ovulation

You probably never saw yourself using the words cervical mucus, much less pulling down your pants and checking to see if you’ve got any. But here you are. You’re trying to conceive, and your best friend told you that you’ve absolutely got to start checking it out if you want to figure out the best time for baby-making sex.

It might sound like an old wives tale that refuses to die, but it turns out tracking cervical mucus really can help some women get a better handle on their cycle. Here’s why you might want to start paying attention.

What's cervical mucus, anyway?

If it sounds like the stuff that comes out of your nose when you’ve got a bad cold, you’re halfway right…only this isn’t snot, and needless to say it’s not coming out of your nose.

Your cervix is located at the lower part of your uterus, says David Diaz, MD, reproductive endocrinologist and fertility expert at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif.

Dr. Diaz describes the cervix as a sort of bridge between the vagina and the uterus, and as an entry portal for sperm when a heterosexual couple has sex during the female partner’s most fertile time of the month—when she’s ovulating.  

Now comes the mucus part.

The cervical canal, which Dr. Diaz describes as, “a tunnel passing through the cervix,” is lined with glands that excrete a clear, slippery mucus during ovulation. The mucus actually helps sperm make its journey toward the egg for fertilization. Aren’t our bodies amazing?

Because the mucus is only set up for aiding sperm during ovulation, its consistency changes throughout your cycle. So just like the arrival (and blessed departure) of your period can tell you that you’re absolutely not ovulating, the arrival of the right kind of mucus can tell you when you are. Which leads us to…

Checking your mucus

Some folks ovulate like clockwork, and they don’t need no stinking mucus to tell them they’re fertile. But if you’re not one of those lucky ladies, you may not need to run to the doctor to find out if you’re ovulating. You can try to do a check on your own to see if your glands are pumping out that slippery liquid.

Dr. Diaz suggests inserting two fingers into the vagina and feeling for something wet and slippery. Pull them out, and take a look at your fingertips:

• Totally dry to just slightly damp: This is typical of the days right after your period ends, when fertility is at its lowest for most women.

• Mucus that’s slightly thick and sticky and either yellowish or whitish: Although you’re still not ovulating, this indicates your body is either preparing for ovulation or has just finished.

• Mucus that’s almost totally clear and stretchy: If the mucus has the consistency of egg whites and can stretch a few inches between your fingers, your ovulation window has arrived! It’s time for frequent sex, Dr. Diaz says.

Do you really have to?

So all this is well and good, but do you really need to stick your fingers into your vagina and feel around for mucus to help you get pregnant?

Well, that’s up to you, but consider this: When scientists at the University of North Carolina, Chapel Hill and the University of Utah in Salt Lake City monitored more than 300 women on their fertility journey for a 2014 study, the women who opted to check their cervical mucus regularly were found to have a statistically significant increased chance of conceiving over women who didn’t bother to check. And theirs was far from the first study to find a solid link between tracking cervical mucus and conception! The science on cervical mucus is pretty well-regarded by the experts.

So, if you’re having trouble nailing that ovulation window but don’t yet want to take the plunge into ovulation test kits, this could be just the thing you need.

There's something about trying to get pregnant that seems to bring out the worst advice from your friends and family. Sure, they mean well, but when your cousins are swearing up and down that they know absolutely the only thing that will help you conceive, it can be hard to tell truth from fact.  

Take the myth that checking your cervical position will help you pinpoint just when you're ovulating so you can rush to the bedroom for some good old-fashioned babymaking sex. Yes, we said it's a myth.  

Although it's widely touted by some women as "the thing" that helped them tell just when they're ovulating, the fact is the only time the cervix goes through major changes is when a woman's giving birth, says Alyssa Dweck, M.D., an OB/GYN and author of The A to Z for Your Vag. Not to mention, "most women can't even feel their cervix" to determine its position, she says, so if it were to change, it would hardly help folks determine where they are in their menstrual cycle.  

If tracking my cervix won't help, how can I tell when I'm ovulating?

Forget what your cousins, best friends, and that overbearing lady at the supermarket swear will help you tell when it's time to have sex. Here are some bona fide ways actual doctors say you can tell if you're ovulating:

• Cervical mucus changes: Although the cervix doesn't move, it does produce a discharge during ovulation that can be a clear sign that you're at your most fertile, says David Diaz, MD, a reproductive endocrinologist at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif. If you insert a few fingers in your vagina, and they come out with a clear, slippery, stretchy mucus on the tips, it's a good indication you're ovulating.  
• PMS-like symptoms: It doesn't sound quite fair, does it? Double the PMS? For some women, symptoms such as breast tenderness or bloating that many associate with the days before their period arrives may actually show up even earlier…when they're ovulating. The good side of this? If this is you, it may help you get a handle on your cycle.
• Cycle-tracking apps: Technology has come a long, long way in recent years, and many of the cycle-tracking apps on the market may help a woman pinpoint her most fertile period, Dweck says. Not all apps are created equal, so it's best to talk to your provider about your cycle and needs (or check out our guide here) to find out if there is an app they recommend you use.  
• Follicle ultrasounds: Cycles vary. Your best friend might have a 28-day-cycle, while yours might be more like 34 days…or maybe 21. If you haven't been able to nail that ovulation window at home, a reproductive endocrinologist may be able to help using ultrasound technology.    

