Many methods exist for tracking your dates of ovulation. Some, such as tracking changes in your cervical mucus or using an ovulation calculator, are free. But many women rely on over-the-counter ovulation predictor kits, which can be purchased at drugstores like CVS, Rite-aid and Walgreens, and at retailers like Wal-mart, K-Mart, and Target. You can also find ovulation calculators online at Amazon.com. They run about $15 to $40, and you can save money by purchasing in bulk online.

Two types of ovulation predictor kits exist – those that measure the luteining hormone in your urine and those that measure estrogen in your saliva. This article explains how to use both and evaluates some of the more popular brands.

Ovulation Predictor Test Strips

Ovulation predictor test strips measure the amount of LH (luteining hormone) in your urine. LH peaks right before you ovulate, giving most women a 36-hour window to try to conceive before they ovulate, and another 24 hours while they are ovulating. While you may get pregnant up to 24 hours after you ovulate, because an egg lives for 24 hours, the best time to try to conceive is the few days prior to ovulation.

Many fertility specialists say that Ovulation Predictor Kits (OPKs) are more reliable than other ways of tracking your fertility. Your results may vary, though, if you have an irregular cycle. Additionally, if you have a long cycle, using an OPK every day until you ovulate, starting on day 10 of your cycle, gets expensive.

Additionally, OPKs only detect the hormone surge that precedes ovulation; they can’t tell if you will actually release an egg during your cycle.

To get the best results, follow the directions in the package for your specific test precisely. Keep in mind, polycystic ovarian syndrome (PCOS), a common cause of infertility, may affect the results of the test, as will certain fertility drugs, including Clomid.

How to Use an Ovulation Predictor Kit

Much like an over-the counter pregnancy test, you simply urinate (mid-stream) on the test strip. In most tests, you will see a control line and then a line that indicates the amount of LH in your urine. If the test result line is the same color or darker than the control line, you are experiencing the hormone surge that indicates you will ovulate soon—usually within 12 to 36 hours of the surge.

Unlike a pregnancy test, you don’t use an OPK with your first-morning urine. Instead, wait until about 2 PM – anytime after noon may be okay. You may have a hormone surge in the morning, but it takes 4 hours to show up in your urine. You may also want to test twice a day, once in the afternoon and once in the evening, to make sure you don’t “miss” the surge.

Since ovulation times vary, you should begin testing on day 10 of your cycle, which is approximately five days after the start of your period. These numbers may vary if you have an exceptionally long or exceptionally short cycle. Continue testing until you detect the LH surge.

Ovulation Kits That Measure Saliva

The QTest, Ovuscope, MaybeBaby and Fertile-Focus saliva ovulation test kits are just a few examples of kits which test for estrogen, rather than LH, to determine time of ovulation. Most of these kits are about $20 to $30, although others exist that are much more expensive.

A saliva ovulation test kit is essentially a small, re-useable 40X to 60X microscope. Some kits work with a supply of slides, while others, which are more expensive, let you test right on the lens. Tests are approximately deemed 98 percent accurate and capable of detecting ovulation up to 72 hours in advance.

As your body nears the time of ovulation, in addition to an LH surge you will experience an estrogen surge. This surge manifests in saline in your saliva. Saliva Ovulation Predictor Kits detect this saline, which shows up as a fern-like pattern on the microscope slide.

How to Use a Saliva Ovulation Predictor Kit

You can use the test first thing in the morning, or anytime during the day, as long as you have not eaten or drank anything, brushed your teeth or smoked for at least two hours before testing.

Use fresh saliva to test; swish your saliva around in your mouth and apply fresh saliva from under your tongue to the test slide.

If you are near the time of ovulation, you will see a fern-like pattern on the slide. During the transition phase, the slide will contain a mixture of ferns and small bubbles. You are not ovulating or in transitions if you see only tiny bubbles.

Keep in mind, smoking, eating, drinking or brushing your teeth up to two hours before taking the test could affect the results. Pregnancy, recent pregnancy, menopause, hormone-based birth control methods and hormone replacement therapy may also affect the test.

You may have to test for a few months before you begin to plan your pregnancy to recognize the fern pattern. Keep track of your cycle by marking every menstrual period on a calendar, too, so that you can begin testing just prior to your most likely time of ovulation. You may want to test at other times of month, too, for a comparison.

If, after several months, you are seeing ferns all the time, or not seeing any ferns around your suspected time of ovulation, check with your doctor. You may be producing estrogen all month, perhaps due to a lack of the hormone progesterone, or you may not be producing enough estrogen to conceive.

Author: Dawn Allcot

Several tests performed by your doctor or reproductive endocrinologist will help diagnose the cause for your infertility. We already covered the tests your partner will go through in the section titled “Visiting Your Doctor.”

The tests for you range from very simple in-office tests no more invasive than a PAP smear or ultrasound to surgical procedures.

