Women who are planning a pregnancy are sensitive to their own ovulation and scrupulously calculate its date. But sometimes it happens that the middle of the cycle has already passed, and a couple more days, and the schedule basal body temperature has not changed and the ovulation test shows only one strip. And just before the most monthly, the long-awaited signs suddenly appear.

This situation is called late ovulation. It may occur occasionally, for reasons unrelated to disease, but observed every month, this condition indicates a pathology. Below we will analyze its main causes, as well as such a question, is it possible to get pregnant with late ovulation and how to determine that conception has occurred.

Definition of late ovulation

The release of the egg (oocyte) from the follicle must occur in strictly certain time. Usually, this period is considered the middle of the cycle, that is, with a cycle of 25-26 days, “day X” is expected on days 12-13, but in fact the calculation is a little more complicated.

The menstrual cycle is divided in two: the period before ovulation (follicular phase) and after it (luteal phase). In the first period, there complex processes. at first functional layer the endometrium, which has not accepted the embryo, is rejected within three days, then the wound surface begins to heal, and by the 5th day, the formation of a new endometrium begins to replace the rejected one. The synthesis of a "fresh" functional layer continues for 12-14 days (starting from the 5th day of the cycle).

The duration of this period is not strictly fixed, because the uterus needs not only to “grow” new cells, but also to give them the opportunity to grow up to 8 mm, and also to provide them large quantity tubular glands.

The duration is strictly defined only for the second phase of the cycle and is 14 ± 1 day (this is how long the corpus luteum lives in anticipation of pregnancy). That is, to find out the day of maturation of the oocyte, you need to subtract 13, maximum 14 days from the first day of the alleged menstrual bleeding. And if this figure is less than 13 days, ovulation is considered late. That is, late ovulation with a cycle of 30 days - when it occurred later than 17 days from the first day of the expected menstruation. When the cycle is longer, for example, 35 days, then the release of the oocyte, which occurred later than 21-22 days, can be called late.

Many women are interested in the question of when the latest ovulation can be. The answer is difficult to calculate, because it depends on the duration of the cycle. So, if the cycle is up to 30-35 days, then the release of the egg rarely occurs later than 10-11 days before menstruation. That is, later than 25 days (if from one period to another - no more than 35 days), you should not wait for it. Most likely, this cycle is anovulatory, and if you are under 35 years old, and anovulation occurs 1-2 times a year, this is a normal situation that does not require intervention.

If more than 35 days pass between menstruation, then in itself such a cycle is already considered a sign of an illness that requires examination, and it is very difficult to predict the release of an egg here.

Hormonal maintenance of the menstrual cycle

To understand why a doctor might prescribe a certain hormonal drug to normalize the cycle and eliminate late ovulation, consider what mechanisms control the period from one period to another.

Regulation menstrual cycle carried out by a 5-level system:

1. The cerebral cortex and its structures such as the hippocampus, limbic system, amygdala.
2. Hypothalamus. This is the body that "commanders" the entire endocrine system. He does this with the help of two types of hormones. The first are liberins, which stimulate the production of the necessary “subordinate” hormones (for example, folliberin gives the pituitary gland a command to produce follicle-stimulating hormone, and luliberin gives the “order” to synthesize luteinizing hormone). The second are statins, which inhibit the production of hormones by the underlying endocrine glands.
3. Pituitary. It is he who, at the command of the hypothalamus, produces FSH, a hormone that activates the synthesis of estrogens, and luteinizing (LH) hormone, which triggers the production of progesterone.
4. Ovaries. They produce progesterone and estrogen. Depending on the balance of these hormones, the production of which is controlled by the hypothalamic-pituitary system, the phase and duration of the menstrual cycle depend.
5. Hormonal balance is also affected by organs that are sensitive to changes in the level of sex hormones. These are mammary glands, adipose tissue, bones, hair follicles, as well as the uterus itself, the vagina and fallopian tubes.

In the first phase of the cycle, the pituitary gland produces FSH and LH. The latter causes the synthesis of male hormones in the ovary, and FSH - the growth of follicles, the maturation of the egg in one or more of them. During this period, there is a small amount of progesterone in the blood. It should be a strictly defined amount, because both the decrease and the increase will negatively affect the onset of ovulation.

