Ovulation Predictor Strips: How Accurate Are They? (Episode 499)

Full Transcript: Episode 499

Lisa: This is the Fertility Friday Podcast, episode #499.

I’m excited to share today’s episode with you. In today’s episode, I’m going to be talking all about ovulation predictor strips. I’m going to be sharing when I think they can be extremely useful, when they may not be that useful, and the best way really for you to identify your fertile window when you’re trying to conceive. So without further ado let’s go ahead and jump right in.

So I wanted to start with just the basic question of what are ovulation strips or they’re often called ovulation predictor kits or ovulation test strips or LH strips. So what are they and what do they do? So ovulation strips They test for luteinizing hormone, also referred to as LH. Now that’s a hormone that we produce as we approach ovulation. So in the menstrual cycle, after your period is finished, your follicles start to develop and as the eggs in the follicles start to develop, they start to produce estrogen.

And the closer you get to ovulation, the more estrogen you’re producing. And once your estrogen hits a certain threshold, that is what triggers what we call the LH surge. So the LH surge is what triggers ovulation to happen. And my favorite analogy, if you think of your ovary or the ovarian follicle as a balloon and the LH as the pin, that is the role, essentially, that LH plays in ovulation. It actually pops the balloon, so to speak, so the egg can be released, but that’s the critical role. So these strips then test for that LH surge and theoretically what would happen is they would notify you within about 24 to 36 hours before ovulation.

This is why they’re often used for timing, but I think it’s helpful to know what they actually do because when you think about it, what is an LH test strip? It’s a strip that has been programmed to change when the hormone hits a certain threshold. So there are certain situations where a woman may be ovulating and the strip won’t turn positive if her hormones aren’t high enough to hit that threshold. And then there are other situations where she may not be ovulating and she may have elevated LH for other reasons and she may then show a positive even if she’s not ovulating.

That’s I think the first piece of it, which is really helpful to understand so that you know that it’s not Confirming that ovulation actually happened. It’s testing for a hormone that is typically released prior to ovulation And so therefore just getting a positive on the strip Actually doesn’t guarantee that you’re going to ovulate or that you’re going to ovulate right at that time And it doesn’t mean that you’re ovulating right now, it means that this hormone is elevated and that is typically associated with ovulation.

With that said, I wanted to start with the positives. What are some of the positives about ovulation test strips? I think one of the biggest positives about these strips is that they do welcome women into this conversation about tracking and charting. They do kind of start at least getting many women familiar with them. likely to happen within the next couple of days and so that can be extremely helpful especially for women who have been trying to conceive and potentially didn’t even know about this window and this could be their first kind of foray into that. So it can certainly help with timing and that kind of brings me to what some of the potential downsides are.

So I think at first glance, you know, you’d think, well, what could the possible downside be? It’s going to to tell me when I’m gonna ovulate, this is great. But I think it can be misleading again, because if this is all a woman has and she doesn’t have any general information or education about her menstrual cycle, then there’s just some missing pieces that she would wanna know. So it certainly can be misleading because a lot of women I think would assume that if it’s positive, it means that they are ovulating or they have ovulated or they’re going to 100 % like definitely going to ovulate. And so that can be misleading because again, it is measuring for an elevated hormone level.

An example, women with PCOS, one of the markers of PCOS, many women with that condition have elevated LH levels due to rapid pulsing of LH. And so for those women, they might be showing a positive multiple times in their cycle and that may have nothing to do with when they’re ovulating. So that can be misleading and confusing for women who are in a situation like that. And they’re also, like I mentioned before, there are other women who may be testing it and for whatever reason, they may not show a positive when they actually did ovulate.

If that is the only sign of fertility that you’re paying attention to, then that could potentially in some situations cause you to miss that window. And we wouldn’t want that, especially if you’re trying to conceive. I think that kind of covers some of the potential downsides. And one more that I’ll add is that it can foster a bit of reliance on these devices in instead of learning how your body works.

I would add that these strips by themselves without the education can kind of prevent women from really learning about their cervical mechis and what’s going on in the cycle. Of course, from as a fertility awareness instructor, I think that it’s useful to have this base of information before we start adding different tools and devices.

What is the best way then to identify when you’re fertile? So I think that using ovulation strips can be part of this equation, but I certainly don’t think they should be the only thing. I think they should be maybe a secondary sign and the primary sign should be your cervical mucus. So this will come as no surprise to any of my long -time listeners that cervical mucous should be the primary sign of fertility that we’re paying attention to.

When you start to learn about your menstrual cycle and you start to pay attention to what’s going on, after your period ends, you typically, in a typical healthy cycle, we may see a few, what we call dry days. So a few days before we start to see cervical fluid, and then as we approach ovulation, as we start getting closer to ovulation, we start to those days where we see some lotion -y type cervical mucus or some clear, stretchy, like raw egg white type cervical mucus.

And so when we’re trying to identify the fertile window, that’s really the most important sign that we want to pay attention to. If you’re trying to conceive, then you want to become familiar. You want to start to familiarize yourself with your cervical fluid. And you want to start familiarizing yourself with how it changes when you’re in that fertile window as you approach ovulation. So when you are paying attention and you notice those days of creamy, lotiony type cervical mucus or clear, stretchy, raw egg white type mucus, it’s helpful to know first of all that all of those days of cervical mucus regardless of the type before ovulation are considered to be fertile. So what I always say is,

You know, you can’t be more or less pregnant, so we can’t consider yourself more or less fertile. You’re either fertile or not. So all of your pre -ovulatory days of cervical mucus we consider to be fertile. But when we’re trying to conceive, you do want to know the difference between the clear stretchy type mucus and the lotiony mucus. You want to be able to tell because the days of clear stretchy are considered optimal. And there’s a couple reasons why they’re considered optimal. One is that the clear stretchy cervical fluid has more of those great properties in case you’re not aware.

Our cervical mucus has a number of interesting fascinating properties including facilitating rapid sperm transport and also helping to screen abnormal sperm. So our cervical fluid actually collects and traps sperm that is not of optimal mucus or optimal morphology and motility. So our cervical mucus acts as a filter so that only the best sperm get through. So, you know, our clear, stretchy, lubricative cervical fluid has more of those great properties.

But I think more importantly, we tend to produce higher quantities of that clear, stretchy cervical mucus, the closer that we get to ovulation because it is in direct proportion to the amount of estrogen that we’re producing. So it’s all kind of working together like a symphony. And those days when we have the clear stretching mucus in the greatest quantities are associated with greater chance of conception.

From that perspective, if you just pay attention to your cervical mucus as the primary sign, have sex on any day of any mucus that you see, but especially pay attention to those days of clear stretch amicus, that would be the best way to identify when you’re fertile in your menstrual cycle.

How do I recommend then using ovulation strips with all of that being said? So I’m not against them. So I think that’s one thing I want to clear up. I’m not anti -ovulation strips. I’m not anti -tech. I just think that they should be used as part of our overall knowledge. I think that we shouldn’t be relying on them only because that can lead to some issues. If we don’t really know what it is and what it’s doing and how it works, and also what the best practices are, then it can actually cause issues.

And I’ve seen that happen and I can give a couple of examples of that in a moment. So I recommend then using your cervical mucus as the primary sign. So make that the thing you pay attention to. Don’t worry about the day of the cycle. So we want to get away from rhythm method thinking. We don’t want to just assume you’re ovulating on day 14 all the time because it’s possible in any cycle to ovulate earlier or later than you normally do. It’s possible to ovulate on day 12 or day 11. It’s possible to ovulate on day 19 or day 37.

So although that would be outside of the optimal normal range, but I just say that because we want to make sure that we’re not relying too heavily on, you know, your ovulation strips. And we also want to make sure that we’re not ignoring your cervical mucous. So step one would be to pay attention to your mucous. You set as your primary sign, prioritize those days where you see any mucous before ovulation, but pay special attention to those days when you see mucous that is clear and stretchy. So that would be the first thing.

And then the second thing is if you want to use your ovulation strips in conjunction with your mucus, then what you can do is you can actually have sex on those days of mucus, continue checking to see if you what the ovulation strips are showing. And then when it also turns positive, which typically you have cervical mucus and it’s turning positive, then that gives you more information. And if you track your cervical fluid alongside your ovulation strip data for a few cycles, then you’ll have a much better idea of what your patterns are and also what your fertile window really looks like.

A potential downside or issue that I’ve seen with clients who are relying only on cervical or ovulation predictor strips. One thing to keep in mind is if you think back to what I said initially, these strips are testing for that LH surge. And I mentioned that that LH surge that the strips start turning positive about 24 to 36 hours before ovulation. Now in a healthy menstrual cycle, you’re typically going to see anywhere from two to seven days of cervical mucus. Let’s say the average is like five or six days.

That would mean that you would have several days of cervical mucus before that strip turns positive. So one of the issues that I have with relying on the strips is that if your fertile window from a scientific standpoint is six days, so five days leading up to ovulation plus ovulation day, and the strip turns positive, you know, the day or two before you ovulate, you have missed half of your window. And that’s many other potential days that could have been useful to you, especially if you’re trying to conceive. And So when you’re relying on mucus as well as the strips, then you have two signs now.

And if for whatever reason, one of them is off, then at least you can rely on the other one. I have seen charts of women who are paying attention to their ovulation strips where it’s turning negative, negative, negative, so they’re not seeing anything happen. But they still ovulated. And I have seen charts of women who had what we call a double peak, where they actually did have a positive on that ovulation strip, but they didn’t ovulate in that. They didn’t ovulate right after it. And then a few days later, they had a positive again and ended up ovulating. Or if they had stopped checking for, if they had stopped using the strips because they thought they ovulated, you know, the temperature, you know, went up where they saw a second round of mucus later on.

Those are just a couple of examples where I don’t think it’s a good idea generally to focus only on one sign of fertility. We have multiple. And so fortunately, we have from, you know, if you’re charting with the fertility awareness method, you can track your cervical mucus, you can track your cervical position, you can track your basal body temperature. And then we can look at secondary signs like the ovulation predictor strips. Some women track all kinds of things, whether it’s their moods, their energy levels, breast awareness, ovulation pain, you know, there’s a lot of what we would call secondary signs of fertility that can be extremely helpful, especially when one of those signs is not optimal.

To kind of wrap up our conversation today about ovulation predictor strips, I just want to say that, yes, I think that they can be an incredible tool. I do encourage some of my clients to use them in certain situations. I think there are situations when it can be helpful and who doesn’t like more data? I’m a data girl, so I definitely like having the option for my clients who are, you know, testing them already or who are wanting to test it or if they have a special specific reason why they want to time sex as close to ovulation as possible, you know, that can be really helpful.

I can give you another example of a situation where that might be kind of more crucial. I’ve had clients who are using sperm donors. And so when you’re purchasing the sperm and doing an insemination, if you’re doing whether it’s an insemination at home, a low -tech option, or whatever the case is, in those kinds of situations, if you’re using like frozen sperm, for example, they don’t last as long as a regular ejaculation.

Sperm can survive in the reproductive tract for about five days. But when you have frozen sperm, for example, they don’t live as long, so they might only survive for a couple of days, like two to three days max. And so in that situation, it is actually a lot more important to have that deposit be made as close to ovulation as possible. And in a situation like that, you know, when my client’s going to all this trouble to make this happen, then it does make sense to track the menstrual cycle, track cervical mucus, also to track the ovulation strips and to start to get a sense of what is happening in the cycle.

To start to get a sense of when is ovulation happening, how many days amicus are we typically seeing and when is that ovulation strip turning positive, are we able to rely on it, do we have any challenges there. So that’s an example of a situation where the ovulation strips can be really helpful to try to time sex as close to ovulation as possible.

With that said, however, most women with normal or relatively low blood pressure can All of these great companies have all these interesting products, but at the end of the day, if you really do get into cycle charting and you start to pay attention to your mucus and you start to identify your own patterns, and so I use the word patterns a lot with my clients.

And when I use that word, I’m not saying that we’re predicting ovulation, I’m not saying that we’re identifying a day of the cycle when we usually ovulate and looking to ovulate on that day all the time because it does fluctuate, but more So to get a sense of what are your periods like, how many days do they typically last? Do you start to see cervical amicus right away or do you have a couple dry days first?

How many days do amicus do you typically see? What typically happens after ovulation? Does your amicus dry up right away? What do your temperatures tend to look like? So that’s what I mean when I say your patterns, to just get a general sense of what’s normal or what’s typical for you.

And with just that information, with just paying attention to your cervical amicus in your cervical mucus changes, for most women that is actually sufficient and the ovulation strips are not necessary, especially if you’re checking temperature and you can use temperature to confirm ovulation. So that’s some food for thought. But again, I’m not anti -tech. I’m not anti -ovulation strips. I think that they can serve a really useful and helpful role. I just don’t think that they’re necessary. And I do think that in some cases they can potentially hinder what you’re trying to do with checking and charting and all of those things.

If you liked today’s episode and you can think of a friend who might benefit from hearing it, you’ll find the show notes page over at fertilityfriday .com /499 and I hope you have a wonderful weekend whenever you’re tuning into the show and of course as always until next time be well and happy charting and that’s a wrap.