There are cases of maturation in a cycle of not one, but two or more follicles. They occur, according to statistics, in 10% of women. This phenomenon is called double ovulation. The most common causes are:
• stimulation medications
• end of oral contraceptives (rebound effect);
• genetic predisposition
Researchers in the field of medicine were long not 100% sure that double ovulation exists. After all, naturally only one dominant follicle matures during the monthly cycle in a woman.
This article I created specifically for women who plan to become pregnant. Here on ovulationdiary.com you can learn more about the phases of the cycle, how and when ovulation occurs and how to define it.
The forms of double ovulation
Two ovulations may occur at the same time, or at a time interval. Simultaneous ovulation occurs when two eggs, formed in the same ovary or different, release at the same time. Some women have ovulation in two ovaries at once, then with a successful conception, give birth to twins who are unidentical and/or of different sex.
The interval between ovulations can also be from several hours and up to a week. Then there is a double ovulation over a certain period of time, caused by the occasional discharge of the sex hormones needed to mature the egg.
Note (!): There are documented 11 double pregnancies in the world, when egg fertilization occurred as a result of two ovulations. When two pregnancies occurred in one woman with an interval of several days.
Double ovulation: symptoms, sensation, discharges
The most accurate symptoms, indicating that there occurred two ovulations in a row, can be determined only with ultrasound diagnostic. During this diagnosis, the specialist also sees the dominant follicle, the process of yellow body formation, as well as the second maturing follicle, from which the second egg emerges.
In practice, folliculometry is carried out every two or three days – it is enough not to miss the moment of release of the first egg and the growth dynamics of the second follicle.
The main symptoms of double ovulation:
1. If double ovulation occurred at one moment – signs of it are the same as in normal ovulation: discharges become more watery, transparent and sticky, there is a slight pain in the lower abdomen or ovaries, and the level of sexual attraction increases;
2. If eggs are released from follicles after a certain interval – the second ovulation usually has less pronounced symptoms, because by this time progesterone is already active in the body.
In both cases, ovulation tests will be positive 6-48 hours before the egg is released.
What is the reason of double ovulations in a single cycle?
Science has still not made a definitive conclusion about why this interesting phenomenon is happening. But there are findings that ovulation happening twice a month occurs for such reasons:
• when the level of luteinizing hormone increases dramatically when a stressful situation occurs;
• irregular and unplanned sexual contacts also play a role;
• eating plant-based foods that contain phytoestrogens;
• the effect of some food;
• hereditary pattern.
Most often, two eggs, and even more, mature when the ovaries are stimulated by hormones during infertility therapy. As a result, the influence of hormonal agents cause several eggs to mature at once. Such stimulation is used for ICSI, IVF, as well as polycystic ovary for lutein deficiency.
Rebound effect of OC
Twins are more likely to be born by women with a genetic predisposition through the female line and the second possible reason is after the abolition of oral contraceptives.
The essence of the treatment is as follows, under the action of high hormonal doses (estrogen/progesterone) natural ovulation stops – folliculogenesis, that is, the development, release and involution of the yellow body, does not occur. The ovaries are resting.
On the ultrasound diagnostic, it looks as if the dominant follicle is not developing – the persistence of the follicle. After rebound OC, some women have rested ovaries working with double force, which can lead to the appearance of two dominant follicles, one in each ovary. These results in double ovulation and the birth of non-identical twins.
OC are most often prescribed by a doctor for the following reasons:
• treatment of endocrine disorders;
• after surgery to allow the ovaries to recover;
• cycle recovery
• drug-induced contraception.
It is important (!): You should not independently assign yourself OC with the goal, as they say, to shoot at a time. No need to specifically stimulate multiple pregnancy. Now, even with IVF and ICSI, 2 blastocysts are not always planted. This is associated with a huge risk of premature birth, a doubled load on the mother’s body and all the ensuing consequences.
Basal temperature at twins
The chart of basal temperature during twin pregnancy may not show clearly that there were two ovulations at the same time in one cycle. In a one-egg pregnancy at a very early stage, the egg immediately divides, forming two embryos.
In the case of double ovulation, when two different female eggs are fertilized, there will not be an increase on the chart. Very rarely, due to the release of HCG and progesterone, a temperature increase occurs in the second half of the cycle, resembling ovulation. This may indirectly indicate there is a likelihood of a double conception.
BBT charts with two ovulations
The date of egg release and the number of ovulations using the chart is not always possible to predict. If both matured cells are released simultaneously, the basal temperature does not always show two ovulations. There will be only a single release of LH and a normal, possibly faster temperature increase.
If ovulation occurs again, the LH content will be lower than the first time due to the high progesterone level, respectively, and the second basal temperature increase will be insignificant. This will not give a picture of the second increase of the BBT and will not give suspicion of repeated release of the egg. Tests will help catch the repeated ovulation.
Note (!): The ultrasound diagnostic will show the most reliable multiple eggs release, 100% confirming there was double ovulation, and there is a chance of several fertilizations.
This is a chart of the basal temperature at twins:
These are ideal options. Unfortunately, this is rare, since 2 ovulations can occur at one moment or there will be no well-marked implantation retraction:
In pregnancy, even before the first ultrasound diagnostic, it is possible to easily establish multi-fertility – in the first six weeks the level of HCG increases by 4 times about every 2 days. In a single pregnancy, HG grows about 2 times (growth table).