In addition to its effect on the follicles, FSH causes the conversion of androgens into estrogens. When the amount of estrogen reaches its maximum and because of this the amount of LH increases, after 12-24 hours the oocyte should leave the follicle. But if the luteinizing hormone or androgens becomes more than normal, ovulation does not occur.

After the release of the oocyte into "free swimming", LH decreases, and the level of progesterone increases, reaching its peak by 6-8 days after the release of the oocyte (20-22 days of the 28-day cycle). These days, estrogen also rises, but not as much as in the first phase.

If the egg leaves the follicle late, on the 18th day or later, this may be the result of one of the following situations:

• During the period before ovulation, estrogen “dominates” in the blood, to which the body cannot “oppose” anything. This prevents the uterus from preparing for pregnancy. If a woman wants to get pregnant, she is prescribed progesterone during late ovulation, a course of 5-10 days from the second half of the cycle (usually from 15-16 to 25 days, but optimally - immediately after determining the release of the follicle, even if it happened late).
• The concentration of LH and androgens increases. In this case, contraceptives with an action that suppresses the production of androgens help to solve the problem.
• There is a deficiency of estrogen, which can be suspected already by the fact that the growth of follicles during late ovulation is very slow. This is corrected by the appointment of estradiol preparations in the first half of the cycle (usually from the 5th day). Against the background of taking synthetic estrogens, pregnancy cannot be planned.

Causes of "late" ovulation

Late release of the egg can be provoked by: prolonged stress, climate and time zone changes, abortion or cancellation of OK. The reason is the change in hormonal balance in the first year after childbirth, if a woman is breastfeeding. Past illnesses, especially infectious ones (flu, etc.), can cause a violation of the menstrual cycle by the type of late ovulation. Also, the shortening of the second period of the cycle will be characteristic of the upcoming one. Finally, sometimes such a deviation in the functioning of the reproductive system can be an individual feature of a woman.

Often the causes of late ovulation are - gynecological diseases, which are characterized by an increase in estrogen in the blood (, some types), diseases with increased level male hormones (, pathologies of the adrenal cortex). Late ovulation on a 28 day cycle may be the only sign of low-grade uterine inflammation or fallopian tubes, ovarian cysts, as well as infections of the genital tract caused by chlamydia, Trichomonas, ureaplasma.

A similar symptom (it is impossible to call the displacement of the release of the egg a disease) is also found in various endocrine pathologies of the pituitary gland, hypothalamus, adrenal glands or ovaries. It also develops in obesity, which is also a disease, because adipose tissue is involved in the metabolism of hormones.

Symptoms

To find out that the release of the oocyte still takes place, although later than the due date, the following signs will prompt:

1. Change in vaginal secretion: it becomes similar in viscosity to chicken protein, streaks of blood may appear in it, and all the mucus may come out colored brown or yellowish. Similarly, implantation bleeding occurs only after ovulation, a week later.
2. Drawing sensations in the lower abdomen, usually below the navel and on one side.
3. Enlargement and extreme sensitivity of the mammary glands: any touch causes discomfort or even pain.
4. Irritability, sudden mood swings, increased emotionality.
5. Enhanced sex drive.

Monthly cycle female body can be called a miracle of physiology, so wisely conceived of his nature. The menstrual cycle of a healthy woman of childbearing age consists of two halves or phases. The folliculin phase begins its countdown from the first day of menstruation and ends with the release of a mature egg from the ovary - ovulation. The main task of this half of the cycle is the growth and maturation of the egg in the ovary and the endometrium in the uterine cavity.

Luteal phase or phase corpus luteum starts immediately after ovulation. In this phase of the cycle, the grown endometrium is preparing to receive a potential embryo. The mucous membrane of the uterus accumulates reserves of nutrients, germinates with vessels. If fertilization does not occur, the uterine mucosa is shed, menstruation begins and with it the next menstrual cycle.

Ovulation is a kind of boundary line between the two phases of the cycle.

What is called late ovulation?

