Can You Ovulate Twice In the Same Cycle
You may be wondering – I have two luteinizing hormones (LH) peaks, does that mean I ovulate twice in one cycle? Many people expect LH testing to have one peak within 24 hours during a cycle (this can be called rapid onset), which most people associate with ovulation. And for many women, this may be how their cycle works! But what if you see more than one or medium and high LH level lasts a couple of days? What does it mean?
According to recent studies, there are three types of gradual onset (2-6 days) of LH surge. Some of them lead to multiple positive ovulation test results for more than one day. We are all different and this gradual onset is NORMAL, in fact over half (57.1%) of studied women have it.
This is why Mira Fertility Tracker is better than over the counter ovulation tracking kits. Mira allows you to see your curve and recognize the highest peak based on the quantitative LH level.
Three types of the gradual onset LH surge
Single Peak or Spike
You may notice that the LH level increases slightly until it reaches the highest peak, and slightly decreases to baseline.
This means you have several high results in a row. If you see a similar pattern, continue to test until LH level becomes lower. The day that it drops is the day you will be the most fertile. Ovulation happens after the last highest peak.
Multiple or Biphasic Peaks
Several ups and downs in one cycle can be very confusing. How do you make sure you recognize the right peak and don’t miss ovulation? Usually, the last peak is the right one. Mira will help you find your last peak. We recommend testing for several days after your predicted last peak, to ensure that there are no more peaks in the row.
Why does this happen? There are many lifestyle reasons that influence us over time that may cause multiple peaks, such as stress, illness, or hormonal changes. Additionally, having two LH surges can be correlated with multiple follicular stimulations.
Multiple follicular stimulations
Traditionally, it has been thought that ovulation takes place only once in every cycle. A wave of 15 to 20 egg-carrying cells, called follicles, grow before ovulation. One follicle will become dominant, and the others die off. Right before ovulation, your follicle swells up until it releases your maturing egg.
If you have multiple peaks, it may be that more than one dominant follicle is produced during a wave, or that dual conception arises as a result of two waves in a single cycle releasing eggs. In order to achieve pregnancy, a follicle is released from an ovary, and then ruptures, which then tells the ovary to release the egg.
In cases of multiple follicular stimulations, your body releases the follicle, but the follicle doesn’t rupture. So, the egg is not released and you are unable to get pregnant. Your body realizes that this has happened and releases a second follicle a few days later. That’s why even after one peak you can continue to see hormonal and symptom indicators of ovulation.
If you’re experiencing this, you should always play it safe and continue to baby dance before the first peak, during the onset and after the second peak, because you can conceive after ovulation has taken place (i.e. conception will not result from the first follicle that was released).
Is it possible to be fertile more than few days per month?
Researchers from the University of Saskatchewan did an ultrasound study on 63 women with normal menstrual cycles. Results showed that all of the women experienced at least 2 waves during their menstrual cycle.
Dr Roger Pierson says, 40% of the study participants had the biological potential to produce more than one egg. Hence, you could be fertile during a longer period of time during the menstrual cycle rather than just a few days. This information along with the research published in the Fertility and Sterility journal can explain why avoiding pregnancy by using the “rhythm” method to track the timing of ovulation is so unreliable.
However, current ultrasound scanning techniques can help with visualization of a follicle developing, but it does not allow actual visualization of the eggs, since these are microscopic.
Hyperovulation and Twinning
Fraternal twins, not to be mistaken for identical twins, are made the same way all humans are made — a sperm fertilizing an egg. The difference is that there are two different eggs being fertilized by two different sperm (in the same cycle). Hyperovulation is a contributing factor to the cause of fraternal twinning. Hyperovulation happens when you release more than one egg during your ovulation cycle. When both of these eggs are fertilized by a sperm, it results in twins.
- Recently quitting birth control can jumpstart hyperovulation, known as the “twinning effect”
- Hyperovulation can be attributed to genetics, sometimes running on the mother’s side of the family
- PCOS and hormonal disorders can increase the chance of hyperovulation by causing irregular cycles
- IVF and other fertility treatments can increase chances of having a multiple-birth by up to 40%
Banafsheh Kashani, M.D., FACOG is a board-certified OB/GYN and specialist in reproductive endocrinology and infertility at Eden Fertility Centers, and has been treating couples and individuals with infertility since 2014. Prior to joining Eden Centers for Advanced Fertility, she was practicing as a top fertility specialist at Kaiser Permanente in Orange County and Reproductive Fertility Center. Dr. Kashani has received numerous awards throughout her years of study and medical training.
Dr. Kashani has conducted extensive research in female reproduction, with a specific focus on the endometrium and implantation. Additionally, Dr. Kashani has authored papers in the areas of fertility preservation, and fertility in women with PCOS and Turners syndrome. She also was part of a large SART-CORS study evaluating the trend in frozen embryo transfers and success rates.
Dr. Kashani is a fellow of the American Congress of Obstetricians and Gynecologists. In addition, she is a diplomat of the American Board of Obstetrics and Gynecology and an active member of the American Society of Reproductive Medicine (ASRM) and Pacific Coast Reproductive Society (PCRS). She is also a member of the Society of Reproductive Endocrinology and Infertility (SREI).