Luteinizing hormone urine test (home test); Ovulation prediction test; Urinary LH immunoassays

How do ovulation prediction tests work?

An LH urine test detects a rise in lutenizing hormone (LH). Such a rise, or surge, signals the ovary to release the egg. This at-home test is often used by women to help predict ovulation.

How the Test is Performed

Ovulation prediction test kits usually come with five to seven sticks. You may need to test for several days to detect a surge in LH. The specific time of month that you start testing depends on the length of your menstrual cycle. For example, if your normal menstrual cycle is 28 days, you’ll need to test on day 11 — that is, the 11th day after you started your period.

You will need to urinate on the test stick, or place the stick into urine that has been collected into a sterile container. The test stick will turn a certain color or display a positive sign if a surge it detected. A positive result means you should ovulate in the next 24 to 36 hours, but this may not be the case for all women. The kit’s instruction booklet will tell you how to properly read the results.

If you miss a day, you may miss your surge. You may also miss recording a surge if you have an irregular menstrual cycle.

How to Prepare for the Test

Do not drink large amounts of fluids before using the test.

Ask your doctor if you need to stop taking certain drugs before using this test.

Drugs that can decrease LH measurements include estrogens, progesterone and testosterone. Estrogens and progesterone may be found in birth control pills and hormone replacement therapy.

The drug clomiphene citrate (Clomid) can increase LH levels. This drug is used to help trigger ovulation. Women taking this drug should wait three days after stopping the medicine before checking their LH levels.

How the Test Will Feel

The test involves normal urination. There is no pain or discomfort.

Why the Test is Performed

The test is most often done to determine when a women will ovulate. It may also be used to determine if you need to adjust doses of certain medications.

Normal Results

A positive result indicates an an “LH surge” and is a sign that ovulation may soon occur. Read your specific manufacturer’s instruction booklet for complete details.

Risks & Considers of Taking an Ovulation Prediction Test

Rare false positive results can occur. This means the test kit may falsely predict ovulation.

If you are unable to detect a surge or do not become pregnant after using an ovulation prediction kit for several months, contact your doctor. You may need to see an infertility specialist.

LH urine tests are not the same as at home fertility monitors. Fertility monitors are digital hand held devices that predict ovulation based on electrolyte levels in saliva, LH levels in urine, or your basal body temperature. These devices can store ovulation information for several menstrual cycles.

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• Day 1 starts with the first day of your period.
• Usually by Day 7, a woman’s eggs start to prepare to be fertilized by sperm.
• Between Day 7 and 11, the lining of the uterus (womb) starts to thicken, waiting for a fertilized egg to implant there.
• Around Day 14 (in a 28-day cycle), hormones cause the egg that is most ripe to be released, a process called ovulation. The egg travels down the fallopian tube towards the uterus. If a sperm unites with the egg here, the egg will attach to the lining of the uterus, and pregnancy occurs.
• If the egg is not fertilized, it will break apart.
• Around Day 25 when hormone levels drop, it will be shed from the body with the lining of the uterus as a menstrual period.

The first part of the menstrual cycle is different in every woman, and even can be different from month-to-month in the same woman, varying from 13 to 20 days long. This is the most important part of the cycle to learn about, since this is when ovulation and pregnancy can occur. After ovulation, every woman (unless she has a health problem that affects her periods) will have a period within 14 to 16 days.

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Knowing when you’re most fertile will help you plan or prevent pregnancy. There are three ways you can keep track of your fertile times. They are:

Basal Body Temperature Method

Basal body temperature is your temperature at rest as soon as you awake in the morning. A woman’s basal body temperature rises slightly with ovulation. So by recording this temperature daily for several months you’ll be able to predict your most fertile days.

Basal body temperature differs slightly from woman to woman. Anywhere from 96 to 98 degrees orally is average before ovulation. After ovulation most women have an oral temperature between 97 and 99 degrees. The rise in temperature can be a sudden jump or a gradual climb over a few days.

Usually a woman’s basal body temperature rises by only 0.4 to 0.8 degrees Fahrenheit. To detect this tiny change, women must use a basal body thermometer. These thermometers are very sensitive. Most pharmacies sell them for around $10. You then record your temperature on a special chart.

The rise in temperature doesn’t show exactly when the egg is released. But almost all women have ovulated within three days after their temperatures spike. Body temperature stays at the higher level until your period starts.

You are most fertile and most likely to get pregnant:

• two to three days before your temperature hits the highest point (ovulation), and
• 12 to 24 hours after ovulation.

A man’s sperm can live for up to three days in a woman’s body. The sperm can fertilize an egg at any point during that time. So if you have unprotected sex a few days before ovulation there is a chance of becoming pregnant.

Many things can affect basal body temperature. To get the most useful chart you should take your temperature every morning at about the same time. Things that can alter your temperature include:

• drinking alcohol the night before
• smoking cigarettes the night before
• getting a poor night’s sleep
• having a fever
• doing anything in the morning before you take your temperature – including going to the bathroom and talking on the phone

Calendar Method

This involves keeping a written record of each menstrual cycle on a calendar. The first day of your period is Day 1. Circle Day 1 on the calendar. Do this for eight to 12 months so you know how many days are in your cycle. The length of your cycle may vary from month to month. So write down the total number of days it lasts each time. To find out the first day when you are most fertile, check your list for the cycle with the fewest days. Then subtract 18 from that number. Take this new number and count ahead that many days on the calendar. Draw an X through this date. The X marks the first day you’re likely to be fertile. To find out the last day when you are fertile, subtract 11 days from your longest cycle and draw an X through this date. This method always should be used with other fertility awareness methods, especially if your cycles are not always the same lengths.

Cervical Mucus Method (also known as the Ovulation Method)

This involves being aware of the changes in your cervical mucus throughout the month. The hormones that control the menstrual cycle also change the kind and amount of mucus you have before and during ovulation. Right after your period, there are usually few days when there is no mucus present or “dry days.” As the egg starts to mature, mucus increases in the vagina, appears at the vaginal opening, and is white or yellow and cloudy and sticky. The greatest amount of mucus appears just before ovulation. During these “wet days” it becomes clear and slippery, like raw egg whites. Sometimes it can be stretched apart. This is when you are most fertile. About four days after the wet days begin the mucus changes again. There will be much less and it becomes sticky and cloudy. You might have a few more dry days before your period returns. Describe changes in your mucus on a calendar. Label the days, “Sticky,” “Dry,” or “Wet.” You are most fertile at the first sign of wetness after your period or a day or two before wetness begins. This method is less reliable for some women. Women who are breastfeeding, taking hormonal contraceptives (like the pill) using feminine hygiene products, have vaginitis or sexually transmitted diseases (STDs), or have had surgery on the cervix should not rely on this method.

To most accurately track your fertility, use a combination of all three methods. This is called the symptothermal method.

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