It is generally accepted that the egg leaves the ovary around the 14-15th day of the cycle. This is true for a woman with a classic "obstetric" cycle length of 28 days. However, each woman has her own characteristics of the reproductive system and hormonal levels. Normally, the length of the menstrual cycle ranges from 21 to 45 days, respectively, and ovulation occurs at completely different times.

Late can be called ovulation, which occurs less than 10 days before the onset of menstruation. Why is the countdown based on menstruation? The specific date of ovulation does not matter for the conception of a child. The length of the subsequent luteal phase is important so that the embryo has time to fully implant in the uterus. It is believed that the length of the luteal phase of more than 10 days ensures the normal onset of pregnancy in any type of ovulatory peaks.

Causes of late ovulation

Very often, women have no idea when they ovulate. It can be late, and early, and normal. All these terms have absolutely no meaning in the case of a regular menstrual cycle and independent offensive healthy pregnancy. In this case, late ovulation is not a diagnosis, but an accidental finding!

Usually, women begin to delve into the peculiarities of their hormonal background and "catch" ovulation when pregnancy does not occur. In this case, late ovulation may be the main cause of an irregular cycle and.

• Stress, nervous experiences directly affect the centers of hormonal regulation in the brain.
• Changes in time zones, climate, improper sleep and rest patterns “confuse” the circadian rhythms of the body.
• Expressed physical exercise, intense sports reshape hormonal background women to masculine type.
• Improper nutrition, starvation diets or low social level. The lack of nutrients directly affects the hormonal background. For example, diets with the exclusion of fats are fraught with hypoestrogenic conditions and the absence of ovulation.
• Inflammatory diseases of the pelvic organs and, especially, the ovary. An unhealthy ovary is not able to fully produce eggs. Ovulation is often delayed or does not occur at all.
• Hormonal imbalance. There can be many options for it. The top three include: hypothyroidism, hyperprolactinemia and hyperandrogenic syndromes. It is on these hormonal panels that women with infertility or dysmenorrhea should first be checked.

Signs and symptoms of late ovulation

The ovulatory peak in the body does not go unnoticed. By carefully listening to your body, you can independently notice some of the symptoms of ovulation:

1. Abundant discharge from the genital tract of a mucous nature, similar to protein raw egg. Sometimes in a clot of mucus you can see streaks of blood - this is a variant of the norm in some women.
2. Drawing pains in the lower abdomen on the right or left side. Sometimes these pains are extremely pronounced, accompanied by diarrhea or constipation, fever, masquerading as acute appendicitis. This situation is called "ovulatory syndrome".
3. Increased libido.

Today, you can confirm ovulation with additional tests:

1. Measuring basal temperature is quite old and laborious, but extremely exact method determination of ovulation and the usefulness of the phases of the menstrual cycle. Basal temperature is measured daily with an ordinary thermometer in the anus or vagina. Measurements must be taken daily in the morning after sleep, without getting out of bed. The received data is presented in the form of a graph. Normally, an ovulatory jump is considered a difference in phase temperatures of more than 0.4 degrees Celsius. That is, the moment of release of the egg on the graph will be represented by a high temperature peak.
2. Special tests for ovulation. These test strips are sold in pharmacies and can be easily used at home. The test responds to changes in the ratio of certain hormones in the urine. Day after positive test are considered the most favorable for conception.
3. Ultrasound or folliculometry. In this case, the dynamics of egg growth is assessed daily. This is a fairly accurate method for diagnosing folliculogenesis disorders. Ultrasonic folliculometry is widely used in IVF and ovarian stimulation programs.

Can late ovulation cause a missed period?

Very often, late ovulation is a one-time phenomenon, for example, against the background of stress or climate change. In this case, there may indeed be a delay in menstruation or complete prolapse one menstrual cycle. Once a year, a delay in menstruation or even its complete absence is the norm for the vast majority of women.

Late ovulation: when will the test show pregnancy?

Since fertilization is also delayed with a later release of the egg, the pregnancy test may not show the second strip for a long time, even against the background of a delay in menstruation. After all, the embryo needs time to grow up a little and begin to produce chorionic gonadotropin, to which all pregnancy tests respond.

