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.

29 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

  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

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