycles and can easily tell when I am ovulating due to changes in cervical mucus. Most literature I read mentions the egg-white appearance occurring for one day, but most months I experience this for 2-3 days. Does this indicate hyper-ovulation? Twins are heavy in my family and I always wondered if there was a correlation.

    • Dr. Marisa López-Teijón Reply

      Dear Rachel,
      Every woman is different so not everyone has the same experiences, when you say that these 2 – 3 days with white flow is normal, it is not indicative of hyper ovulation or because of the number of twins that there are in your family. When you ovulate you can have this kind of flow a couple of days instead of just one day as usual.

      I hope I helped you

  14. Rachel Reply

    I also want to mention that when I had an ultrasound performed during my cycle (I was to become an egg donor) I was told I had a high follicle count. I think it was somewhere between 20-30. Is a high follicle count related to hyper-ovulation or twin pregnancies? I am concerned about twins because I plan to conceive in the next few months. I already have two children who were total surprises; as in we thought we were being as safe as one can be without the use of contraceptives, and I am worried that the one time I actually try to conceive it will be twins.

    • Dr. Marisa López-Teijón Reply

      Dear Rachel,

      Such a high number of follicles is characteristic of polycystic ovaries. So under an ovarian stimulation in an assisted reproduction treatment, it can cause a hyperstimulation but it is not an exact science. I advise you to go to your gynaecologist. The doctor will give you all the necessary informations checking your ultrasounds and studying your case. I have very little information to tell you more

      Warmest regards

  15. Millie Reply

    Does painful ovulation mean it lasts longer than normal?? I get crampy and have the EWCM for about a week its alot and annoying! Is that normal? I dont use BC but still no baby, and wondering if i should get checked out

    • Dr. Marisa López-Teijón Reply

      Dear Millie
      Many women could feel pain during the ovulation process as well as cramps, chills, heavy flow…
      I do not have enough information to know why you don’t get pregnant.
      I advise you to do a review to check the EWCM.

      Best regards

  16. Sanjana Reply

    Hello Marisa, hope u r doing good. i want to share my history of pregnancy that lasted for 3 months in the year 2017 as my fetus got detected with Edward syndrome but that was an unplanned pregnancy and also i felt that it happened due to alcohol intake the very same month due to unawareness of pregnancy.

    i am now looking forward to plan for my pregnancy again in the month of March but i lastly had alcohol in the month of November 2017 n that too moderate amount. Now since recently i read that the egg starts maturing 3 months before it goes for ovulation, i am feeling worried whether or not i should go for planning in the month of March. Its high time now, i will be of 30 years this September. Can u please suggest whether i must wait 2-3 months more.

    Thanks

    • Dr. Marisa López-Teijón Reply

      Dear Madam,

      There is no problem in looking for a pregnancy now because if you have not taken alcohol excessively since November there is no risk for diseases related to alcohol abuse.

      Best regards

  17. Lucy Reply

    Thank you for your article! Very informative.

    I am on my third cycle post-miscarriage. According to my ovulation tests, I ovulated on day 15 last cycle. I am currently on day 12 and had a scan. The tehnician could see “lots of follicles” but no dominant follicle. Does this mean I will likely not ovulate this month?

    My other concern is that my luteal phase seems to be varying. My first cycle post-miscarriage it was 13 days, and last cycle it was 10. I thought the luteal phase was always the same?

    Thank you!

    • Dr. Marisa López-Teijón Reply

      Dear Lucy,

      By day 12 is common to see a dominant follicle but not having one not necessarily means you are not going to ovulate as this could be a long cycle with a delayed ovulation. The luteal phase is generally 10-14 days so don be worried about a slight variation.

      Kind regards,

  18. Akanksha Kulshrestha Reply

    Hi,

    I had an ectopic in Dec-16. through out 2017 I was taking different different medicines for Ovulating (Letoval, Good Ova, Ovasheild DS).
    So this month in JAN -18 I thought of not going to any doctor for a month or two.
    Just did my follical study yesterday (Day 13th) and there is no follicle.