How to calculate the gestational age for late ovulation?

It is very common for women with long menstrual cycles and late ovulation to miscalculate and miscalculate due dates. The classic formulas for calculating the duration of pregnancy are designed for a 28-day cycle with normal ovulation. Therefore, in such patients, the gestational age will be objectively less than the date of the last menstruation. It is important to remember this when diagnosing pregnancy, doubts about the normal development of the fetus and disputes about the term of delivery.

Alexandra Pechkovskaya, obstetrician-gynecologist, specially for the site

Useful video:

Anovulatory cycle: signs, causes and consequences. Is it possible to get pregnant and how to treat the condition

If the body does not respond to such a "vacation", you need to be examined to find out the causes of the problem. As a rule, these are various hormonal "storms" and disturbances in the functioning of organs associated with the female reproductive system:

The cycles before and after treatment can be without any special differences, therefore, without a doctor, a woman herself will not be able to evaluate the result (except indirectly - according to BT). Menstruation after an anovulatory cycle can be similar to normal, so you can’t do without a visit to the doctor if you are serious about having offspring in the future. Pregnancy after an anovulatory cycle will not occur, there is no point in hoping for a miracle.

Treatment of anovulation

After the instrumental research and taking tests, the doctor will find out the cause of the symptoms that alerted him and offer a treatment regimen depending on it. If it turns out that the patient is suffering, she will be offered drugs that reduce prolactin (for example, bromocriptine). If it is necessary to stimulate the work of "dormant" ovaries, duphaston will be prescribed in the second phase of the cycle. You may need estrogen-gestagenic drugs or dexamethasone (the latter - if there is an excess of male hormones). Diseases to be cured thyroid gland, do an MRI to see if there is a pituitary tumor.

In any case, on present stage development of medicine, which can not only explain what an anovulatory cycle is, but also offer adequate methods of treatment, this diagnosis does not sound like a sentence for a woman. If a woman wants to become a mother, she will cope with this problem. You just need to strictly follow all the recommendations of the doctor and be sure of success.

Pregnancy directly depends on such a process as the release of a mature egg from the follicle, which is fully prepared for fertilization. This process called ovulation, which usually occurs in the middle of the cycle. But sometimes the egg is delayed in maturation and release. The reasons for late ovulation may be different, but, most importantly, such shifts can make it difficult for the onset of conception if a woman is guided by the ovulatory calendar. Why such violations occur and how to eliminate them, can such a deviation be the norm, how to correctly determine the date of ovulation with a delay - we will tell you everything below.

Ovulation refers to the period when a mature female cell enters the abdominal space. It is difficult to say in advance exactly when day X will come, but approximately it falls approximately in the middle of the cycle. When it is 28 days old, the follicle matures on the 13-14th day, and when it is 36 days old, on the 18th day. If, with a 28-day cycle, maturation occurs on day 18 or later, then late ovulation is suspected.

This condition occurs for a variety of reasons. Moreover, it can be detected with equal probability in sick and relatively healthy patients. Doctors say that menstruation is closely related to ovulation, the longer the maturation of the cell proceeds, the longer the cycle will be and the menstruation will be more abundant. Late ovulation is extremely rare, but it does happen.

Why is ovulation delayed?

As already mentioned, quite a variety of reasons can affect late ovulation. Sometimes they are caused by female physiology and are considered the norm, but there are also pathological factors. The most common reasons why ovulation is delayed are:

• Infectious pathologies of the reproductive system;
• Recent deliveries, induced abortions or spontaneous abortions;
• Excessive loads of a psychological or physical nature, therefore, it is recommended to avoid such overloads at the time of planning;
• Hormonal disorders in the body;
• Little weight. Deficiency of adipose tissue negatively affects estrogen production, provoking a delay in the maturation and release of the female cell;
• Uncontrolled reception emergency contraceptives in past. Similar drugs contain shock doses of hormones, which means that these drugs lead to hormonal imbalance, which entails a variety of ovulatory disorders;
• Hard training and sports activities, strength training, coupled with the use of steroid drugs.

In addition, factors such as menopause, unfavorable environmental conditions, etc., can provoke a delay in cell maturation.

