A couple is unable to conceive after 12 months, and the male evaluation is normal. How can ovulation be confirmed in the female?

Confirming ovulation in females can be effectively done by measuring serum progesterone levels. Progesterone is a hormone produced by the corpus luteum following ovulation, and its levels typically rise after ovulation due to the signal from luteinizing hormone (LH). A serum progesterone test performed during the luteal phase (usually about one week before the expected menstrual period) can indicate whether or not ovulation has occurred. A higher level of progesterone in the blood supports the conclusion that the female has ovulated.

While other hormones like FSH, LH, and others are involved in the reproductive cycle, they do not provide as direct proof of ovulation as progesterone does. For instance, measuring luteinizing hormone can indicate that ovulation is imminent (as it spikes shortly before ovulation occurs), but it does not confirm that ovulation has actually taken place. Thyroid-stimulating hormone and prolactin, while important for overall reproductive and menstrual health, do not directly indicate ovulation status. Thus, checking progesterone levels is the most reliable method for confirming ovulation in this context.