The net-net

You can skip the cervix checks (and you might want to stop taking medical advice from your cousin). But there are plenty of other methods that may help you figure out the perfect time to schedule some baby-making sex sessions. Good luck!

Understanding reproductive health is crucial, especially when it comes to fertility. Anti-Müllerian hormone (AMH) is one of the key markers used to assess ovarian reserve, which refers to the quantity of eggs. Many factors can impact AMH levels, including age, genetics, and certain medical conditions.

One common question that arises is whether birth control, a widely used contraceptive method, can affect AMH levels. In this article, we will explore the relationship between birth control and AMH levels to shed light on this topic and provide valuable insights for those concerned about their fertility.

What is AMH?

Before delving into the impact of birth control on AMH levels, let's first understand what AMH is and its significance in assessing ovarian reserve. AMH is a protein produced by the small follicles in the ovaries. These follicles contain immature eggs, and the level of AMH in the blood provides an estimate of the remaining egg supply. Ovarian reserve tests can help you make decisions about egg freezing. In general, higher AMH levels indicate a larger number of follicles and potentially better ovarian reserve, while lower levels may suggest a diminished egg supply.

Can birth control affect your AMH levels?

One common concern among women is whether taking birth control can influence AMH levels. Birth control methods, such as oral contraceptive pills (aka “the pill”), patches, injections, and intrauterine devices (IUDs), work by regulating hormones and preventing ovulation. So it is reasonable to question whether these hormonal interventions can impact AMH levels.

Research suggests that hormonal birth control may affect AMH levels. But it depends on the type of birth control.

One study looked at data from women on various types of birth control and found: 

• Combined oral contraceptive pill led to 23.7% lower AMH
• Progestin-only pill led to 14.8% lower AMH
• Vaginal ring led to 22.1% lower AMH
• IUD led to 6.7% lower AMH
• Implant led to 23.4% lower AMH
• Copper intrauterine device led to 1.6% lower AMH

The authors concluded that birth control use is associated with a lower mean AMH level than for women who are not on contraceptives, with variation depending on the type of birth control

Learn more: Egg Freezing and Birth Control: An Overview

The amount of time you are on birth control may also be a factor. A systematic review of 15 studies concluded that AMH is unchanged in women using combined oral contraceptive pills if they were using it under six months. 

However, they found a lower AMH in long-term users of the pill. But it’s just temporary – AMH levels rebounded after they stopped using birth control.

Is AMH accurate if on birth control pills?

One study compared the AMH levels of 228 hormonal contraception users and 504 non-users. They found that users of birth control had 29.8% lower AMH concentrations. Because of this, the authors concluded that AMH may not be an accurate predictor for women using hormonal contraception.

You may want to consider the timing of the AMH test when using hormonal contraceptives. Estrogen can suppress the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are necessary for the development and maturation of follicles. 

As AMH levels are influenced by FSH and LH, you could wait for a few weeks after discontinuing birth control before measuring AMH levels for a more accurate assessment of ovarian reserve. Or, you could take the test knowing the results may be lower due to birth control. It’s best to discuss this with your doctor.  

Do I need to get off birth control to get AMH tested?

In general, it is not necessary to discontinue birth control before getting an AMH test. However, it's important to be aware that hormonal contraceptives, such as oral contraceptive pills, can potentially lower AMH levels temporarily while being used. This means that if you are currently using birth control, the AMH results may be lower than they would be if you were not on contraceptives.

If you are concerned about the accuracy of your AMH test or have specific fertility-related questions, it’s best to consult with a fertility doctor. They can provide personalized guidance based on your individual circumstances and help you understand how birth control may impact your AMH results. They will take into consideration factors such as the type of birth control you are using, your reproductive goals, and any underlying medical conditions. This will help ensure that you receive the most accurate and relevant information regarding AMH testing and its interpretation.

Will my AMH change if I get off birth control?

AMH can and will change throughout your life. And, it is generally believed that AMH levels should return to their baseline after stopping hormonal contraceptives. 

Birth control methods, such as oral contraceptive pills, work by suppressing ovulation and altering hormone levels. Once you discontinue birth control, your body will naturally resume its normal hormonal patterns, and AMH levels should stabilize accordingly.

