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What Does Free Fluid In POD Around Day 13 Of Menstrual Cycle Indicate?

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Posted on Wed, 11 Jun 2014
Question: Hi I had a miscarriage 7 weeks ago and had to do a d&c. 5 weeks later I got my period. I am now trying to get pregnant so I have been using opks and got a positive cd 13. I did a scan and it showed a 13mm follicle and free fluid. However I felt cd 13 was too early. So cd 16 I did another scan and it showed the follicle had grown to 16mm.
My question is did I ovulate cd 13? Or did I get a false positive opk test.
Also I tested positive on the ovulation kits from cd 13 to cd 15 night. Had egg white cervical mucus cd14 and a little 15.
Do you think I ovulated cd 13 or I am still yet to ovulate and it was just a false positive ovulation test?
doctor
Answered by Dr. Manisha Jain (16 minutes later)
Brief Answer:
true positive result of OPK,ovulation around 13may

Detailed Answer:
Hello mam, thanks for trusting health care magic.

Firstly I would like to appreciate your insight about follicular study and predictive values of test kits.
Free fluid in POD is quite suggestive of follicle rupture and is supported by the positive result on ovulation prediction kit and egg white cervical mucus.So it suggests that you ovulated on or around day 13 of your cycle.

The growing follicle shown in your follicle study is an additional follicle growing which is quite common and is an incidental finding. This additional follicle may
- grow to maturity and ovulate or
- just go atresia due to the progesterone released from the previously ovulated follicle.

So the bottom line is you ovulated on or around day 13 and true positive result on ovulation prediction kit.

I hope i have answered your query; but in case you have any other question I will be happy to help.

Dr. Manisha Jain (infertility specialist)
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Manisha Jain (22 minutes later)
Thanks for the response. However the follicle grew 3mm in size after the supposed ovulation on cd 13. So 3mm from cd 13 to cd 16. I thought a follicle of 16mm was considered mature. Also my ovulation tests were positive for 2 consecutive days after the scan on cd 13 showing i had free fluid. Also the egg white cervical mucus started cd14 which would have been a day after ovulation. I have another scan tomorrow. If the 16mm follicle is bigger will you still suggest i ovulated day 13?
doctor
Answered by Dr. Manisha Jain (11 minutes later)
Brief Answer:
SURELY YOU OVULATED ON DAY 13.

Detailed Answer:
Welcome back.
Follicle of size 18 mm or more is considered mature and usual growth of follicle is 2 mm per day.
Ovulation prediction kits detect ovulation by detecting levels of a hormone 'LUTEINISING HORMONE' and for positive result levels of LH should be more than at least 40 IU.
But usually its levels are more than 80 and thus detection kits keep on detecting It for a couple of days after peak levels thus first positive OPK test is of maximum value.
And when you will go for follicular study tomorrow if the follicle enlarges then also i will stick to the fact that you surely ovulated on or around day 13th.
So wish you all the best for conception and in case of further consultation you are most welcome.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Manisha Jain (21 minutes later)
If the follicle enlarges to 18mm then how is it certain i ovulated day 13 still? In addition my gyno did mention that i have fluid naturally which she mentioned previously so it might not have been pod fluid but maybe pre existing fluid. This fluid waa still showing up cd 16 as well.
But if i did indeed ovulate cd 13 then can you
explain why the egg white mucus showed up aftet ovulation insteaf of before? And the symptoms showed up after too. The egg white mucus has stopped but i still feel ovulation pains on my right ovary where the 16mm is growing
doctor
Answered by Dr. Manisha Jain (21 minutes later)
Brief Answer:
OVULATION ON 13 OR 14TH OF MAY

Detailed Answer:
Hi, good to see you again.

Even if you had some pre-existing fluid then also getting 3 consecutive false positive results is highly unlikely.

It is very common to have two eggs released at different times in single cycle itself so this another follicle can grow and rupture or can undergo atresia without any ovulation.
Egg white mucus usually precedes or coincites with positive OPK because it is due to peak levels of estrogen which initiates rise of LH (read by OPK as positive result)
BUT important thing to note here is FIRST POSITIVE OPK TEST IDENTIFIES IMMINENT OVULATION i.e. within 12-36 hours and till then estrogen levels are maintained. This egg white mucus implies estrogen still present to wane as soon as ovulation occurs.

SUMMARY IN YOUR CASE
- Estrogen peak started on day 13
- LH rises soon after rise of estrogen on day 13
- egg white mucus started with estrogen peak and maximum on 14th day
- ovulation on 14th day
- subsidence of egg white mucus once ovulation occurred.

This is the most probable chronology of events in my opinion after a close study of your history.
Ovulation pains persist for a day or two after ovulation and are due to the substances released from rupture of follicle which tend to irritate the peritoneal surfaces, and because you said you had pre-existing fluid in peritoneum these substances are absorbed at a slower rate.
So fair chances of pregnancy in case you had sex around day 14 of your cycle.

Take care and all the best.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Manisha Jain (6 hours later)
Im not sure you understand my question. How could i have ovulated on day 14 if i had a scan on day 13 and there was no mature follicle. If there was only a 13mm follicle on day 13 which has not ruptured because yeaterday on day 13 that same follicle was 16mm. So thr question is did i ovulate day 13 as my opk was positive and there was no follicle so it might have ruptured. Or was it a false positive because 1). The ovulation symptoms like egg white mucus and pains came between cd14/15 and the opk continued to stay positive from cd 13 to cd 15. And 2). The follicle is still growing and is 16mm cd 16.
doctor
Answered by Dr. Manisha Jain (38 minutes later)
Brief Answer:
True positive OPK

Detailed Answer:
No my dear, I would like to satisfy you from my answer this time and make you feel that health care magic is worth spending your valuable time and money.
As I have stated earlier I will like to stick to the fact that you definitely ovulated around 13th may for sure reason being -
- positive OPK ( LH peak - single important factor for ovulation to occur)
- free fluid ( not of much significance in your case because you said you had it already)
- egg white mucus ( most inconclusive because it occurs due to the presence of estrogen which kept on persisting as you had another follicle of 13 mm size which had been secreting that estrogen)
I UNDERSTAND your main question is if the OPK was false positive!!
This positive OPK is due to rising levels of LH which is initiated by a critical size of ovum viz more than 18mm size that is why 18 mm is taken as mature ovum size which can rupture to release ovum anytime.
But as your second ovum was just 16 mm it is unlikely that those three positive OPK were related to that ovum.
I hope I have made myself clear and that I have been able to make the situation clear that those positive tests were true positive.
Take care and wish you all the best for a healthy pregnancy and healthy baby.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Manisha Jain

OBGYN

Practicing since :2007

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What Does Free Fluid In POD Around Day 13 Of Menstrual Cycle Indicate?

Brief Answer: true positive result of OPK,ovulation around 13may Detailed Answer: Hello mam, thanks for trusting health care magic. Firstly I would like to appreciate your insight about follicular study and predictive values of test kits. Free fluid in POD is quite suggestive of follicle rupture and is supported by the positive result on ovulation prediction kit and egg white cervical mucus.So it suggests that you ovulated on or around day 13 of your cycle. The growing follicle shown in your follicle study is an additional follicle growing which is quite common and is an incidental finding. This additional follicle may - grow to maturity and ovulate or - just go atresia due to the progesterone released from the previously ovulated follicle. So the bottom line is you ovulated on or around day 13 and true positive result on ovulation prediction kit. I hope i have answered your query; but in case you have any other question I will be happy to help. Dr. Manisha Jain (infertility specialist)