Fertility Tracking: Apps?

Tracking Your Fertility: why apps aren’t the golden ticket they appear to be

Written by Dr. Fiona Callender, ND

Apps have become a huge part of our lives - our health and healthcare are no exception. They can help us stay on track and accountable, book appointments, help us see patterns in our health and activity levels and, as many claim, they can even help us get (or avoid getting) pregnant. Period tracking apps have been around for over a decade - some better at predicting than others. Although there are various algorithms used to make predictions, most of them use calendar dates to help predict ovulation and/or your fertile window. One of the challenges is that the fertile window may vary considerably between women (or even within the same woman from cycle to cycle), especially when they have different cycle lengths. Most apps predict ovulation as the 14 days before the start of the next period. Though this is sometimes the case, apps often miss the actual date by atleast a day or two.

What is the Fertile Window?

The fertile window is a period of time - usually about six days - where conception is most likely. This is typically the day of ovulation and the 5 (or so) days prior. This is really based on how viable an egg and a sperm are within the female reproductive tract. Sperm may live as long as 5 days within the female body, while an egg can survive about 12 to 24 hours after ovulation. This gives us a timeline of about five days before to about one day after ovulation where you could still get pregnant. The challenge is timing this!

As mentioned above, most apps predict ovulation to be day 14 in a “typical” 28 day cycle. That tends to actually be an early prediction for many, even if they have a 28 day cycle. If you are trying to avoid pregnancy, and use an app to help you do this, you may think you are past your fertile window, when in fact you are primed for unintended pregnancy. On the other hand, apps tend to predict ovulation to be later than it actually is for those who have longer cycles. This can be a challenge for those trying to conceive as they may time sex too late and miss their window.

Understanding your own fertile window

In most cycles - as long as you are ovulating - there is a typical pattern that occurs. This is something that we can observe! Leading up to ovulation we have an increasing estrogen level, which is associated with a surge in the hormone LH, followed by a rise in progesterone. These events give rise to signs and symptoms that we can use to understand what is happening with your hormones and predict your fertile window. At home, we can monitor your cervical mucous, we can test for that LH surge, and we can track your body temperature to give us clues as to when ovulation will happen (or has already happened). The more methods you put together (as long as it doesn’t increase your stress) the more information you have and the more accurate you may be able to be. 

Monitoring your cervical mucus

Cervical mucus changes give us clues about that rise in estrogen pre-ovulation. These changes, which can be sensed by most women, are highly predictive of ovulation. Leading up to ovulation you will notice higher volume of discharge, it might be white and more creamy. In the day or two around ovulation we notice a shift and are looking for secretions that are more slippery, stretchy and clear - often described as “egg white. consistency”. This can be sensed with your fingers or even just noting the “wet sensation” in your underwear. Post-ovulation, discharge is dryer and much more scant. You can start to notice patterns in your own body each month!

LH Strips or Ovulation Predictor Kits (OPKs)

These kits are really accurate at predicting ovulation in most people. Tracking the hormone LH in your urine for the days around expected ovulation can give us a good clue as to whether you experience the “surge”. This LH surge occurs 24-36 hours before ovulation. On your strips, you should see a few days of negative results followed by positives (could be a smiley face or a stronger line) for a couple of days and then negatives again. This positive suggests likely ovulation but can’t confirm ovulation. If you are a person with polycystic ovarian syndrome (PCOS), you will want to keep in mind that these strips may cause false positives for you. This is because LH is often chronically high with this condition because your body needs bigger signals to ovulate. 

Basal Body Temperature

Changes in body temperature around ovulation are related to the rise in progesterone after ovulation. Basal body temperature, compared with OPKs, will help you confirm ovulation but not predict it. Because the rise occurs after ovulation, it’s best to use this method in combination with other methods - and to get patterns over time. You’ll want to use a thermometer that has two decimal points - we are looking for a distinct rise of about 0.5°C. This method can be challenging - and fickle! You have to take your temperature at the same time each morning, before doing anything else. This means, before even turning on a light. A bad sleep, illness, and consuming alcohol can all impact temperature.

As you can see, the more of these methods you use together, the more likely it is for you to have an accurate sense of your fertile window. That said, for some they can increase stress and pressure on the experience. For others, it allows them a way to connect with their body and build some awareness around their cycle. Everyone is different and not everyone has to approach family planning or fertility in the same way!

It’s also reasonable to note that although apps may not be the best to predict the fertile window on their own, they can be incredibly helpful tools for understanding your cycle and having a record of it. It can be helpful to track symptoms and have information to bring to your healthcare provider. Tracking PMS symptoms and understanding your body can be really empowering and help build body awareness. Noting cycles shorter than 24 days or longer than 35 could spark some investigation that could inform how we support your fertility journey as well. 

When to speak with your practitioner

It can take some time to get pregnant - even when everything seems to be perfectly timed! More than half of healthy couples get pregnant within the first six months, and substantially more within a year. We know it can be a frustrating waiting game as you do everything in your power to build your family. Guidelines suggest you seek support after a year of trying if you are under 35 years old - 6 months if you are over 35 or have health conditions that may impact your fertility. We tend to refer a little earlier as waitlists can sometimes make the process a little longer! There’s also a lot we can do to support your fertility journey - including guiding your timing, investigating causes of infertility or miscarriage, and supporting your health overall.

Curious about what your fertility journey could look like with the support of our team? Feel free to book a meet & greet appointment with Dr. Fiona