Signs of delayed ovulation

Signs of the onset of late ovulation usually frighten patients, as they begin to think that serious disorders are occurring in the body, or there is a certain pathology. Signs of late maturation of the female cell are closely related to the causes of such a deviation. Since one of the frequent factors is stress or overwork, such conditions - characteristics late arrival of ovulation. If a girl is planning the onset of conception, then it is better for her to refrain from unrest, to categorically avoid stressful situations and nervous strain. Unnecessarily frequent flights with a change are not recommended climatic conditions and time zones, you need to avoid any overwork, not only moral, but also physical.

Hormonal imbalance or imbalance of pituitary hormones also refers to late ovulatory manifestations. To clarify the ovulatory state in the first half of the cycle, the patient is recommended to undergo a study on hormones. If a woman suffers from reproductive infectious lesions, then a delay in the ovulatory period is inevitable. In addition, against the background of infectious processes, various menstrual disorders occur, often there are delays that make you think about pregnancy. Therefore, infectious pathologies of the genital area are characteristic signs and causes of the late onset of the ovulatory phase.

Gynecological pathologies such as cystic processes, infections and the absence of menstruation are also characteristic companions of the late arrival of ovulation. It is also worth waiting for ovulatory delays for girls during the 3-month post-abortion and year postpartum period, as well as ladies after 40 years of age.

How to calculate ovulation if it is late

Such a state is quite possible to calculate independently. For this use basal measurements, inner feelings women and special ovulatory tests. Each of the methods is simple in its own way, but requires certain conditions to be met in order for the data obtained to be as reliable and correct as possible.

To determine the exact date the onset of ovulation, professional medical assistance is needed. They spend gynecological examination and laboratory research pituitary hormone levels, as well as ultrasound monitoring. Similar procedures are also carried out over several cycles, which allows you to accurately determine all the manifestations of late ovulation. Such measures are necessary only for those patients who are trying to get pregnant, because against the background of the late ovulatory period, various deviations can occur, which prevents conception.

How does late cell maturation affect pregnancy

Having figured out what a late onset of ovulation is, patients often worry about whether they will be able to conceive and give birth to a baby in a similar condition. Yes, getting pregnant in such a clinical situation is quite possible, but quite difficult. This condition is often associated with various difficulties in conception. Why is this happening? If this ovulatory shift occurs only in rare cycles against the background of completely harmless factors, then such a feature will not interfere with conception. In the first or second cycle, pregnancy will indeed be impossible due to temporary hormonal disorders, but by the third cycle, the condition stabilizes and nothing prevents pregnancy.

If late ovulation is a regular occurrence, then this is already a more serious problem for pregnancy, but it is also quite solvable. In many women, a condition when the cycle is more than 30 days is considered the norm, while the egg matures only on day 15 or later. This is their physiological norm, in which there are no deviations, and reproductive system completely healthy. In such a situation, there will also be no problems with conception, the main thing is that the second, postovulatory phase should be no shorter than 13-14 days.

If late ovulation is due to pathological disorders, such factors can cause serious problems with the onset of pregnancy. Usually, this is observed with ovulatory delays against the background of gynecological ailments or serious hormonal disruptions, sexual infectious lesions and age features like postmenopausal. miscarriages and abortions, influenza and colds, irregular cycle - all this also affects ovulation and leads to problem conception.

When ultrasound diagnostics will show conception with late ovulation

If the patient knows for sure that her follicle grows and matures longer than usual, and the ovulatory period comes later, then this feature should be reported to her gynecologist, otherwise he may set inaccurate pregnancy dates, which will entail a variety of worries, experiences, and sometimes unnecessary appointments , without which it is quite possible to do. But a woman can definitely say about late ovulation only if from cycle to cycle the patient had a late onset of this period by basal charts or when measured by ovulatory tests.

• When such mothers are registered with the LCD, then the card indicates two probable dates: one by the date of the last menstruation, and the other by the date of late ovulation.
• After the patient undergoes an ultrasound examination, it will be possible to accurately determine for how long the pregnancy should be taken.