    Is it ok to not have follicle for a month or two. Or should I immediately go and check with doctor

    • Dr. Marisa López-Teijón Reply

      Dear Akanksha,
      The number of follicular counts at the optimal moment of the cycle gives us important information about the ovarian reserve.
      After the follicular study, I recommend you to trust in the specialist who did the exam.
      Kind regards,

  19. Jessica Reply

    I was born with one kidney right. My left ovary is where my kidney should be. My uterus is on right side of my body and right ovary on left side of uterus. Only one ovary attached.. do i ovulate from the “good” ovary every month or do i switch even thpugh my left ovary isnt close to the tube or uterus at all on other side of body?

    • Dr. Marisa López-Teijón Reply

      Dear Jessica,

      Even in women with a normal ovular situation, ovulation does not necessarily occur alternately. In your case, therefore, it is not possible to know if both ovaries take turns ovulating.

      Best regards

  20. Meagan Reply

    Hi!

    Due to PCOS(which I never knew I had until I started seeing a reproductive endocrinologist) my son was conceived through my second IUI. During my second try at IUI my RE had to continue stimulating my follicles to get them to mature, which resulted in conception and a very healthy pregnancy. I want one more. Can someone who has PCOS and could only conceive after further follicle stimulation to only get pregnant from IUI ever be able to conceive on their own?

    Thanks!

    • Dr. Marisa López-Teijón Reply

      Dear Meagan,

      Good Morning,

      It depends on the polycystic syndrome stage you have if you can get pregnant naturally.
      You will have to go to a specialist to be evaluated.

      I wish it goes well,

      Warmest regards

  21. Krys Reply

    Good day!
    My right ovary is polycystic. I undergo transvaginal ultrasound last January and found 1 mature follicle on my left. I have regular period. I had period this February 16. My question now is, is it possible to still ovulate on my left ovary this month?

    • Dr. Marisa López-Teijón Reply

      Dear Krys,

      Yes, indeed, it is still possible that you ovulate on your left this month. Ovulation does not have a pattern , so it is possible to ovulate on any of them in each cycle. The only way to know for sure is if you undergo an ultrasound during ovulation.

      Thank you for taking part in our blog.

      Regards and good luck.

  22. Sonia Reply

    Hello,
    My doctor told me i have very low ovarian activity and very little eggs left, do this mean i am going to enter early menopause on a very short time?
    Thanks and Best regards

    • Dr. Marisa López-Teijón Reply

      Dear Sonia,

      The low ovarian activity may be related to menopause but it is not a clear indicator. In order to check it you could have some hormonal blood test, such as FSH or pay attention to some symptoms such as hot flashes, urogenital symptoms, irregular menstruations or mood changes.

      Good luck and thank you for taking part in our blog.

  23. Mrs.Z Reply

    Hi, today is my cycle day 10, I took clomid cycle day 3-7, I went for my blood work and ultrasound , the nurse told me, my right ovary has one 20mm follicle , meanwhile left one had two 6.7 , but my right tube is blocked, I am so nervous, is my iui gonna cancel since I ovulated from the wrong side?

    • Dr. Marisa López-Teijón Reply

      Dear Mrs.Z

      The ovulation can take place in each one or sometimes both at the same time, there is not a pattern. The fact that your right tube is blocked means that you will not be able to get pregnant when it is the right ovary that ovulates because the egg cannot be fecundated.

      I hope I have helped, good luck.

  24. Lori Reply

    Dear Dr,

    I am 34 and have regular periods on a 27 or 28 day cycle every month. 14 days before my period I get intense pain on my left side only – I have always assumed this to be ovulation pain – and it lasts for around 6- 12 hours or so. but it is only ever on my left side…

    I have been trying to conceive now for 8 months but no luck – could the pain be something other than ovulation pain? perhaps something wrong with my left fallopian tube? I’m worried I am not ovulating from my right side at all and that there is something wrong with my left.

    Thanks

    • Dr. Marisa López-Teijón Reply

      Dear Lori,

      The pain you describe is the typical pain of ovulation. It does not mean that you only ovulate from the left ovary, but that the reflection of that pain appears on your left flank. If you are very concerned about the permeability of your tubes, there is a test called Hysterosalpingography used to determine the permeability of your tubes.
      On the other hand 8 months is a short time for trying to have a baby, there are couples who take more than a year to become pregnant. Do not get discouraged and keep trying.