Individual responses to stopping birth control may vary. Some may experience a temporary fluctuation in their hormone levels as their body adjusts, which could potentially affect AMH measurements. However, these fluctuations are typically short-lived, and AMH levels should gradually return to their baseline within a few menstrual cycles.

If you are planning to assess your ovarian reserve through an AMH test, you may want to wait for a few weeks or consult with your fertility doctor to determine the most appropriate timing after discontinuing birth control. This will help ensure a more accurate assessment of your current ovarian reserve without the influence of hormonal contraceptives.

Remember, AMH levels provide valuable insights into ovarian reserve but are just one piece of the puzzle when it comes to fertility. 

Does birth control help egg reserve?

Although birth control does not directly affect AMH levels or egg reserve, it can provide some indirect benefits related to reproductive health. By preventing ovulation and regulating menstrual cycles, birth control can help manage various gynecological conditions such as polycystic ovary syndrome (PCOS), endometriosis, and irregular periods. By providing symptom relief and controlling hormone levels, birth control can potentially improve overall reproductive health (thanks birth control!).

Additionally, certain forms of birth control, such as combined oral contraceptive pills, may help reduce the risk of ovarian cysts and decrease the incidence of ovarian and endometrial cancers. These benefits contribute to the overall well-being of your reproductive system, indirectly supporting egg reserve.

AMH and egg sharing

If you are looking to donate your eggs through Cofertility’s Split program, where you freeze for free in exchange for donating half to a family that could not otherwise conceive, we require a minimum AMH of 2.0 (though clinics may have their own unique requirements). This is to increase the chances of retrieving enough eggs to actually split, to ensure positive outcomes for both parties involved.

You are not a number

With all the nuances involved here, it’s important not to get lost in the weeds. Fertility is impacted by so many factors that you can drive yourself crazy trying to manage all of them. 

Remember, you are more than any number. This process can be overwhelming, but focusing on the things that you can control can help you feel more grounded during your fertility journey, whatever it may look like. 

Cofertility is here to help you every step of the way on that journey. 

Our Split program offers women a chance to freeze their eggs for free when donating half the eggs retrieved to a family who cannot conceive otherwise. If you qualify for the program and decide to donate half of your retrieved eggs, every expense associated with the egg freezing procedure —  medications, supplements, travel if necessary, insurance, and 10 years of storage — are completely free of charge. We don’t even need a payment or credit card up front, as the family you match with covers all the expenses.

Or, in our Keep program, you can freeze and store your eggs for your own future use, with lower prices on things like storage and medication – as well as our team’s support and access to our community.

The benefits for of working with Cofertility include:

• Power of choice: Freeze your eggs more affordably or, if you qualify, freeze for free when you give half to a family who can’t otherwise conceive.
• Community: Our inclusive online spaces allow you to connect with others going through the process in our private online community.
• Compassion: We’ll always treat you with care, and our Split program gives you the opportunity to make someone’s family building dreams a reality.
• Data-driven: We provide you with trustworthy guidance and evidence-based research so you can make informed decisions about your fertility.
• Free egg freezing: Freeze and store your eggs for 10 years, entirely for free if you qualify for our Split program.

Ready to learn about more affordable (even free!) egg freezing with Cofertility? Fill out this quick quiz to learn about our accessible egg freezing options and see if you qualify for our programs — it only takes one minute.

Whatever your journey looks like, our team is here to guide you through it and keep your family-building options open.

Summing it up

Understanding reproductive health is crucial, especially when it comes to fertility. AMH is a key marker used to assess ovarian reserve, which refers to the quantity eggs. While birth control does not directly impact AMH levels or egg reserve, it can have temporary effects on AMH measurements while being used. The type and duration of birth control can influence the degree of impact on AMH levels. 

If you are currently using birth control, it is not necessary to discontinue it before getting an AMH test. However, it's important to be aware that hormonal contraceptives can potentially lower AMH levels temporarily. This means that the AMH results may be lower than they would be if you were not on contraceptives. Consulting with a fertility doctor can provide you with specific guidance on timing and interpretation of AMH results.

If you decide to discontinue birth control, AMH levels should return to their baseline over time as your body adjusts to its natural hormonal patterns. Temporary fluctuations in hormone levels may occur, but these are typically short-lived, and AMH levels should stabilize within a few menstrual cycles. (And if you do discontinue birth control, definitely use backup contraception during that period if you’re trying to avoid pregnancy). 

Remember, AMH levels provide valuable insights into ovarian reserve, but they are just one piece of the puzzle when it comes to fertility. Consulting with a fertility doctor can help you understand the broader context of your reproductive health and provide guidance on any concerns or questions you may have.

Read more:

• What AMH Level Do I Need to Freeze My Eggs?
• Which Matters More for Fertility: AMH or Age?
• I’m Going Off Birth Control. Now What?