Rachel Root L.Ac, FABORM, Chinese medicine practitioner specializing in fertility, pregnancy and postpartum, @rootcare_

When trying to get pregnant, it can be easy to jump to conclusions and get discouraged if you’re not successful after a few months of trying. However, there are useful tools out there to help you understand more about your body and your fertility before you consider other routes. If you have the time to put in some effort and get educated on what to look for, you might actually be surprised by what you can discover about your body.

If done correctly, a few months of observing your basal body temperature (BBT) can give you a ton of answers. There is little to no cost to you and it's a highly valuable fertility diagnostic tool to help you get pregnant. We chatted with Chinese medicine practitioner Rachel Root to get all the details.

Note: In several areas below we suggest acupuncture to optimize fertility. Given current global circumstances, we know that these in person treatments aren’t possible. However, many Chinese medicine practitioners are offering virtual services that will help make your BBT charting informative and effective.

What is BBT charting and how do I do it?

BBT stands for basal body temperature. This is the temperature of your body when it’s been resting for at least four hours. You measure it by taking your temperature with a sensitive thermometer as soon as you wake up in the morning. 

In order to do it correctly, you must take your temperature upon waking up and before doing anything else; before you move, speak, scroll through your phone, drink something, etc. Keep your thermometer next to your bed and take it every morning at the same time. 

BBT charting will require you to keep a solid routine for a while, but that has added benefits to your health and hormones, giving you all the more reason to do it. Consistency is required, but perfection isn’t necessary. If every once in awhile you want to sleep in or you have to get up earlier than usual, you can note the variance.

Other details you should mark on your chart include: 

Poor/restless night sleep or insomnia

Alcohol consumption the night before

If you took an NSAID such as ibuprofen

If you’re sick, especially if you have a fever

Days you have intercourse 

Observations of your cervical mucus 

Other changes outside of your normal routine

It’s best to get a thermometer that is made specifically for BBT, but expensive, high-tech versions are not necessary. Features that you may want to look for include a backlit screen and one that saves the last temperature. Here is one we like. There may be days you want to take your temperature then hit the snooze button, so don’t count on remembering what that number was coming right out of your dreams. 

What you can learn from your BBT? And, how can a Chinese Medicine practitioner help?

It’s important not to analyze single readings or get caught up in one-day-to-the-next numbers. 

After the entire month is completed, you and your fertility expert can start making sense of your data points. It takes about three completed charts to make confident predictions, but don’t despair, you can still learn a lot about yourself as you go. The following are some important potential discoveries:

When and if you’re ovulating and egg quality

BBT charting can be a reliable tool for figuring out when you ovulate. Test strips are pretty easy and handy for most people. However, your luteinizing hormone (LH) can rise —  a change that may be picked up by the strip — but that doesn’t mean ovulation has actually occurred. After you’ve ovulated, your corpus luteum secretes progesterone which causes your body’s temperature to rise by 0.5-1 degree Fahrenheit. If we can see that there is a stable change in temperature, we can assume ovulation has actually occurred. 

In addition, after the change in body temperature, we would expect to see your rise in temp stay relatively stable for the next 14 days. Gradual, early decline can suggest poor egg quality, while no real change in temperature can suggest that you’re not ovulating. Acupuncture and herbs can both help restore ovulation, or help to improve egg quality.  

If you have a hormone dysfunction 

A little fluctuation is normal, but if your temperatures are all over the place (we call this a “saw tooth temperature pattern”)  that could suggest thermoregulation from the hypothalamus is compromised. The hypothalamus is a part of the hypothalamic pituitary (or HPA) axis which controls our stress responses, hormone regulation, immune system,  and more. If that system is overburdened while regulating the stress responses, other systems, such as thermoregulation, can be compromised.

The functioning of the hypothalamus is closely related to the heart system in Chinese medicine. Current stressors or past traumas can both affect this the heart channel and the HPA axis. If this is you, it’s excellent that you’ve figured it out because we can address it with herbal medicine and acupuncture. If you have trauma from your past that needs to be released from your body, you can start working on that now.  

Insights about your thyroid 

You might notice when you take your temperature you are not exactly 98.6 degrees F. That’s because women’s body temperatures are typically lower than men’s. You will have your own unique average. However, if it’s consistently very low, it could suggest your thyroid is not functioning optimally. If you see this pattern, it becomes important you see your primary care provider to get a full thyroid workup done (but first try another thermometer, just in case it’s the equipment). 

Consider yourself lucky if you’ve found that one out early, before major signs and symptoms have developed. Now you have a chance to take special care of yourself and restore your thyroid’s functioning. Women with lower functioning thyroids have an increased risk of miscarriage, preterm birth, and other risks for both the mother and the baby. So it’s very important that you have this one figured out before you get pregnant. 

Chinese Medicine has a lot to offer in the way of herbal medicine and acupuncture to assist your thyroid’s function. Low body temperatures have long been treated with herbal medicine to support kidney yang and spleen function. Improving nutrient assimilation and adapting the stress response are the first steps toward treating the root cause of thyroid dysfunction; the traditional medicine used for this diagnosis does exactly that. 

If endometriosis is suspected

Most women with endometriosis probably don’t even know they have it. That’s because surgery is the only way an endometriosis diagnosis is confirmed. However, the magical BBT chart is a useful clinical tool even with this condition. After your period ends, your temperature drops again, and the follicular phase (or pre-ovulation phase) has begun again. However, there is an association with endometriosis and BBT charts where temperatures are high throughout the period and take a while to come back down in the follicular phase. If you and your acupuncturist see this over a few cycles it’s a good idea to present this to your OBGYN. Herbal medicine, acupuncture, and lifestyle changes are also extremely useful in addressing this fertility challenge. 

When NOT to BBT chart 

Fertility challenges can be heartbreaking and scary, so there is no need to add to the stress of it. I’m a big believer that whatever you can do to keep this journey fun and exciting for you and your partner should be prioritized. Many people wanting to become pregnant find BBT charting an interesting and empowering project during their journey. If you’re finding it overwhelming, or a daily reminder of something that sucks joy from your day…don’t do it! You can find success in many different avenues, it’s important you find the one that makes the most sense for you.

The other good reason not to BBT chart is if you travel a lot for work. If you’re changing time zones on a regular basis, you won’t have a consistent basal body temperature. Charting while you’re traveling would not only be hard to do, it would be an inaccurate assessment of your body. 

If you feel like this is the right next step for you and you’re feeling inspired…

If you’re ready to give it a go, get started at the beginning of your next cycle and get excited to learn about yourself on a deeper level. If you’ve tried it before and didn’t find it useful the first time, give it another chance and this time consult an acupuncturist who works closely with fertility patients. You just might find the answer you’ve been looking for.