      Warmest regards

  25. Sophie Reply

    Hello,

    Can anyone help. I am a 29 year old healthy (ish!) lady, I am lucky enough to already have a 6 year old daughter and she was conceived when I was taking the pill. Since her birth my periods have been irregular and periods of bleeding, however for approx 1 year I have only been having periods every 2-3 months so it has gone from bleeding a lot to hardly nothing. I have not been on birth control for years, I did try the pill for a couple of months a while back to try and regulate but just ended up bleeding all the time

    I have been trying for a baby since approx Aug 17. My periods to date have been Late Jul, 21 Sep (5days), 1 Dec (5days), 14 Feb (6 days) and still nothing yet. I went to the GP who advised to continue trying for 1 year then refer me to a fertility clinic. The GO also said I am in premature ovulation failure, but to be honest was disinterested and was not even willing to refer to gyyne or even have a blood test. Has anyone experienced this before? Can anyone offer any advice? It is really getting me down but I also feel this has a huge impact on my well being eg: Mood etc…

    • Dr. Marisa López-Teijón Reply

      Dear Sophie,
      I would recommend you to go to a fertility specialist to do an ultrasound for a follicular count and a blood test of the antimulerian hormone (AMH). With the results of this tests you could know more about your infertility problems.
      Best regards

      • Eva Reply

        Sophie, have the doctors checked your thyroid status? It is quite common to have an underactive thyroid gland especially after giving birth and it can cause a variety of problems including infertility. It is easy to fix by taking synthroid. So if they haven’t checked it yet ask them to do the test, a simple blood sample.

  26. Sreejaya Reply

    Hi Doctor,
    I am 32 year old and trying to conceive for past few years. Commenced treatment this month and as per my gynac did the below blood tests FSH 1.32,AMH 4.12,TSH 2,PROLACTIN 12.35,LH 2.50 as per blood samples given on 28th day of cycle. On my second day of menstruation, started Fertyl 50 mg for 5 days and later from 11th day did follicular study but I had only few follicles on left ovary and on 15 th day as per my gynac, I may not be ovulating this month but my endometrium thickness is 10mm on 15th day. Why does this situation comes as I do not have overweight, PCOS. I have an anteverted uterus. Please advice.

    • Dr. Marisa López-Teijón Reply

      Dear Sreejaya, I suggest you to carry out a complete endocrinological study, to check all the hormones and to be able to carry out a good reproduction treatment.

      Warmest regards

  27. Kim Reply

    Hi! Dr. Marisa López-Teijón, I`m 26 years old
    I got a transviginal ultrasound and the result was normal size uterus with unthickened endometrium normal ovaries with dominant follicle seen on the right. The uterus is anterverted.
    Uterine corpus measured 3.8 x 3.2 x 3.1 cm
    Endometrium with thickness 5 mm
    Dominant follicle measuring 1.2 cm seen on the right ovary..

    I was tried to get pregnant and i dont know if im totally get ovulated.. Please help me about these.. Thanks

    • Dr. Marisa López-Teijón Reply

      Dear Kim,

      If during the scan it was possible to observe a dominant follicle, you have to wait for that follicle to free the oocyte. The ovulation cannot be confirmed without a blood test or scan – performed few days later – that shows the presence of a corpus luteum.

      Thanks for taking part in our blog

  28. Sarah Reply

    Hi Dr Marisa.

    My name is Sarah I am 29 yrs old just recently had a tubal reversal I got left with 3.5 cm on the left tube and 4.5 on the right my question is if you say is true that is woman ovulate on both sides do I stand a better chance at trying to become pregnant when my right tube is ovulating

    • Dr. Marisa López-Teijón Reply

      Dear Sarah, both tubes have a correct measurement, while both are permeable you have the possibility of getting pregnant with either of the two ovaries.

      Warmest regards

  29. Mam i have only right tube bt i m ovuluting from left side from 4 months.is it any prblm right overy or can i ovulute right side….

    • Dr. Marisa López-Teijón Reply

      Dear Neha,

      Regardless of not having the left tube you can ovulate from both ovaries. To make sure the right ovary has as much activity as the left one you can have a follicle count.

      Warm regards.

  30. Danielle lee Reply

    How accurate are OPKs? I am using Clearblue and last cycle tested I had a positive LH surge that was detected. Now this cycle the LH surge wasn’t detected and now I fear I didnt ovulate. My periods are regular so could this be possible I didn’t ovulate?

