Ovulation Prediction While on Testosterone
“How does testosterone impact ovulation prediction?
This question is one of the most commonly asked in online trans pregnancy spaces. So we thought we’d tackle it in an official article!
So how DOES testosterone impact ovulation prediction?
To start with, let’s make sure you understand what ovulation prediction is. Each month, the body matures one egg for possible fertilization by sperm. It takes a couple of weeks for an egg to get from its immature state to a mature state, which happens at the beginning of an ovulation cycle. Eventually, when the egg is ready to be fertilized, it is released into the fallopian tube, which is where fertilization can happen. That moment when the mature egg is released into the fallopian tube is called ovulation. Sperm cells need to be in the fallopian tube right around the time when the egg shows up there. Otherwise, the egg will not get fertilized and the uterus will shed its lining through menstruation… starting the whole cycle over again. Ovulation prediction tools help you time the introduction of sperm into the body, so you have a higher chance of getting pregnant.
Ovulation prediction tools have the potential to radically decrease the amount of conception attempts required to achieve a pregnancy, which is especially important for trans folks. For one, most trans people want to limit the time they have to spend off of hormones (if they were on hormones prior to attempting conception). Trans people may use donor sperm in order to conceive, which can cost money (if being purchased) or time (if using a known donor) or both (if working with a medical clinic or midwife to assist with the process). Attempting conception may be psychologically or even physically difficult for some trans folks, especially those with profound dysphoria. For these reasons and more, any tool that can increase the likelihood of a successful conception is one worth trying!
However— some ovulation prediction options may work better than others for the trans community. Let’s start with Ovulation Predictor Kits (often called “OPK’s”). These kits are usually just sticks that you pee on; a line appears if you are ovulating and no line appears if you aren’t ovulating. These kits track the hormone that spikes right before ovulation, but this hormone can actually spike without actual ovulation happening. A positive OPK cannot guarantee that you’re going to ovulate. This is true regardless of testosterone use.
Additionally, there is a higher incidence of polycystic ovarian syndrome (PCOS) in the transgender community, and PCOS can cause false positives on OPK’s. Further, OPK measures are based on “average” hormone levels, and many people (again, regardless of hormone use) have naturally higher or lower levels, which can impact the results of the test.
Finally, testosterone is a fertility suppressant. Yes, it’s possible to get pregnant while taking testosterone, but it is also possible to get pregnant on any contraceptive, including the pill or an IUD. So if you are taking testosterone, it’s highly likely that you’re not ovulating at all, in which case ovulation prediction would not be helpful for you. Make sure that you have stopped taking testosterone before attempting to conceive; doing so will greatly increase the accuracy of ovulation prediction tools and will improve your chances of conceiving and carrying a viable pregnancy to term.
Hopefully this is helpful information. We know that many topics within fertility are complicated, and we’ve tried to explain things as simply as possible. At times, this means describing things without the level of detail that a doctor or midwife might; this is intentional. We want to give a basic overview to increase understanding so it actually makes sense when/if you go to a provider and they give you a more thorough explanation. If you ever have questions about our articles or want to add additional or contradicting information, please email us at info@collaborate.consulting.
