All About Ovulation Tests & Fertility Prediction

Fertility Prediction: Do Ovulation Tests Work?

Ovulation test strips – sometimes called ovulation predictor kits or OPKs – are at-home urine tests used to detect ovulation. Many women struggling to conceive turn to ovulation kits to try and predict the optimal time each month that they are fertile.

Ovulation tests work by detecting luteinizing hormone (LH) in the urine, which surges before ovulation. For fertile women these tests can sometimes be beneficial, providing an estimation of when they may be approaching ovulation.

But, because OPKs only measures one potential marker of fertility, the LH surge, they can also be misleading. This may prevent them from being effective, or even helpful, for women facing underlying infertility issues.

In this article, Austin, TX board-certified Internist and renowned Women’s Integrative Health Specialist Dr. Ruthie Harper explains the drawbacks of over-the-counter ovulation tests, discusses other methods of predicting ovulation, and explores the implications of OPKs for women suffering from infertility.

How Ovulation Kits Predict Fertility

In healthy women, once every month a mature egg is released from one of the ovaries and is available to be fertilized. This corresponds to a 12 to 24-hour window when fertility peaks, making it the best time to try and conceive.

But while ovulation occurs in the middle of the menstrual cycle, each woman’s cycle is different. So, the exact timing of ovulation can vary from woman to woman and month to month. Since luteinizing hormone (LH) typically surges right before ovulation, OPK tests are designed to indicate when and if a woman is ovulating.

Drawbacks of Ovulation Kits to Predict Fertility

One of the biggest drawbacks to at-home ovulation predictors is that while the test can estimate the time that ovulation should occur, it cannot determine if ovulation has actually taken place. In some cases of infertility, such as LUFS (luteinized unruptured follicle syndrome), a woman experiences a surge in LH, but an egg is never released. So, even though the OPK is “positive” indicating the surge in LH that occur prior to ovulation has occurred, the women still do not conceive because in reality, she does not ovulate.

Ovulation kits are also not useful in predicting fertility for women suffering from PCOS (Polycystic Ovarian Syndrome). This is because PCOS can cause many spikes in LH levels, even without ovulation, so the ovulation test kit can provide misleading results.

Similarly, women who are experiencing a decline in fertility as they approach menopause may experience increased levels of luteinizing hormone, which can result in the OPK test providing false positive results for ovulation.

Women whose LH surges last less than 10 hours and who only use the ovulation prediction kit once a day may miss their LH surge depending on what time of day they test. Additionally, women with lower levels of luteinizing hormone whose LH surges do not quite reach the OPK’s threshold may also get false negative results even if they indeed do ovulate.

Some women regularly experience mini LH peaks throughout their cycle, before the real LH surge that leads to ovulation. They may receive false positive results and have intercourse earlier than they should – which lowers their chances of pregnancy.

And, women with irregular cycles often will receive invalid ovulation predictions, since the test’s kit covers only 5 to 9 days each month. A woman with a cycle ranging between 24 to 40 days may actually have ovulation during a 16 day range, which is much longer than the kit’s effective range.

Other Causes of Invalid OPK Results

If an ovulation prediction kit is not kept in the proper conditions, for example if it is exposed to heat during delivery or storage, it may no longer be able to predict ovulation accurately.

Ovulation tests also do not predict fertility accurately if a woman is taking any fertility drugs containing FSH, LH or HCG, and/or antibiotics containing tetracycline and/or is undergoing hormone therapy.

Ovulation kit results will usually be invalid if the women is pregnant, postpartum, or breastfeeding.

Better Options for Predicting Fertility

The two ovulation detection devices discussed below are more accurate than common, over the counter at-home ovulation prediction kits.

Clearblue Fertility Monitor

This is a palm-sized electronic device that measures the levels of LH and estrogen in the urine and estimates if the woman is currently in the low, high or peak phase of their menstrual cycle. It can then determine ovulation one to two days before it occurs and notify the woman a number of days before.

However, this test may also be inaccurate at predicting fertility if the woman is in menopause, was recently pregnant, is breastfeeding, is suffering from PCOS, or taking certain drugs including: antibiotics such as tetracyclines; is on hormonal treatments such as Clomiphene citrate; or is on fertility treatments containing hCG or LH.

OvaCure Fertility Monitor

This device is a handheld monitor with an oral and vaginal sensor. It measures changes in the electrolyte levels in the saliva which are affected by estrogen every day, and then displays the trends in a color-coded calendar to identify the Optimal Fertility Day.  And, the vaginal sensor detects when the body has switched from producing more estrogen to more progesterone, which indicates that ovulation has occurred.

When combined, the data from the dual sensors can better estimate possible ovulation, even in women with PCOS or irregular cycles, as the results do not depend on LH levels.

However, even these more advanced methods of ovulation prediction still do not provide any information about a woman’s key fertility signs, which are cervical fluid or waking temperature.

Accurate Fertility Prediction – Austin, TX

If you are attempting to conceive, using an at-home ovulation test, or the more advanced ovulation predicting technologies can be useful – but they are neither foolproof nor 100% accurate.  Charting your key fertility signs is still one of the most important ways to boost your fertility and maximize your chances of conception!

If you have been trying to conceive without success for more than several months, it is best to consult with a knowledgeable physician who can diagnose any underlying problems, as well as help you track your potential fertility dates with greater accuracy using all of the methods above.

Austin, TX board-certified Internist Dr. Ruthie Harper, MD is an Integrative Medicine Specialist and offers   a wide array of diagnostic procedures, along with scientifically developed health protocols, that can help your body be better able to conceive. She is passionate and compassionate in helping to diagnose and resolve infertility issues.