Post Coital Test
During the Post Coital Test the doctor takes a sample of your cervical mucus. The doctor will examine the cervical mucus under a microscope to determine if it is hospitable to sperm.

Timing is everything with this test; it must be performed four to 10 hours after sex when just prior to, during, or immediately following ovulation (i.e., your fertile period, or the time of your cycle when you should be able to conceive.) Use an ovulation predictor kit to be certain, although you can certainly use other timing methods, including tracking BBT (Basal Body Temperature) and cervical mucus.

Do not:

• Use lubricant during sex

• Douche after sex

• Bathe or swim after sex (a shower is okay)

The doctor will take a small sample of cervical mucus and examine it for:

• Quantity – There should be more plentiful amounts during your fertile period;

• Consistency and clarity – It should be very thin and clear and also very stretchy, almost rubbery;

• Ferning – Under a microscope, the doctor should see a fern-like pattern in the dried cervical mucus, indicating the presence of estrogen without progesterone hormones;

• Cellularity – Few cells, other than sperm, should be present.

If any of these factors show problems, this could be the reason you are having difficulty conceiving. The doctor may recommend artificial insemination by means of intrauterine insemination in order to bypass the cervix all together.

However, the number one reason this test fails is poor timing; if the test was not done four to 10 hours after intercourse or was not done while you were ovulating, then the cervical fluid may not show a favorable environment for sperm to survive, swim and fertilize an egg. If this is suspected to be the case, a second test should be performed at the time of ovulation.

Other causes for an unfavorable cervical environment include:

• Infection or irritation. If this is the cause, testing will show white blood cells in the mucus.

• Procedures performed on the cervix to treat an abnormal Pap smear, such as freezing or laser treatment.

• Medications. Clomid (generic: clomiphene) a fertility drug used to treat infertility caused by anovulation, can have adverse affects on cervical mucus. If your doctor prescribes the drug or increases your dosage, he should perform a post-coital test to be sure the cervical environment is still hospitable to sperm.

Ultrasound
Most people think of ultrasounds as a non-invasive, painless procedure performed on pregnant women in order to see the unborn baby. True, an ultrasound can determine the gender, size (give or take 2 pounds), and often the general health of a fetus, but it can also give a doctor information about why you haven’t been able to conceive yet.

Your doctor will use an ultrasound to evaluate the condition of your ovaries and fallopian tubes, and check for cysts, tumors and uterine fibroids. He will be looking for Polycystic Ovarian Syndrome, endometriosis, and anything else that may be impairing your ability to get pregnant. An ultrasound can show the doctor if your eggs are developing properly and are being released from the ovaries and if the endometrial lining thickens sufficiently to permit implantation.

An endometrial biopsy is used to detect cancerous cells, precancerous cells, infections or any abnormalities that may be affecting your ability to conceive. The doctor inserts a thin catheter, called a pipelle, into the uterus and uses it to draw out cells for testing.

You may experience mild to intense cramping during and after the test. The doctor may recommend you take ibuprofen, such as Motrin or Advil, before and after the test to minimize cramping, or he may offer a prescription painkiller. You may have minor bleeding following the test.

You should take a pregnancy test prior to an endometrial biopsy since the procedure may terminate a very early pregnancy.

Hysteroscopy
A hysteroscopy is an out-patient procedure performed that will allow your doctor to spot abnormalities in the uterus such as:

• fibroid tumors

• polyps

• scar tissue

A hysteroscope is a very thin telescope with a camera on the end that can enter the cervix with no dilation. The uterus is expanded by means of saline solution or carbon dioxide, permitting the doctor to view the inside on a television monitor in the office. Minor cramping may result from the introduction of saline or carbon dioxide into the uterus, but the procedure is not considered especially painful.

Falloposcopy
Cleared by the U.S. FDA (Food and Drug Administration) in 1997 for use to diagnose fallopian tube blockages in women trying to conceive, falloposcopy is regarded as a relatively new and complicated procedure. However, since nearly 35 percent of all female infertility cases are related to fallopian tube damage, this procedure may be invaluable in determining the cause of infertility. Your doctor will probably order less invasive tests first, however, including an ultrasound.

Because the fallopian tubes are located so deep within the reproductive system, past diagnostic procedures carried a 40 percent rate of false diagnoses. The STARRT Falloposcopy procedure, patented by Conceptus, Inc., shows a much greater accuracy rate.

The procedure takes about 45 minutes and is performed with local anesthesia or intravenous sedation. Another benefit of the test is that tubes can be repaired at the same time, with the same equipment, if the doctor finds any abnormalities. Tubal repair can take as long as two hours and your doctor will use a general anesthesia. If abnormalities are found but the tubes cannot be repaired, your doctor will discuss the possibility of in vitro fertilization with you and your partner.