    • Dr. Marisa López-Teijón Reply

      Dear Danielle, the ovulation tests have a high reliability. The months in which ovulation is not detected may be due to the fact that this cycle could have been anovulatory. Do not worry, it is normal sometimes do not ovulate in every cycle.
      Good luck and best regards,

  31. Nora Reply

    Hello Dr, I am 29 with regular 28 day cycle, 14-16 day OPK +ve, it’s been four months I have been trying and monitoring but with no results, I did an follicular monitoring & the US showed no obvious follicle on CD 11, I was again called on CD15 still no follicles but a mild free fluid was detected, what does that mean, what to expect, pl. enlighten me.

    • Dr. Marisa López-Teijón Reply

      Dear Nora,

      If you have regular cycle, every 28 days specifically, it means you ovulate normally.
      It may be that on the ultrasound performed on day 15 you had already ovulated, that is why you saw the free fluid. The proof that you have ovulated is if 14 days later you have you menstruation cycle.

      Warmest regards

  32. Nichelle Reply

    Hi I’m 34 I have Endometriosis never had any treatments for it but many many many ruptured cysts. I have a 9 year old son tried to get pregnant for a about 5 years nothing happened. I just had a cyst the size of a grapefruit on my right ovary and the OBGYN DID SURVERY February 7, 2018 and removed my right tube and ovary. She said my left ovary has scar tissue along with other scar tissue aka webbing she called it. Identical twins and fraternal twins are on both My mom and dad’s side of the family as am I a fraternal twin however My twin died before birth. My question is
    1.) can I still get pregnant with a scared left ovary?
    2.) what chance would I have to have fraternal or identical twins?
    3.) can my one lonely little ovary release more than 1 egg?

    Sorry to be a pain in just curious and my Dr keeps giving me the run around.

    Also I have a regular 28-29 Day Cycle.

    • Dr. Marisa López-Teijón Reply

      Dear Nichelle,

      You can get pregnant with just one ovary. It’s really important to know your ovarian age and I recommend you doing a AMH (antimullerian hormone) to check it.

      You have a family history of twins so you have a little more probability than other patients without cases of twins in their families.

      It’s really uncommon that you can ovulate of more than one egg in the same ovary.

      Best wishes

  33. Nichelle Reply

    Thank u so much for your help and advice.

  34. imelda Reply

    Hi Dr. I have an ectopic pregnancy at my first pregnancy so my right fallopian tube was removed and two years after I have my first baby. We again workout this year for another baby and took fertility drug last month’s cycle. Last April 30, 2018, my ultrasound revealed that there is a matured follicle but on my right ovary however, I feel slight pain at my lower left abdomen during my fertile period. What could be the meaning of this? Second, how is my chance to ovulate in the left ovary if ever my period comes this month? Do ovaries alternately ovulate each month?…Hoping for your response..Thank You

    • Dr. Marisa López-Teijón Reply

      Dear Imelda,

      First, I am sorry to hear what happened. When ovulating many women feel a slight pain in the lower part of the abdomen. The symptoms you describe might be due to ovulation, you should not worry. As per the ovulation itself, ovaries do not have a pattern, so it is hard to say whether they ovulate alternately or not.

      Best regards.

  35. Sara Reply

    Great article! I was recently diagnosed with PCOS and am currently taking a month off from Letrozole+trigger protocol we have been on with an RE. I have 2 questions:
    1 – if elevated LH is commonly seen in PCOS, why aren’t all my OPKs super positive all the time? (I’ve actually never had a positive)

    2 – If I had a 16mm dominant follicle seen on ultrasound on CD 16, is it likely I will actually ovulate in my own this month? I’m currently CD 21 and my vaginal temps have been trending down since CD16.

    Thank you in advance!

    • Dr. Marisa López-Teijón Reply

      Dear Sara,
      in order that an ovulation occurs, an LH peak has to be produced in the cycle and this LH peak depends on the increase of the oestradiol produced by the follicles. In the case of the polycystic ovary syndrome, this does not always happens. Regarding the 16mm follicle – it is possible that ovulation is produced since with this size it seems that it is the selected follicle this month.
      We wish you good luck!

