The ovulation test

There are a number of ovulation tests, which will give you a good indication of whether or not you have ovulated, and – if you have – when this is likely to have occurred. Recent advances in medical technology have made the ovulation test an easily accessible and relatively cheap option. 

Healthy young couples trying to get pregnant are usually told that they should not worry about seeking medical advice until they have had twelve months of ‘trying.’ 

However, as the average age of first-time mothers rises, we are seeing an increase in fertility problems. 

As a result, many couples are keen to eliminate potential problems as soon as possible – and the ovulation test is an easy way to ensure that at least one part of the complex process of getting pregnant is probably on track. 

Some women fail to ovulate regularly. This can be caused by any one of a number of common conditions, such as obesity, polycystic ovary syndrome (PCOS) and a variety of thyroid conditions. Many of these can be treated, once you’ve identified the cause. 

Is the ovulation test 100% accurate?

The short answer is – no. The only ovulation test that can give you definite proof that ovulation occurred is a pregnancy ultrasound showing the presence of a foetus. 

The ovulation test does tell you whether your body is producing the level of certain hormones that is likely to cause you to ovulate, and – crucially – when that particular hormone level is at its peak, allowing you to then pinpoint your most fertile time (which is the four to five days just before you ovulate). 

What different varieties of the ovulation test are available?

A number of different types of ovulation tests are available. 

The most common is the ovulation predictor urine test, sold in home-test kits. The other main self-administered ovulation test is the ‘saliva-ferning’ test, which usually involves a once-off purchase of a measuring gadget. The first is relatively cheap, whilst the latter can be a pricey first-time investment. 

You can also arrange for an ovulation test through your doctor, with results sent to a professional laboratory for analysis. These tests are far more accurate, but obviously more costly and time-consuming. 

Ovulation test: Home-based kit that detects LH levels in urine

This ovulation test measures the levels of luteinising hormone (LH) in your urine. LH is produced by the pituitary gland and is always present in the body in very small amounts, but this ovulation test detects the LH surge that happens mid-cycle, typically between 24 and 48 hours before ovulation. 

Some versions of the urine-based ovulation test also measure the presence of another hormone (estrone-3-glucuronide, or E3G), which is produced when oestrogen breaks down in your body and causes cervical mucus to change to a thin and slippery texture around the time of ovulation. 

This is a ‘qualitative’ test, meaning that it only reports whether your LH or E3G levels are elevated. It cannot definitely tell you whether you have ovulated or if you will get pregnant.

This ovulation test will predict your fertile period with around 90% accuracy provided you follow the instructions carefully. It only works if you start testing at the right time in your cycle, when a hormone surge is most likely to occur. 

Usually this ovulation test comes in a packet of multiple test strips, designed to be used once each day for a week or so. 

The test is done by either adding a few drops of your urine to the ovulation test, dipping the test in a container of your urine or by holding the tip of the ovulation test in your urine stream and then waiting around five minutes for the results. 

Test results differ depending on the manufacturer. Usually, the test gives coloured lines that tell you a result, but some tests need to be placed into a special monitor (sold with the test strips). 

Ovulation test: Home-based device to measure ‘saliva-ferning’ or oestrogen in saliva

The presence of oestrogen in saliva can change the appearance of saliva when it dries, so that (when observed under a microscope), it forms a fern-shaped pattern. While the test involves only a once-off purchase and can be used indefinitely, it does not suit everyone. 

Accuracy can be very good for some women, however ferning can be somewhat unpredictable and is affected if you eat, drink, smoke or brush your teeth too close to the time of the test. 

This ovulation test involves placing a small sample of saliva on a removable glass slide supplied with the test device and waiting until it dries (between five and thirty minutes). The pattern of the dried saliva is observed through the test device; normally dots or circles are spotted but during the fertile period, a fern-like pattern can be seen.

A positive test will only indicate that your hormone levels are high and therefore you may be near the time of ovulation. 

Ovulation test: Blood tests for the presence of FSH, Estradiol and LH

Your doctor can arrange for a series of blood tests to be taken throughout one monthly cycle to determine whether you are ovulating and when this is likely to occur. The blood tests usually involve taking a baseline level of FSH (follicle stimulating hormone) at the very beginning of your cycle. 

Approaching the middle of the cycle, from around Day 10, blood tests that measure the levels of the hormones Estradiol and LH (luteinising hormone) are taken either daily or every second day, to establish whether the hormone levels are appropriate and which day ovulation occurs. 

Depending on the arrangement, either the pathology laboratory or your doctor will often call you when results indicate that you are in your most fertile period so that you can try for a pregnancy at that time. 

If a woman knows she has a short menstrual cycle or if there is indication of early ovulation from previous tests, these hormone tests may start earlier in the cycle. 

Sometimes, part of the series of ovulation tests will include a test for the presence of progesterone about a week after the likely date of ovulation, to check that the cycle is proceeding normally and occasionally laboratories will be asked to check for the presence of other hormones (e.g. testosterone) to evaluate your pituitary function and fertility. 

Occasionally, as well as a blood sample drawn from your arm by needle, tests of urine samples every few hours over a 24-hour period may be requested, because LH levels can vary throughout the day.