Similar to a hysteroscopy, a falloposcopy views the inside of the fallopian tubes by means of a camera inserted into the body. It enters through a catheter that travels through the cervix and uterus and finally, into the fallopian tube. A fiber optic endoscope with a camera on the end is then inserted through the catheter, so the doctor can view images on a television monitor in the office.

Risks include infection and bleeding, so your doctor may prescribe an antibiotic as a preventative measure.

Laparoscopy
Laparoscopic surgery is an advance in medical technology which permits diagnostic surgery through a very small incision, into which a thin instrument (laparoscope) is inserted in order to take pictures of the abdomen. Carbon dioxide is used to expand the abdomen, permitting the doctor with a clear view of the uterus, cervix, and ovaries and fallopian tubes on a television monitor in his office or in the operating room.

Doctors in the late 20th century commonly recommended this diagnostic procedure in couples trying to conceive. Today, however, other procedures are recommended first. Although laparoscopy is simpler and safer than traditional surgery with a full-size incision, it is still surgery, and often performed under general anesthesia. Rarely does a laparoscopy turn up any abnormalities not spotted by other fertility screening tests.

Hysterosalpigogram (HSG)
According to the Advanced Fertility Center of Chicago, a hysterosalpigogram is a common infertility diagnostic procedure that is helpful in detecting tubal infertility. Since 25 percent of all infertility is caused by tubal abnormalities, this test may be an important one. Less invasive than a laparoscopy, top fertility clinics makes it part of its basic fertility screens.

The test is performed in the radiology department of the fertility clinic, hospital or medical center between days six and 13 of the patient’s menstrual cycle.

Dye is injected into the uterine cavity, through the vagina and cervix. If the fallopian tubes are normal, the dye should spill out into the abdominal cavity. If there is a tubal blockage, the dye will stop at that point. The X-rays will be available for evaluation that day.

An HSG test also detects:

• uterine anomalies

• polyps

• fibroid tumors

• uterine scar tissue

• tubal defects

• scar tissue around the fallopian tubes

One way to increase your odds of conceiving quickly is to make sure you are having sex during the most fertile part of your cycle — the days just before, during and after ovulation.

Because sperm can live in the body for up to five days, but an unfertilized egg dies after 24 hours, you increase the odds of having sperm and egg meet by having sex just prior to ovulation. But how do you know when you are ovulating?

If your periods are very regular, and come consistently anywhere from 21 to 35 days apart, you can also use our ovulation calculator to predict when you are fertile.

But by tracking the physical signs of fertility, you will get more exact results, even if your cycle varies slightly each month. You can track your fertility by charting your Basal Body Temperature (BBT), Cervical Fluid, and Cervical Position.

Basal Body Temperature
BBT is the temperature of your body before any activity—your body’s baseline temperature. Your BBT rises slightly on the day of ovulation and remains elevated until just before your next period starts. To track your BBT, take your temperature orally with a BBT thermometer (they sell for about $10 at any drug store) every morning before you get out of bed and chart the results. A BBT thermometer only registers temperatures between 96 to 100 degrees F. and can detect very slight changes in your temperature. Most women have a BBT of 96 to 98 degrees normally before ovulation and 97 to 99 after ovulation.

Cervical Fluid
Cervical fluid, sometimes called cervical mucus, is produced by the lining of a woman’s cervical canal and varies in consistency, color, and amount based on where you are in your monthly cycle.

As you get closer to your time of ovulation, your cervical mucus will change in order to better permit the transfer of sperm into your cervix.

To get a good sample of your cervical mucus at any time, place your fingers (make sure they are clean) inside your vagina. When you pull your fingers out, examine the sample you’ve obtained, noting its consistency and color.
Immediately after menstruation, you will have several “dry days,” where there is very little fluid at all.  What is there may be white or opaque and thick and sticky. As you approach mid-cycle, you will note more moistness, and the fluid will be thin, and possibly cloudy. If you hold some between your fingers, it will be slightly stretchy.
In the few days just before ovulation, which is when you are most fertile, your cervical fluid will be copious, thin and transparent. It will be very stretchy, almost the consistency of egg whites.

Just as your cervical fluid changes throughout your cycle, so does the position of your cervix in order to facilitate the transportation of the sperm and fertilization of the egg during your fertile time. Monitoring the position of your cervix is another way to track your ovulation times. Using these three methods combined will give you the most accurate results.

Begin by checking your cervical position at the end of your period, and check it daily until you reach your time of ovulation. You should do this at the same time each day, and in the same position each time. You can check your cervical position while sitting on the toilet, or it may be easier to place on foot on the toilet and keep one on the floor. Move your middle finger all the way up into your vagina until you hit your cervix, which will feel like a rounded cylinder.

At the beginning of your cycle, your cervix will be low and easier to reach. During ovulation, it will rise to a higher position, and may even be difficult to reach with your middle finger. It will drop back down to a place where it is easier to touch after you ovulate.

Author: Dawn Allcot