14 Feb 2020

Feedback Friday: Ovulation Predictor Kits

by | posted in: Feedback Friday, Intrauterine Insemination, Ovulation DIsorder, Ovulation Induction, Starting Out, Testing, The Clinic, Treatment | 0

Dear Eggsperts–Hello! I have a question. My doctor prescribed Clomid. She also asked me to do ovulation kits. Do you have recommendations on ovulation kits? –Bewildered in Birmingham

Dear Bewildered–So, your nurse or doctor tells you to pick-up and use an “OPK,” and you’re like, “Ummmmmm, Okay?!”

After you ask your new bestie at the checkout counter what OPK means, but before you’ve even left the waiting room, you log onto Amazon, right?  You’re like, how hard can it be? I mean, seriously, how many of those really exist?. WRONG! The truth is there USED to be only one or two options.  Nowadays, there are “gazillions” of options.  

Image by Lacie Slezak on Unsplash

Nervous to even ask, you’re thinking to yourself, “what the hell is an OPK?”  Ovulation Predictor Kit, also known as an Ovulation Test Kit, or OTK. “You can find it OTC,” she says.   Shorthand for Over-The-Counter. More medical jargon, great. You know, more of those acronyms that make you even more confused. Do they somehow ever make someone feel smart when they use the terms?

This is our opinion only. Your doctor may recommend a specific test.

Image by Mohammad Metri on Unsplash

Although there are lots of options, there are really 3 different groups of products: Cheap & Messy, Fancy-Yet-Pricey, and then all the rest, Middle of the Road.  Just like pregnancy tests (hopefully, you’ll be doing that soon enough), All of these tests are measuring the presence of a hormone in a woman’s urine. Luteinizing Hormone (LH) is secreted about a day before ovulation. Some tests also test levels of Estrogen, which rises while follicles are growing and peaks around the same time as the LH “surges.” “Peak” fertility days are the day of the LH “surge” and the day after the LH “surge.” Regardless of a kit’s ability to SPEAK, SMILE, or WINK at you (or not), it should test LH, and maybe Estrogen.

  • CHEAP & MESSY:
    • Typically cost between $5-15 dollars for as many as 50 test strips in a box.
    • You have to collect your urine in a very small cup and then dip the test strip into your urine, wait a few minutes to watch for a line to develop. You do all of this while trying to not pee on your hand, or (and yes, I’ve done this) spill your urine all over yourself and your bathroom!  UGH!!! Nothing worse than having to explain that to your co-workers on your lunch break.
    • BOTTOM LINE: Yes, they work; but, they can be messy.
    • RECOMMENDATION: Spend a few more bucks and save yourself the embarrassment. 
Image by Ani Kolleshi on Unsplash
  • FANCY-YET-PRICEY: These are digital/electronic ovulation predictor kits and typically cost $150-250 per kit. In addition to the device that you can use time and time again, you will have to replace the test strips after each use.
    • These are fully equipped to tell you everything you need to know about your cycle, and then some.  These tests are best known for their smiles and winks. Heck!….some might even talk to you! And don’t misunderstand, we think every lady could use an extra wink and a smile when peeing on a stick, but at the the end of the day, you are simply peeing on a stick with the goal of being told when to have intercourse for your best chance of becoming pregnant.
    • These kits also tell you “high” and “peak” fertility days.
    • BOTTOM LINE: These pricey models may be more expensive and have more functions than you need or care for. 
    • RECOMMENDATION: Save a few bucks and steer towards a more moderately priced, simplified version. 
  • MIDDLE OF THE ROAD: These ovulation predictor kits are moderately priced at $18-33 dollars per box. Depending on the length of your cycle and how you are instructed to use these, they may get 1-3 months out of each box.
    • These tests are probably the ones you are most familiar with and can easily be mistaken for pregnancy tests, as they are often sold on the same shelf.
    • The user urinates on the end of the stick, using a new stick with every test attempt. (NOTE: some of these tests will give a digital result, via smile, plus sign or line, but it is still a one time use device.)
    • BOTTOM LINE: Reasonably priced, easy to use, not too many frills. They have worked for women for decades.
    • RECOMMENDATION: If you couldn’t tell, we really like these tests!

How and when to test? Depending on the kit you choose, this may vary.

  • Read and follow the manufacturer’s instructions.
  • Test daily before you expect to be fertile to avoid missing the surge. Be sure to test early enough in your cycle. Your first positive result will likely indicate that you are about to ovulate. A true positive result would be negative one day and then positive the next.
  • To avoid spending too much money on kits, time your cycle and testing.
    • Day 1 of a women’s cycle is her first day of FULL FLOW menses. 
    • A “cycle” is from Day 1 of one cycle until Day 1 of the next cyle. Most women will have cycle lengths between 26-33 days. (Many women are confused by this because they are accustomed to counting the number of active bleeding days, which for most women would be 2-9 days – so you can see these calculations are very different.)
    • Your ovulation day will be later if you have a long cycle, and earlier if you have a short cycle. Some women may produce a positive reading on Cycle Day 10, some on day 16.  We typically recommend to all women to start testing on Cycle Day 9. Once you have tested positive a couple of months in a row, you will be able to adjust accordingly.
  • Check the manufacturer’s instructions to determine the best time of day to use your OPK. Your first morning’s urine may not be the best test source as your LH surge often begins while you’re still asleep. Late morning or early afternoon urine is often best unless the manufacturer’s instructions suggest otherwise.
  • If the test line on your OPK is as dark as or darker than the control line, record your results as positive. If the test line is lighter than the control line, record your results as negative. Follow the manufacturer’s instructions for digital OPK tests.

If you have tried using an ovulation predictor test of types for 2-3 months and don’t feel you are ever getting a positive reading, or always get a positive reading:

  • Switch test types, or brands.
    • Frankly, sometimes the kits are just hard to interpret for some women. It doesn’t mean you are doing anything wrong, it’s just that the signal is hard to interpret, or your hormone level isn’t enough to cause a change even if it is enough to cause you to ovulate.
  • If the kits never turn positive, it’s possible that you don’t ovulate regularly, or even at all.
  • Some women with certain diagnoses (for example: Polycystic Ovarian Syndrome) may have chronically elevated levels of LH and always show a positive.
  • If you find the kits never turn positive, are always positive, or are just hard to read, check in with your doctor and let them know. Your doctor may be able to do blood work, or ultrasound, in correlation with your home monitoring to offer more information
www.verywellfamily.com

Note 1: If you are using OPKs to time ovulation and intercourse, know that your fertility window your fertility window is a few days before and a day after ovulation. The test kit turns positive the day BEFORE actual ovulation. But, for timing purposes, if you have regular sex for a few days before you expect to ovulate and maybe a day or two after you think you may have ovulated, you are hitting the right time window.

Note 2: There are lots of ovulation predictor apps that time ovulation based on the length of your cycle. They are just guessing on timing of ovulation based on cycle length. They are pretty good estimators if you have regular cycles. But if you need more precision for timing ovulation, then we recommend using a test kit to check hormone levels.

We hope we met your Eggspectations—An Eggspert

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Disclaimer: All of the comments on this page are for basic information only. They are based on the opinions and expertise of the authors and are not meant to provide a substitute for medical care or specific treatment recommendations. Each person is unique and requires individualized diagnosis and treatment plans. Any specific questions should be directed to your personal healthcare provider.