I recognize that a trying-to-conceive (TTC) post on a blog about babyloss might be a trigger for some, but I felt compelled to share what I’ve learned over the past year and a half about charting. I’ll try to keep it entertaining.
To preface, when we started TTC the first time, we went to a fabulous clinic that specializes in helping LGBT couples have babies. They are therefore used to working with women who have no known fertility issues except the obvious lack of sperm, which means that they fully support drug-free attempts at IUI and ICI. It also means, however, that they’re sticklers about charting for at least three full months before any doctor-assisted process (we chose doctor-assisted IUI, as this sh*t’s expensive and this has shown the greatest probability of success within four months of trying). When you begin the process with CWHC, you are required to attend a one-hour consultation in which you learn all about charting and exactly how to do it, and are given sheets on which to track everything, daily (no app. A literal chart on a literal sheet of white paper, which you then take to work and surreptitiously photocopy).
The first go-round, I took extensive notes on everything, from my level of cramps and pain to the exact look of my cervical mucus. It helped a bit; for example, I discovered that I get a low, dull backache when I ovulate. But now that I’m a veteran at this, I’ve learned that really, only three things matter when taking a good chart: cervical mucus, ovulation predictor kits (OPK), and basal body temperature (BBT). The first tells you that you’ll likely ovulate in the next few days, the second that your ovulation is imminent, and the third that you’ve ovulated. These three things in combination will help paint a picture of what your specific ovulation pattern looks like for you and your doctor. Let’s break them down.
Cervical mucus – don’t bother Googling images. They’re gross. And what your cervical mucus looks like isn’t necessarily what someone else’s will. Pay attention to yours, though. It will likely – and I say likely – start out watery and then turn egg white when you’re about to ovulate. This is good – healthy cervical mucus is what helps lubricate and protect the sperm on its journey. For me, it means a few days of discomfort at the gym, when running feels like I’m peeing in my pants. Good times. Also, however, it is the most accurate way for me to determine when’s the right time to use a…
Ovulation Predictor Kit – necessary for pinpointing your most fertile window. I’ve actually heard doctors with various theories on when you’re most likely to get pregnant. I will say that I got my first OPK positive on a Thursday evening, and my IUI was scheduled for noon on Friday and 8 a.m. on Saturday (two per cycle is recommended). And I got pregnant. My friend’s doctor would have scheduled her for Saturday and Sunday (she’s not pregnant). So make of that what you will. When you’re actively trying to get pregnant, it’s not uncommon to test first thing in the morning, mid-day, and in the evening starting around day 10 of your cycle. Currently, I’m only testing in the morning (a positive should be visible for 24-48 hours), though I did start at day 10. I didn’t want to get too obsessed over charting since we’re not actively trying to conceive, yet. That said, the other night I was describing to K how anxious I was that it was day 14 and I hadn’t gotten a positive OPK yet (usually I ovulate around day 12). “Could you have missed it?” she asked. “Unlikely,” I shrugged, “but possible. After all, I’m only testing in the morning. I don’t want to obsess about it too much.” “Tell me,” she laughed. “Would testing twice a day make you obsess about it more than you are right now?” I had to concede this was an excellent point. Next month, twice a day it is. Other notes on OPKs – buy the sticks in bulk from Amazon. You’ll save tons of money, and they usually come with a handful of pregnancy test strips, too. No frills, but less than half the price you’ll find at the drugstore. The only other thing you need is disposable cups in which to pee. Once you get a positive OPK, time to check your…
BBT – granted, you should have been charting your BBT since the first day of your period (day 1 for charting). This establishes a baseline, as all your BBT will tell you is if you actually ovulated – your BBT should spike several tenths of a degree post-ovulation. This is helpful information for fertility docs, since this helps them determine if further tests are needed and provides evidence that a medical intervention like Clomid might be necessary. Taking BBT sucked the first time around, but as I’ve mentioned, I’ve learned a few things. One, buy a good, reliable thermometer, cotton balls, and alcohol (for cleaning said thermometer). If you’re lucky, you have an alarm clock with a flat top, like mine. I put the thermometer right on top of my snooze button. Five days a week, the alarm goes off at 6:50, I reach over, pop the thermometer in my mouth, wait until it beeps, turn it off, hit snooze, and go back to sleep until the alarm goes off again at 7 (then I lounge around until around 7:15, when I drag myself into the kitchen for coffee, but that’s neither here nor there). Actually, when I finally sit up in bed, I first turn back on my thermometer, which retains the last reading, put a dot on the chart I taped to the wall next to my bed (it’ll ultimately look like a line graph), go pee in a cup and dip in my OPK, and let it do it’s 5-minutes thing while making coffee. I take the coffee back to the bedroom, check the OPK (“stupid bleeping negative!”), throw out the test strip, and pout while handing K her coffee (I do weekdays, she does weekends. Pretty fair deal). Oh, back to BBTs. It’s a pain, true. And most of the time, it seems completely unnecessary. But the post-ovulation spike can be quite reassuring. Now, most of the time I get up around the same time, and my temp is pretty steady. But as you’re just looking for a pattern, don’t worry too much about it. Take your temp regardless, whether you went to bed late, got up late, drank too much alcohol the night before, were hot, were cold, were traveling, etc. If you miss a day, just miss it and take your temp the next day. Patterns, after all. I do note on my chart the time I took my temp and if there was any other anomaly that could explain an errant reading (like last Saturday, when we went camping and I was restless most of the night due to a thunderstorm). The time matters, because your body temperature rises with time, so if you’re, say, at 97.0 every morning at 7, then a reading of 97.6 at 8 would be perfectly normal and within your pattern. On the other hand, a 97.6 at 7 might indicate you have ovulated…. or that it was 95 degrees in your bedroom because your air conditioning was on the fritz. Write it down. Look for the pattern. But don’t obsess too much. Remember, BBT is helpful for your doctor in determining if you’re ovulating, but waiting for a spike in BBT to have sex would likely be too late for pregnancy purposes. Use it as a confirmation, not a predictor.
There you have it. Charting 101. It’s a pain. But it’s also a way to feel like you’re doing something to pass the time. Really, they should have taught us this in school. How many pregnancies could be prevented if teenage girls knew that cervical mucus was a big “danger/congratulations, you’re fertile!” sign? Especially knowing that our hormones prime us to feel randier during these days.
Finally, a disclaimer. I’m not a doctor. This is what I have learned, and what seems to work for me. This may not be 100% scientifically accurate (though I’d welcome corrections in the comments, if you notice anything that needs a clarification).