  36. Nora Reply

    Hello Dr, missed my period for 6 days now, HPK shows negative, should I wait few more days or should I start taking meprete as directed by my doctor? But I am unsure about its side effects on the foetus i.e if I am pregnant.

    • Dr. Marisa López-Teijón Reply

      Dear Nora, if you want to be sure about the pregnancy test, you can have a blood test: its results are more accurate.

      Best regards.

  37. Thoko Reply

    Can i usk question I’m 34 yrs I’m having ovarian cyst on my right ovary my Dr send me for check up my ovary the right one is not clear the left one is clear so which means my right ovary is blocked? And did I have chance of getting pregnant again

    • Dr. Marisa López-Teijón Reply

      Dear Thoko,

      Don’t worry, the fact that you have a cyst in the ovary does not mean that you are not fertile. In these cases, we would recommend to study what type of cyst is, and analyze your ovarian reserve by performing a blood test to measure the AMH.

      Kind regards,

  38. Val Reply

    Dear Doctor,
    Two months ago I miscarried at 6 weeks. It was my first pregnancy. I wasn’t given any methotrexate, nor did I need surgery. The miscarriage was diagnosed as an ectopic pregnancy since the uterus appeared empty in all the ultrasounds (there was apparently no pregnancy in the Fallopian tubes either). My corpus luteum was on the left side but the suspected ep was on the right even though I have both Fallopian tubes. Is this possible? Could it have been a normal miscarriage?

    • Dr. Marisa López-Teijón Reply

      Dear Val, so sorry about what happened. It does look as a normal miscarriage, you should not worry, since it was 6-week pregnancy and therefore your tubes are not affected. That is why your have not needed any extra medicine either. Anyway, you’d better have a checkup in a few weeks to make sure you are fully OK.

      Best regards.

  39. Sally Reply

    Hi doctor, I left a comment yesterday and it was waiting to be moderated but now has disappeared. Will it appear again once it’s moderated?
    I would be so grateful for your advice or reassurance.
    Thank you

    • Dr. Marisa López-Teijón Reply

      Dear Sally, you should repeat the fertility tests since with the time and the age the hormonal values could change. You do not have to be worried about how they were in the past given that just as they can get worse, they can also get better.
      To have an idea of your current ovarian reserve and quality, you need to test the AMH level and have a transvaginal ultrasound to make a count of your antral follicles in addition to the rest of the tests. On the other hand it is also advisable to study your partner since fertility problems can occur on both sides.

      Regarding the ovulation test, they show you start the ovulation process, but they don’t assure if in that cycle an egg has been released or not (in the case of anovulatory cycles).

      I wish you good luck, a big hug.

  40. Barbara Reply

    Hi I had an hsg done. Says right tube good left blocked or I have hydrosalpinx. Everything else great including my hubby sperm. First they said he had 2% morophology but second time perfect. Should I get a second opinion before surgery. I was pregant July 2017 but had a missed mc waited it out naturally by oct my body cleared everything. Menstrual cycle between 29-30 days.

    • Dr. Marisa López-Teijón Reply

      Dear Barbara,

      When a hydrosalpinx is diagnosed, surgery is recommended. Asking for a second opinion or not, it’s up to you. That depends on whether or not you are convinced of the diagnosis that your doctor has made and the trust you have in him.

      Warmest regards

  41. Jabu Reply

    hi Dr. Marisa

    I am 34 years and have a 13 year old child. my husband and I have been trying to conceive for 2 years and eventually last year I did conceive but it became an ectopic so they had to cut my tube on the left side. I have never gone for a gynea check up and I do not know what to ask and where to start. I know when I am ovulating and even know the signs but its not happening,
    please advise what can I do? when I is it that I should go to the gynea?
    when having sex during ovulation it pains so much that I sometimes don’t want to have sex,

    warmest regards,
    Jabu

    • Dr. Marisa López-Teijón Reply

      Dear Jabu, the most important thing is to perform a gynecological visit in order to check if everything is correct, tell your doctor to do an antral follicle count and a hormonal analysis, your partner should go to an andrologist to get the necessary tests.
      With all the results will be easier for your doctor to make a diagnosis.

