The simple idea (no memorising)
Question 1 — Is she ovulating? Her cycle history answers most of this: regular cycles (about 21–35 days) usually mean she's ovulating. If confirmation is needed, a mid‑luteal progesterone (about a week before the expected period — not rigidly "day 21") shows whether a corpus luteum formed.
Question 2 — What's her ovarian reserve? This asks how many eggs are left and how she'd respond to fertility drugs — a different question from "did she ovulate this month." It's judged with:
- AMH (a blood test — handily, any day of the cycle);
- antral follicle count (an ultrasound tally of resting follicles);
- early‑cycle FSH.
The most important sentence in fertility
As age rises, egg quantity and quality fall and chromosomal problems rise. That's why a fertility picture can't be read without age — and why "wait and see" is riskier at 39 than at 29.
Two gentle cautions
- Ovulating regularly ≠ good reserve. A woman can ovulate every month yet have a low reserve.
- A low reserve test ≠ "impossible." These tests predict response to treatment better than they predict natural pregnancy — so they should never be used to crush hope or as a general screening test.
PCOS, revisited
Recall Part 3: in PCOS there may be many follicles but irregular ovulation — lots of eggs, poorly released. So the treatment is to induce ovulation (letrozole first).
Why it matters
Separating ovulation from reserve — and respecting age — lets a couple make clear, timely, realistic decisions instead of anxious guesses.
Quick check ✅
- What usually tells you a woman is ovulating, without any test?
- What's the single strongest predictor of female fertility?
Remember this 🌟
Where we're going next → Even with a good egg and healthy sperm, the tube must be open. Concept 32.