A positive ovulation test is generally a good sign that indicates an LH surge and normally ovulation should occur within 36 hours. But in some women ovulation may not occur and LH surge may be because of conditions such as polycystic ovary syndrome (PCOS), pituitary disorder, or perimenopause.
Ovulation tests are more than 95% accurate, but can sometimes give false-positive results. Getting a negative result may not necessarily indicate a lack of ovulation, but may also be because you tested too late or too early, or possibly missed following some instruction. Repeating the tests for a few cycles may produce more reliable results.
What is an ovulation test?
An ovulation test helps determine the precise time frame in which a woman ovulates during the menstrual cycle. Ovulation tests measure the level of luteinizing hormone (LH) in the urine. A spike in the LH level in the urine indicates that ovulation is imminent.
Ovulation tests can help women trying to conceive find the ideal time to have sexual intercourse to improve pregnancy chances. The fertility window is only about five days during the menstrual cycle. The sperm has a life of five days and an egg lives for just 24 hours after release, so a woman is fertile on the day of ovulation and for approximately four days before.
What is ovulation?
Ovulation is the release of a mature egg by the ovaries during the menstrual cycle. Ovulation usually happens in the middle of a monthly cycle. In a woman with a 28-day cycle, ovulation may happen around day 14. Ovulation may be more difficult to predict in women who have irregular cycles.
The menstrual cycle consists of three phases:
Follicular phase: Starts on the first day of menstrual bleeding when estrogen and progesterone levels are low. The pituitary gland secretes follicular stimulating hormone (FSH) which stimulates the growth of a few follicles (fluid-filled sacs with egg cells) in the ovaries, among which one dominates and continues to grow and produce estrogen.
Ovulation phase: The fertile period when there is a surge in the luteinizing hormone, secreted by the pituitary gland. Luteinizing hormone stimulates the rupture of the follicle and release of a mature egg (two eggs, rarely) within 36 hours.
Luteal phase: The follicle, after releasing the egg, becomes a structure known as corpus luteum and produces progesterone which stimulates the uterus and breasts to prepare for pregnancy. If pregnancy does not take place, the corpus luteum disintegrates, hormone levels drop and the next menstrual cycle begins.
How can I tell I am ovulating?
You may need to monitor a few cycles to be able to successfully predict your ovulation time. Following are some signs of ovulation you can watch for:
- An increase in libido
- A slight dip in basal body temperature one day before ovulation and an increase of up to 1.0 F after ovulation
- Changes in the texture of cervical mucus (vaginal discharge) which becomes thinner and clearer acquiring the consistency of raw egg white, which facilitates sperm movement
- Tender breasts
- Bloating or cramps
- Light spotting
When should I start testing for ovulation?
Observe a few cycles to learn the average length of your menstrual cycle. The luteinizing hormone surge takes place 36 hours before ovulation. Start testing for ovulation four to five days before the midpoint of your cycle. Make sure you test at the same time every day.
What are the types of ovulation tests?
The types of ovulation tests include the following:
- Ovulation predictor home test kits: These are simple test kits that can be used in home tests with a urine sample. Less expensive options are paper strips, but these results may be difficult to interpret for some. Costlier digital devices can give out the reading from the strips. Some tests are supported by mobile apps that help interpret results.
- Blood tests: Blood tests can detect hormone levels accurately, but are not commonly performed because of the inconvenience of frequent laboratory visits.
- Transvaginal ultrasound: Transvaginal ultrasound of the ovaries and endometrium may be done by the doctor to check follicle size and growth if you undergo fertility treatment.
How can I test my ovulation at home?
Ovulation predictor home test kits usually contain five to seven sticks. If you have a regular cycle, you can start testing for LH surge about five days before the midpoint. The ovulation test is done by placing a stick in your urine collected in a sterile container, ideally at the same time every day. You must not skip any day till ovulation occurs, because you might miss the LH surge.
The stick will change to a certain color if the result is positive or display the results if it is a digital device. Do not drink large amounts of fluids before the test, because it can dilute the urine. Estrogen and progesterone in birth control pills and hormone replacement therapy can reduce LH levels.
It may require several more days of testing and may be more difficult to find your ovulation dates if you have irregular menstrual periods. It may be helpful to seek professional help from a fertility specialist. Doctors sometimes prescribe clomiphene citrate (Clomid), which is used to stimulate ovulation if you have irregular or infrequent periods.
Along with LH surge testing, being conscious of subtle body changes, watching for your cervical mucus, and taking your temperature every day for a few cycles can help determine your pattern of ovulation to a great degree.
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