      Kindest regards

  42. Katie Reply

    My daughter is 37. She has been going to a fertility dr for three or 4 weeks now. She was told that they are pretty sure she has endometriosis because of the pain on her ovaries

    • Dr. Marisa López-Teijón Reply

      Dear Katie, it is necessary to study the degree of endometriosis of your daughter, according to the degree, it will affect more or less to its fertility.
      It is best to follow your doctor’s instructions

      Warmest regards

  43. Angel Reply

    What happens to the ovary while the other works? Sonar results showed that the right ovarian follicle is 14mm while the left is 16mm. And the egg growing in both ovaries, ovulation can occur twice, once from the left ovary, and then two days from the right.

    • Dr. Marisa López-Teijón Reply

      Dear Angel, during the menstrual cycles you could have several follicles, although finally it is only one that grows and ovulates. In some cases it is possible to ovulate several follicles at once, although it is not normal. While one ovary ovulates the other one rests.

      Best regards

  44. Jhen Reply

    Hi. I just had ultrasound today (CD 12) which revealed that I have BILATERAL PCOS, thin endometrium (5mm) and NO dominant follicle. TTC since Nov2017 as I withdraw from hormonal pills last Oct17. Since then I had 30-39 days cycle. I was diagnosed with PCOS since I was 18 and I already have 1 princess(7y.o). I want to conceive again as I was already turning 30 in Jan2019. Do you think it still still possible for me to conceive this month spontaneously or should I seek medical help so i can get pregnant. I really felt bad that I dont have dominant follicle and the ob-sono also said I even have a thin endometrium. 🙁

    • Dr. Marisa López-Teijón Reply

      Dear Jhen, you are young and if you didn’t have any problems in the past I recommend you use the ovulation tests as they can guide you on the most fertile days of your cycle. If after several months after trying it in a natural way you can not conceive, you can go to a specialized reproduction centre where they will carry out a personalized study.

      Good luck

  45. Adeline Reply

    Dear Dr.Marisa,
    I had a ruptured ectopic on my Right fallopian tube in October 2017. I have been on Clomid 100mg and this is my 2nd cycle on it. During the recent USG, the follicle was noted to be on the right side. My question is should I con’t to try with Clomid or should I consider IVF? I have also had a miscarriage in May 2017 prior to the ectopic. Thank you.

    • Dr. Marisa López-Teijón Reply

      Dear Adeline,

      If you have been on Clomid for several months and still do not get pregnant, you should consider going to a specialized centre so that they can give you orientation about an IVF treatment.

      Best of luck.

      Kind regards.

  46. Jessica Reply

    I developed a large hemmorhagic cyst over the course of two cycles on my right ovary. They were big before my period at about 4cm and became smaller during my period (2cm).

    The right ovary also contained the dominant follicle on my past two cycles and i haven’t gotten pregnant yet.

    The left ovary finally looks it will be the winner for the dominant follicle. It has 9mm follicle on day 5 with other smaller one’s . The right has multiple 6mm ones plus the hemmorhagic cyst.

    could the rt cyst prevented me from ovulating or even then released a weak or immature egg on rt ovary ? and now that I most likely will be ovulating (finally) on the left side this month, will the rt cyst still affect my ovulation ?

    • Dr. Marisa López-Teijón Reply

      Dear Jessica,

      There is no need to worry. From your comments, I see that the size of the hemmorhagic cyst is small, so that it does not have any effect in your ovulation nor in your fertility.

      I would advise to pay a visit to your gynaecologist and take all related controls to see the evolution.

      Kind regards.

  47. Rita Reply

    Hi Dr.

    I was diagnosed with an ectopic pregnancy in my left tube in August 2017 and was treated with methotrexate. After my hcg went down to zero my dr recommended I go for an hysterosalpingogram where he said that everything is normal and no tube is blocked. However i’ve been really scared of ttc again and getting another ectopic. Any advice? Is there a higher probability of getting an ectopic pregnancy in my left tube vs my right now or might the first ectopic have been just a fluke? Thank you.

    • Dr. Marisa López-Teijón Reply

      Dear Rita,

      Ectopic pregnancies happen without any reason. It is impossible to know whether they can happen again or not.
      If the hysterosalpingogram has turned out normal, don’t be afraid of TTC again.

      Best of luck.

      Kind regards.

