Ovulation Confirmation and Timing
Based on your hormone pattern—LH peak of 45 IU on cycle day 13, estrone-glucuronide (E1G) peak of 288 ng/mL on day 13, and rising pregnanediol-glucuronide (PDG)—you ovulated on cycle day 14, approximately 24-36 hours after your LH surge.
Did You Ovulate and When?
Yes, ovulation occurred on cycle day 14. The evidence is clear:
- Your LH peaked at 45 IU on CD13, which triggers ovulation within 24-36 hours 1, 2
- Your E1G peaked at 288.2 ng/mL on CD13, indicating maximal follicular maturation before rupture 1, 3
- Your PDG began rising from 3.1 on CD13 to 4.7 on CD14, confirming follicular rupture and corpus luteum formation 1, 4
- The pelvic pressure you experienced at 5:50pm on CD14 that resolved within 2 hours is consistent with the physical sensation of ovulation (mittelschmerz)
The timing follows established patterns: ovulation occurs 24-36 hours after the LH surge begins, and your LH was still elevated at 45 on CD14 morning before dropping to 27.9 by evening, indicating the ovulatory event occurred during CD14 3, 2.
Oocyte Viability Window
The egg remains viable for fertilization for approximately 12-24 hours after ovulation, with maximum viability of 0.7 days (16.8 hours). 2
- Since ovulation occurred on CD14, the oocyte was viable through the evening of CD14 and possibly into the early morning of CD15 2
- At CD14 9:30pm (your current time), you are still within the viable fertilization window, though approaching its end
- Sperm can survive 1.4 days on average in the female reproductive tract, with 5% surviving beyond 4.4 days 2
- The fertile window extends from 5 days before ovulation through the day of ovulation itself, with conception probability highest on the day before and day of ovulation 2
Progesterone Supplementation Timing for Luteal Phase Support
Do NOT start progesterone supplementation yet. You must first confirm adequate ovulation and assess your natural luteal function:
- Progesterone supplementation should only begin after confirming luteal insufficiency with mid-luteal phase testing 5, 6
- Test PDG (or serum progesterone) on cycle day 21 (7 days post-ovulation) to assess luteal function 5, 4
- A serum progesterone ≥5 ng/mL (≥16 nmol/L) or equivalent PDG elevation confirms adequate ovulation and luteal function 5, 7
- If mid-luteal progesterone is <5 ng/mL or PDG remains inadequately elevated, this confirms luteal phase deficiency requiring supplementation 5
Critical Timing Considerations:
Your baseline PDG on CD5 was 3.2, and on CD14 it rose only to 4.7—this is a modest early rise 1, 4. Normal luteal function requires PDG to increase at least 3-fold from baseline and continue rising through mid-luteal phase 4, 6:
- Expected mid-luteal PDG should be significantly higher than your current 4.7 level 4, 6
- If your CD21 testing shows inadequate progesterone rise, supplementation would typically begin 3 days post-ovulation in subsequent cycles (around CD17 in your case) 6
- Some protocols start progesterone immediately after confirmed ovulation if prior cycles demonstrated luteal insufficiency, but this requires prior documentation 6
Important Caveats
Your early follicular FSH pattern requires attention:
- CD5 FSH was 8.7 IU/L, but CD7 FSH jumped to 12.2 IU/L before dropping to 2.4 on CD9 7, 3
- FSH >10 IU/L on cycle day 3-5 suggests diminished ovarian reserve 7
- This fluctuation pattern (19% of normal cycles show fluctuating hormone patterns) may indicate variable ovarian response 3
- Your cycle shows characteristics of normal ovulation despite the FSH fluctuation, but this warrants monitoring in future cycles 3
Next steps: