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Cycle Monitoring: What to Expect, the Benefits, and the Limitations

Young woman or girl shows positive pregnancy test with two stripes. Lifestyle background. Pregnancy family concept.
Sometimes when trying to conceive, couples find themselves hitting a roadblock. After all, there are a lot of factors to consider, from having the right hormone levels to determining the exact window of ovulation. If this sounds like a scenario you and your partner are facing, there’s no need to be embarrassed or intimidated. Fertility clinics offer a wide variety of treatments, such as cycle monitoring to help you better understand what’s going on in your body and help you conceive, whether you want to do it naturally or through insemination. What is the cycle monitoring process and how can cycle monitoring benefit couples who are struggling to get pregnant? Here’s what you need to know about cycle monitoring and what you can expect from this fertility service.

What Is the Purpose of Cycle Monitoring?

When trying to conceive, timing is everything. Cycle monitoring is the process of observing a variety of factors within a woman’s body throughout the menstrual cycle to determine the right window of opportunity to get pregnant. It’s an important part of the initial fertility treatment process, because it determines if there are any underlying issues with various elements of the reproductive system. The optimum time to try to conceive naturally also becomes evident. Cycle monitoring, therefore, may give valuable information about the menstrual cycle and may also enhance the probability of conception. Cycle monitoring typically occurs during the first half of a woman’s menstrual cycle. It can be done on a natural cycle or while using fertility medication to stimulate the ovaries. By performing various examinations during the cycle monitoring process, the fertility doctor can determine the following information:
  • Whether and when you are ovulating
  • Whether your hormone cycle is normal
  • Whether an ovarian follicle (containing an egg) is growing
  • Whether your endometrium is preparing for implantation of a fertilized egg (either naturally or through insemination)
  • The thickness of the lining of your uterus (endometrium)
With this information, the fertility doctor can determine the best days for you and your partner to have intercourse to maximize the likelihood of a successful pregnancy. Sometimes cycle monitoring might be the only procedure you require from a fertility clinic. Other times, it might be part of further fertility treatments, such as intrauterine insemination, in-vitro fertilization (IVF), or intracytoplasmic sperm injection (ICSI).

What Can You Expect with Cycle Monitoring?

Depending on why you are undergoing cycle monitoring, your doctor will monitor one monthly menstrual cycle. You can expect to visit the fertility clinic a few times throughout your cycle. Typically, cycle monitoring involves having internal (trans-vaginal) ultrasounds and blood tests done at intervals throughout your cycle, so that your doctor can monitor your hormone levels and the growth of your follicle(s).

Day 2-4 of Your Cycle

Your cycle monitoring begins as soon as you start menstruating. It’s important to visit the fertility clinic either on day two, three, or four of your cycle, so that can the required bloodwork and ultrasound are performed. During your first examination, you will have your reproductive hormone levels assessed and ultrasound to determine how many resting follicles you have. Ultrasound is also used to examine your ovaries and womb to exclude abnormalities, such as cysts and fibroids.

Day 10-12 of Your Cycle

Your second examination occurs shortly before you are expected to ovulate. During this examination, your doctor will once again examine your hormone levels through bloodwork. They will then perform an ultrasound to determine if a follicle has matured, and whether the endometrium has thickened. Over the last few days, your follicles should have grown about 1-2 mm in size each day. Once you have a mature follicle that is 20-24 mm in diameter and a measurable surge of luteinizing hormone (LH) level, you are ready for insemination. If you want to conceive naturally, your doctor will instruct you to begin having intercourse daily, for two to three days. If you want to be inseminated, the fertility clinic will schedule you an appointment for your insemination the next day.

One week after Ovulation

After you have ovulated, your doctor will once again check your hormone levels, particularly progesterone. The presence of progesterone is required for the embryo to implant in the endometrium. If your doctor determines that an embryo has not implanted or that there is an issue with ovulation, they may recommend a hormone treatment. This will facilitate egg maturation and induce ovulation. Administering progesterone can also help with the implantation stage and lead to a successful conception. Cycle monitoring can be carried out over several menstrual cycles in order to note patterns. Menstrual cycles vary each month, so performing cycle monitoring for two to three consecutive months—although it’s not always necessary—might produce results.

What Are the Benefits of Cycle Monitoring?

There are many benefits of cycle monitoring, including the following:
  • Informative: Cycle monitoring can provide patients with valuable information about the cause of their fertility struggles, so they can work with their doctor to find the best treatment option for their needs.
  • Safe: Cycle monitoring is completely safe, because it doesn’t involve the use of any medications, especially during natural cycle monitoring, meaning the risk of side effects is virtually non-existent.
  • Easy: Natural cycle monitoring is a simple and straightforward procedure. It doesn’t cause any physical strain on the patient and is therefore considered rather stress-free.
  • Affordable: Cycle monitoring and other services to diagnose infertility and support natural conception are covered by OHIP; however, should you decide to pursue other fertility treatments not covered by OHIP, many employee benefit programs also provide partial or full coverage for the treatments.

What Are the Limitations and Side Effects of Cycle Monitoring?

When natural cycle monitoring is performed, there are virtually no side effects. However, sometimes medications might be administered during the cycle monitoring process to help with implantation or during the IVF or IUI cycle. Side effects of medications include:
  • Nausea
  • Headaches
  • Bloating
  • Fatigue
  • Mood changes
While cycle monitoring is an effective way to track your fertility and gather valuable information about your ovulation, it has limitations. It requires a few visits to the clinic, for blood work and internal ultrasound. It does not directly deal with more serious fertility issues. Fertility services are an individualized process and results will vary from person to person. Sperm abnormalities and advanced age in the woman could lower the success rate of cycle monitoring. Often, if three medicated cycle monitoring procedures have not rendered positive results, you may need to reconsider whether further treatment options, such as IVF and IUI, are necessary to increase your chances of getting pregnant.

ONE Fertility Kitchener Waterloo’s Cycle Monitoring Service

At ONE Fertility Kitchener Waterloo, we believe in providing our patients with comprehensive fertility care and customized treatment options that suit the needs and comfort level of each individual patient. Our evidence-based medical approach and compassionate care ensure that our patients understand their treatment plan throughout the entire process and receive safe and high-quality fertility treatment with high success rates. To learn more about our state-of-the-art fertility clinic, our treatment options, and counselling services, give us a call or send us an email and we would be happy to answer any questions you might have about our fertility services.


4271 King St East, Suite 200
Kitchener, ON
N2P 2X7

Working Hours

Monday-Friday: 7am-3pm
Saturday-Sunday: 8am-12pm

Contact Us

Phone: 519.650.0011
Fax: 519.650.0033