  48. Laura Reply

    Hi Dr.,
    Thank you for your article, I found it really interesting.
    My OB placed me on Femara (2.5mg CD 5-9) (PCOS) and I had an US on CD 13 and he said I had a good follicle measuring roughly 13mm and my lining looked good and I should ovulate in a couple days.
    This was a week ago, and I still haven’t ovulated. Is it possible that I could still ovulate?

    I have been having some cramping on the ovary which had the dominant follicle. I texted my doctor yesterday but I haven’t received a response, it is the holiday weekend so I may not.
    What happens to a dominate follicle if you do not ovulate? Will I be ok?
    Thanks,
    Laura

    • Dr. Marisa López-Teijón Reply

      Good afternoon,

      Since I haven’t got all the information I am unable to confirm if the ovulation will or will not take place. You can get some help from the ovulation tests; they could give you an estimation.

      The cramping on the ovary could be due to ovulation. In case you have ovulated you do not need to worry: the dominant follicle will be reabsorbed following its normal physiological functioning.

      All the best.

  49. RB Reply

    Hello Doc,
    I’ve been searching the web for hours to find answers in my situation and I came into your article.

    My periods were irregular ever since and became more irregular when I got married. Upon checking with the doctors, they found out that I have bilateral polycystic ovaries. Gone through different treatments and within 3 yrs of being married, I would only have faint positive tests.

    And to make this short, my LMP was last June 16th and it lasted 12 days just like my previous cycles this year. Feeling unwell, I decided to get a pregnancy test and it gave me another faint positive. So I went to have an ultrasound only to find nothing, except for my PCOS. I went home feeling confused and did another test yesterday but same result.

    My question is, is it possible that the sonologist saw nothing, even if i have faint positives? I am confused as I was yesterday. If I didn’t ovulate, why am I getting these faint lines? And if I did ovulate, why there’s no corpus luteum seen? I’d highly appreciate it if you can enlighten me.

    Truly,
    RB

    • Dr. Marisa López-Teijón Reply

      Dear RB,

      Good afternoon.

      In order to clear doubts about faint positives, the best thing to do is a blood test.
      Regarding ovulation, you could keep track with temperature, flux and ovulation tests. Since you have such irregular periods it is very difficutl to catch a glimpse of the corpus luteum in an ultrasound.

      All the best.

  50. Dana Reply

    I came across this site, I am currently going thru insemination process trying to get pregnant. I bought the Clear Blue ovulation tests and I keep getting a positive smiley face. But my blood is coming back with a low LH Surge. My doc said it may just always read a positive even on my period. How is this possible? I thought I can use the tests if we decide to try on our own but now I don’t know when I ovulate. My period was never regular since i stopped the pill 2 years ago. My cycles would be short (about 17 days) one month and long (as long as 42 days) the next. My longest cycle was 69 days and I went on a pill to bring on a period. I did one round of iui but it didnt work. I also may have a cyst, they can not tell if its a follicle or a cyst. Its not growing or shrinking in 4 days. And I dont have any other follicles more than 10 mm. I am on day 8 of my cycle. Am I ovulating? I dont think I can get pregnant. I am 35 years old by the way.

    • Dr. Marisa López-Teijón Reply

      Dear Dana,

      Since you have such irregular cycles it is really difficult to tell whether you are ovulating or not. I would advise to use the ovulation tests. Should this not work for you, another option is to take a trasnvaginal ultrasound, in order to check if there is follicle growth.

      With such small follicles it is very difficult to determine if you are ovulating or not.
      In order to check if it is a cyst or the corpus luteum your doctor should be able to tell you by carrying out an ultrasound examination.
      If you are worried about whether you can or not get pregnant, ask your doctor to carry out all hormonal tests required.

      All the best.

  51. Sunita Reply

    Hello Doctor, I am 37 yr old and my husband is 39. Trying for second child. In April 2017 i had an spontaneous abortion after that i avoided pregnancy for 3 months then i had a right ectopic pregnancy in sept 2017 which got treated by 1 shot of methotrexate then again avoided pregnancy for 3 months. My hsg test shows my left tube is blocked. My husband’s semen analysis is good. Rest of the reports came normal. Then I took letrozole for 3 months and went for follicular monitoring which showed i ovulated from left ovary in all the three cycles. Plz suggest what should i do? I am worried because of age factor.

