No two women have exactly the same menstrual cycle, and no woman has exactly the same cycle every month. That said, if your cycles are on the long side and especially if they’re irregular, you may be wondering if you ovulate late — and how that affects your ability to get pregnant.
Most women who ovulate late in their cycle have long periods, and they may or may not ovulate every cycle. That can make conception a bit trickier. In fact, irregular ovulation is the most common cause of female infertility, according to the American College of Obstetricians and Gynecologists (ACOG), occurring in up to 25 percent of couples who are treated for infertility.
Here’s what you need to know about late ovulation and getting pregnant, including treatments to help you conceive.
What is late ovulation?
Late ovulation is when you ovulate (i.e. your ovary releases an egg) after day 21 of your menstrual cycle.
Women with regular cycles consistently have periods every 21 to 35 days. If you have a 28-day cycle, your ovary likely releases an egg 14 days after the first day of your last period, although the timing can vary. In general, ovulation occurs 14 days before your period starts, so if you have regular periods, count back 14 days from when you expect your period and that is when ovulation is probably occurring.
If your cycles last 35 days or longer, you probably ovulate at day 21 or later. Most women who have longer cycles also have irregular cycles, which means the length between their periods varies from month to month. They also may not ovulate at every cycle.
Very rarely, women have a normal 28-day cycle but ovulate around day 17, 18 or 19 instead of around day 14. That means they have a short luteal phase, or the time between the day they ovulate and their period is less than 12 days.
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It’s hard to know the exact day you ovulate, but tracking your cycles and knowing the signs of ovulation can help. Keep in mind your actual day of ovulation may change slightly by a couple of days from month to month — and that’s totally normal.
What are some possible late ovulation causes?
Long, irregular cycles are usually caused by one of the following conditions:
Polycystic ovary syndrome (PCOS)
PCOS is a leading cause of female infertility — and it’s relatively common, affecting up to 10 percent of reproductive-aged women. The condition disrupts hormone levels, especially androgen levels. That can affect your body’s ability to release a mature egg from your ovary every cycle.
Instead, eggs develop into very small cysts in the ovaries. In other words, if you have PCOS, you may not ovulate during some cycles or you may stop ovulating altogether.
Hyperprolactinemia
A rarer cause of longer cycles and missed ovulation, hyperprolactinemia is having higher-than-normal levels of prolactin, the hormone that stimulates milk production when you’re breastfeeding. That can lower levels of estrogen and disrupt your menstrual cycle.
Women with hyperprolactinemia often have shorter luteal phases and longer menstrual cycles; as prolactin levels rise, periods may stop altogether.
The condition may be caused by some medications and be linked to a benign tumor on the brain. In addition to irregular or skipped periods, you may have vaginal dryness and breast discharge when you’re not breastfeeding.
Hypothyroidism
If you have an underactive thyroid, your thyroid isn’t making enough thyroid hormone to meet your body’s needs. Low levels of thyroid hormone can disrupt your menstrual cycles and stop ovulation. Hypothyroidism is sometimes linked to PCOS or hyperprolactinemia.
If your cycles are long, your doctor will likely give you a blood test to check your various hormone levels. If PCOS is suspected, he or she may check your fasting glucose levels for insulin resistance, which is linked to PCOS. Your doctor will also likely check your estrogen levels to rule out premature menopause (the end of your menstrual cycles before the age of 40).
How does late ovulation affect your chances of getting pregnant?
If you have long, irregular cycles, it can be really hard to know if and when you’re ovulating — which means it can be hard to time sex so egg and sperm meet. The good news is, your eggs themselves are likely just fine. PCOS, hyperprolactinemia and hypothyroidism are all treatable with medications, which makes ovulation more regular and greatly improves your chances of getting pregnant.
In the extremely rare case that you don’t have any of these conditions but just have a short luteal phase, some doctors think that the uterus may not have enough time between cycles to build up its lining for an embryo to attach. That could theoretically lower your odds of getting pregnant, but it’s far from certain.
What can you do if you ovulate late in your cycle?
If you have PCOS, your doctor may prescribe clomiphene citrate or letrozole, both of which can help stimulate ovulation. He or she may also prescribe metformin to help you get pregnant. Many women with PCOS have insulin resistance, and metformin improves the cells' response to insulin.
Many women with PCOS are overweight. If that’s the case for you, your practitioner will likely work with you on a diet and exercise plan to lose weight. Losing as little as five pounds can significantly increase your odds of ovulating, since it helps balance out your hormone levels, and it improves your chances of conceiving and having a healthy pregnancy.
If you have hyperprolactinemia, your doctor will prescribe medicine to lower your body’s prolactin production and shrink the tumor in your brain. If you have hypothyroidism, a pill can control your thyroid hormone levels. In both cases, medication normalizes your cycles so you ovulate regularly — which makes it much easier to time sex and conceive.
If your doctor thinks you have regular periods with a short luteal phase, he or she may prescribe supplemental progesterone, which helps your uterine lining build up, giving your eggs better odds of attaching to the uterine wall. Your practitioner might also prescribe clomiphene citrate to stimulate ovulation.
When to call the doctor about late ovulation
Any time your cycles are long and irregular, it’s a good idea to check in with your doctor to rule out PCOS, hyperprolactinemia or hypothyroidism. Getting treatment for these conditions can greatly increase your chances of getting pregnant and having a healthy pregnancy.
Also check with your doctor if you’re under 35 and haven’t conceived within a year of trying, or if you’re over 35 and haven't conceived after six months. A reproductive endocrinologist or other specialist can get to the root of the problem and suggest treatments to help you get pregnant.
Can early ovulation affect your chances of getting pregnant?
Early ovulation is ovulating while you’re still on your period, which is very uncommon but possible. Ovulating early may lower your chances of getting pregnant because there isn’t as much uterine lining when an egg is fertilized, making it harder for the embryo to attach to the uterine wall.
While early ovulation can happen to anyone, it’s more common in women who are starting to have a diminished ovarian reserve (i.e. fewer eggs in their ovaries). A blood test can check for certain markers linked to low egg count. Your practitioner may also prescribe medication to stimulate ovulation — although it won’t increase the number of eggs you have.
It can be frustrating if you’re trying to conceive and your cycles are long and irregular. The good news is, your practitioner can usually find a cause and offer treatments that may very well help you get a bun in your oven sooner than you think.
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