Ultrasound can see in the uterus fertilized egg around 4 weeks of gestation. Before this time to spend ultrasound diagnostics meaningless. If the gynecologist has set an approximate period for the last menstruation, then 2-3 weeks must be added to this period, then you can go for an ultrasound.

Sometimes women during pregnancy are prescribed supportive treatment, which is not necessary. The reason for this error are some features of late ovulation. For such patients, the gestation period is often incorrectly determined, therefore, in the future, the doctor discovers some developmental delay in the fetus. Sometimes a pregnant woman is misdiagnosed as anembryony only because the actual gestational age does not correspond to the obstetric one.

How to restore the cycle

Before determining the need for treatment, the patient needs to be fully examined. There is no specific therapy to eliminate late ovulation, since this is not a pathology, but a consequence of certain processes in the body. Therefore, to eliminate it, it is necessary to identify the cause of deviations and neutralize it. Usually to therapeutic activities they start if a woman wants to conceive, and late ovulation prevents this. To do this, they resort to stimulation of ovulatory processes with the help of medications, diet therapy and lifestyle modification.

Ovulation is not only the central event of each menstrual cycle in physiologically, but also almost the most important process in the lives of almost all women planning a pregnancy. Ovulation time they track a variety of accessible ways and begin to worry in case of its late onset, believing that pregnancy in this case is impossible. But it's not.

When is ovulation considered late, and why can it be late?

Ideally, the release of the egg should occur around the 14th day of the cycle. Late is considered to be ovulation that occurred after the 18th day of the cycle, and this is not a pathology if the woman is healthy. At the same time, there are a number of reasons why ovulation can occur later than the due date:

Thus, it can occur both in absolutely healthy women and in women whose body is affected by various factors that can, one way or another, shift ovulation by more late deadline. Therefore, in itself, late ovulation cannot cause a woman's infertility, since it is quite possible that this is such idiosyncrasy organism. With the impossibility of getting pregnant, late ovulation can be associated only when it is a clear sign and a consequence of any disorder in the body. For a healthy woman, late ovulation, subject to determining its timing, will not become an obstacle to achieving the cherished goal, namely, to pregnancy.

How can you reliably know the day of late ovulation?

You can determine late ovulation in standard ways:

• Ovulation tests.
• Measurement of basal temperature.
• Ultrasound monitoring, or folliculometry.
• Laboratory tests blood to measure the level of individual hormones.
• Home studies of urine and saliva using a microscope or a special device.

You need to be aware that the conclusion about the presence of late ovulation can only be made on the basis of a study of several menstrual cycles.

Late ovulation and pregnancy - the likelihood of conception

According to surveys of many women and approximate statistics, late ovulation most often does not in any way affect the possibility of fertilization of an egg by a spermatozoon and its further development. The only downside is that in women with late ovulation, the chance to conceive a child happens somewhat less frequently than the rest, since the egg does not mature every month, but every 35-40 days. There are healthy women with more rare ovulation - once every one and a half to two months.

What should women with late ovulation need to know?

First, it is extremely important to make sure that there are no internal or external, direct or indirect causes for late ovulation. The attending physician will help to deal with this issue. Otherwise, you can plan a child for a very long time and unsuccessfully, because such disorders as hormonal imbalance or inflammatory processes in reproductive organs rarely go away on their own.

Secondly, it would not be superfluous to mention that with late ovulation, the gestational age by ultrasound will be noticeable less time, which is usually set according to the last menstruation. On average, the difference can be 2-3 weeks, depending on which day of the cycle ovulation occurred. We must not forget about this so as not to be nervous once again about the mismatch in the size of the embryo.

And thirdly, among other things, it is extremely important for women planning a pregnancy to know that the duration of the cycle in the “exemplary” 28 days is not so important. A much more important indicator of a physiologically normal cycle is the fact that ovulation occurs 13-14 days before the onset of "critical" days. If this period is much shorter or longer, then there is already a violation of the menstrual cycle.

If, according to the results of the examination, it is revealed that ovulation is delayed for any specific reason, then the good news is that in most cases, with timely treatment medical institution, everything can be corrected and a regular cycle can be established, subject to the treatment prescribed by a good specialist.