If you are struggling with infertility, we welcome you to contact us at Ruthie Harper, MD Integrative Health in Austin, TX. We understand the frustration and stress of infertility – and we are here to assist you with love, compassion, and the latest diagnostics and integrative medical technologies to support you in having the family you have always wanted.

Fertility Prediction & Treatment – Austin, TX: (512) 343-9355

Treating Infertility with Hormone Therapy

Infertility is a deeply personal issue that can lead to feelings of loss, grief, isolation, and frustration. Sadly, the inability to conceive a child can also cause a couple to feel embarrassment, stress and even lowered self-esteem.

If you have been unable to become pregnant, Dr. Ruthie Harper, MD in Austin, TX is here to help you determine the underlying cause(s) of your fertility issues and offer you the treatments that may help.

Generally, a fertile couple under age 30 has about a 25% chance of conceiving in any menstrual cycle. For each year that the couple is over 30, the chances of pregnancy become less.  And as a woman ages, many factors can cause a decline in fertility including: the quality of healthy eggs; the number of days she produces high-quality cervical fluid; and the number of ovulatory cycles vs. non-ovulatory cycles.

However, one very common but often overlooked contributor to infertility is hormone imbalance. A woman’s levels of estrogen and progesterone, thyroid hormones, prolactin, follicle stimulating hormone (FSH) and luteinizing hormone (LH) can all affect ovulation and fertility.

Infertility & Thyroid Imbalance

The health and proper functioning of a woman’s thyroid gland is directly related to her menstrual cycle, and her fertility. While most people associate the thyroid with metabolism or energy, the thyroid gland interacts with every other hormonal system in the body including the ovaries. So, when a woman is having difficulty getting pregnant, evaluation of her thyroid for optimal function must always be considered.

Thyroid problems come in two forms: hypothyroidism (producing too little thyroid hormone) and hyperthyroidism (producing too much thyroid hormone).

Infertility & Hypothyroidism

Hypothyroidism is a common, but often undetected, contributor to menstrual cycle irregularity and fertility problems. Hypothyroidism can lead to an imbalance of estrogen and progesterone levels, which leads to irregular cycles causing infertility issues. Insufficient thyroid hormone can also disrupt metabolism and reduce cellular energy, affecting normal ovulation.

Additionally, low thyroid function causes a shortened luteal phase (the days after ovulation when the body prepares for pregnancy), as well as reducing the quality of the cervical fluid that allows sperm to enter the uterus and reach the egg.

Hypothyroidism is the most prevalent form of thyroid disease, and greater than 90% of people diagnosed with hypothyroidism have Hashimoto’s disease, which is an autoimmune disorder in which the immune system begins to attack the thyroid gland. This form of hypothyroidism can result in irregular, short or absent menstrual cycles, contributing to infertility.

Infertility & Hyperthyroidism

Hyperthyroidism (Grave’s Disease) is the opposite condition, where an excessive amount of thyroid hormone is produced.  Though less common than hypothyroidism, Grave’s Disease can also result in overstimulation of the body which can lead to difficulty getting pregnant.

Because optimal thyroid function is critical to the health of the baby as well as the mother, pregnancy will typically not be possible unless thyroid levels are not only “normal” but are “optimal”.

A complete thyroid evaluation in cases of infertility requires TSH testing, as well as additional tests of thyroid function including total T4, free T4, free T3, reverse T3, and thyroid antibodies (both thyroglobulin and thyroid peroxidase antibodies).

Infertility & PCOS Hormone Imbalance

Polycystic Ovarian Syndrome (PCOS) is one of the most common causes of female infertility, affecting about 10% of women. It is caused by an overproduction of hormones including insulin and male hormones. This hormone imbalance leads to production of immature follicles that rarely release eggs – making it difficult or impossible to become pregnant.  

Dr. Harper can perform diagnostic tests to see if PCOS may be the cause of your inability to conceive. An ultrasound can reveal enlarged white ovaries that appear to have a ‘string of pearls’ on the surface due to immature follicles that don’t reach maturity to release an egg with PCOS.

She can also evaluate your hormone levels, including elevated testosterone and LH levels (including LH produced in excess of Follicle Stimulating Hormones) – which is the opposite of the normal hormone ratio needed to conceive.  And, testing for Anti Mullerian Hormone (AMH) will measure the number of follicles present, determining if a normal or excessive number of follicles are present- an important marker for PCOS.

Infertility & Excessive Prolactin Hormone

An excessive of the hormone prolactin (hyperprolactinemia) can suppress follicle stimulating hormone (FSH) and luteal hormone (LH) both of which are vital for ovulation. Women produce prolactin when breastfeeding, which is why there is a decreased possibility of conception while a mother is still nursing her infant.

In rare cases, a woman can also have a small (usually benign) pituitary tumor which produces prolactin and prevents ovulation, causing infertility. So, checking prolactin hormone levels should always be part of the evaluation for women having difficulty becoming pregnant.

Infertility Treatments – Austin, TX

While there are many causes of female infertility, many of them are related to an underlying hormone imbalance or deficiency. Unfortunately, many times the simplest and most obvious reasons that pregnancy is not occurring, such as hormone imbalance are not addressed.

Austin, TX board-certified Internist Dr. Ruthie Harper, MD is an Integrative Medicine Specialist who is both passionate and compassionate when helping identify the cause of your infertility. She offers a wide array of comprehensive, cutting-edge diagnostic procedures, along with scientifically developed health protocols, that can identify and remedy your underlying medical issues so that your body is better able to conceive.

If you are struggling with infertility, we welcome you with open arms at Ruthie Harper, MD Integrative Health in Austin, TX. We understand the grief and stress of infertility – and we are here to assist you with love, compassion, and the latest diagnostics and integrative medical technologies to help you have the family you have dreamed of.

Infertility Treatment – Austin, TX: (512) 343-9355