    • Dr. Marisa López-Teijón Reply

      Good morning Sunita,

      If, as you tell me, the results of HSG show that your left tube is blocked and after follicular monitoring you ovulate from your left ovary, you should go to a Reproductive Medicine Center so that they can tell you what assisted reproductive technique suits you best, since the fact that your tube is blocked will make it quite difficult to get a natural pregnancy.

      Because of your age, you should not worry too much. You are still in an adequate reproductive age, but go as soon as possible to a Reproduction Centre.

      I wish you all the best.

      Kind regards.

  52. Rinki Ninoriya Reply

    No follicles are found in both of my ovaries on day 5 of my menstrual cycle,but I have regular periods ,can I be pregnant?

    • Dr. Marisa López-Teijón Reply

      Dear friend,

      At your age, 27 years old, and with regular cycles, I do not have any motive to think that you cannot get pregnant.

      It is normal to not find follicles in your ovaries on day 5 of your menstrual cycle, since they can be observed from day 10 onwards.

      There is no need to worry.

      Kind regards.

  53. Teagan Reply

    Hi DR, I have been diagnosed with PCO without the syndrome, which to me meant my female and male hormones where fine, no facial hair acne etc.. my periods are fairly regular about the 28-32 day cycle, I have been told I do not have a dominant follicle.. does this mean I can’t get pregnant? I thought if I was having regular periods every month I was ovulating I’m very confused.

    • Dr. Marisa López-Teijón Reply

      Dear Teagan,

      Of course you ovulate very month, that is why you regularly have your periods. That you do not have a dominant follicle doesn’t mean you are not ovulating. It simply means that many eggs do mature at the same time and that there is not one that stands out from the restin the moment that the ultrasound was made. But there is a moment when a follicle does stand out from the rest and matures; it is then that it is expelled, so that your fallopian tubes can pick it up.

      It is usual for PCO patients not to have a dominant follicle, hence you do not need to worry, because you do ovulate every month. If you want, you can take an ovulation test in urine to check that you really ovulate every month.

      All the best.

  54. Alana Maria Reply

    Dear DR, In 2007 I had an ectopic pregnancy resulting in me losing my left fallopian tube. In 2016 I had a dermoid cyst growing on my right ovary which resulted in me having to had my right ovary remove in order to get the cyst out. Is it possible that I can still get pregnant naturally? And if not Will IUI work for me? OR will I need IVF. Bearing in mind that I have my right fallopian tube without notice right ovary and my left ovary with no left fallopian tube.

    • Dr. Marisa López-Teijón Reply

      Dear Alana Maria,

      Because of the lack of your right fallopian tube and your left ovary it is impossible to get pregnant naturally or via IUI. You could go for an IVF; in any case, you should first have all necessary tests done and, according to the results, do what your doctor thinks is more suitable.

      Best regards.

  55. Maria Jimenez Reply

    I am 38 years old and have 4 kids. I got pregnant in May but miscarried at 10 weeks. My question is does the month you ovulate and get pregnant matter after a miscarriage? For example after I miscarried I ovulated and got my period. Should I wait until my next cycle to try to get pregnant so it won’t be on the same cycle as when I got pregnant originally? Thank you for your article. I look forward to hearing from you

    • Dr. Marisa López-Teijón Reply

      Dear friend,

      After a miscarriage, periods suffer from changes in its periodicity and they tend to normalize after two or three months. If your wish is to get pregnant again, I would say that from the age of 35 the quality of eggs, as well as the ovarian reserve, falls significantly. A proof of that is, that at that age, there are more transfer failures, as well as more repeated miscarriages. Should you not achieve your objective after 6 months of trying to conceive again, my advise would be to reach to an Assisted Reproduction team so that they can orientate you about the diagnostic tests to be carried out, as well as the most adequate technique in your particular case.
      I wish you all the best.

      Kind regards.

  56. Miron Reply

    Hello Doctor, hope you are fine. We are trying to have baby more than two years now. Recently on 16 August 2018 (9th day of my cycle) I did Hsg . I have 28-32 days cycle normally, but just after Hsg I missed my period. 14 days passed that i have missed period now. I did home pregnancy test but showed result negative. Can you please advise can this situation be considered as normal phenomenon or what I should do?

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