LH Ovulation Tests FAQ-what does it mean if I do not detect an LH surge ?

Ovulation test strips LH surge
Detecting LH surge with ovulation test strips

This is a fairly common question and one that causes quite a lot of anxiety, as not ovulating is a fairly common cause of infertility. However although this is one explanation,there are other possible reasons why you may not detect the LH surge with your ovulation tests.

  • The LH surge may have occurred before you started testing and you therefore missed it
  • The LH surge may have occurred after you stopped testing and you may have missed it.
  • The urine that you tested may have been too dilute, meaning that the concentration of LH in the sample was not sufficient, to give a positive LH test. Make sure you restrict your fluid intake for about 2 hours before you take the test.
  • You may have missed the LH surge because you tested at the wrong time of day. This is not uncommon. LH levels are low first thing in the morning and so if you test at this time, you may miss the LH surge. LH levels are usually highest at early to mid afternoon , so this is the best time to collect your urine for LH testing. Knowing the right time to test can be more tricky for shift workers, as their circadian rhythms are disrupted so they may also miss their LH surge.
  • LH surge may not be strong enough to be detected by the LH test. Most LH tests detect 40mIU/ml of Lh in the urine. It may be worth trying an ultra sensitive LH ovulation test that detects a lower level i.e. 20mIU/ml.
  • Insufficient urine may have been absorbed by the LH ovulation test. if this was the case then there would be no control line visible on the test. It is important to check that the control line is visible. if it is not it means the test has not run and so the result is invalid. If this happens it is worth quickly dipping the test into the urine sample again for a few seconds as it may still work. Do not delay doing this or the result will be invalid because too much time has elapsed.
  • The LH test could in fact be faulty, out of date or been incorrectly stored. Although this is quite uncommon, it can happen. To avoid this problem always buy from a reputable supplier.
  • You may be testing at the wrong time of your cycle. For women who have irregular periods, knowing when to test can be very difficult.
  • You may not have used the test correctly. Make sure that you read the instructions carefully before starting the test and use a timer.
  • You may not be going to ovulate this month. This may just be a one off, but if it happens repeatedly you should see your doctor, as it may mean that you are not ovulating and need further investigations.
  • You may already be pregnant. There is always a small possibility that you may already be pregnant. If your last period was different to usual, or very light it may be worth doing a pregnancy test.

To see more answers to FAQ’s regarding ovulation tests visit Access Diagnostics UK Fertility site 

Ovulation tests are available to purchase online from Access Diagnostics

FAQ-What exactly is ovulation & how do urine LH ovulation tests work ?

Ovulation test strips UK
Ovulation test strips

Thought it may be helpful to some readers to run over the basics of ovulation and when the most fertilie time occurs.

Ovulation is the release of an egg from the ovary. The egg then passes into the fallopian tube where it is ready to be fertilised. In order for pregnancy to occur, the egg must be fertilized by sperm within 24 hours after its release.

Immediately prior to ovulation , the body produces a large amount of luteinizing hormone (LH) ,which triggers the release of the ripe egg from the ovary.

This LH surge usuallly takes place in the middle of the menstrual cycle.

Ovulation Prediction Tests help you to predict the time of ovulation & therefore peak fertility.

It is during this fertile time that pregnancy is most likely to occur.

The ovulation prediction test detects the LH surge in urine, signalling that ovulation is likely to occur in the next 24-36 hours

Click here to for more info on home urine ovulation tests (LH tests)

LH test strips-which sensitivity is best for me ?

ovulation tests-ovulation test kit
Ovulation test strips

Urine LH ovulation prediction tests are now available in a range of sensitivities. This can make buying choices confusing.

The WHO still recommends 40miu/ml as the cut off for professional urine ovulation prediction. For this reason all professional packs of LH tests will universally cut off at 40miu, which makes comparison between brands easy.

When it comes to home tests there is no longer an international agreed cut off level. Different brands have different sensitivies and in some cases brands offer an ultra option. Levels of detection for a positive result vary from 20miu, through 25miu to 30miu.

This makes choosing an LH test a matter of trial and error, as the more sensitive tests are not suitable for every user, and the same is true for the less sensitive urine ovulation tests also. This is because every women’s LH physiology is slightly different, and to a degree varies each cycle. In some women a 40miu test will never give a clear positive result, the test line simply darkening around the peak, but never exceeding the control comparison. These women should try a 25 or 30 miu LH test for a series of 3 cycles to find a test which for their LH urine excretion gives a clear positive result. Only those who still find no clear positives should move to the 20miu membrane, as for most users this would give a positive result far too early in each cycle to be any use at indicating ovulation, indeed for some this test will be positive for over half each cycle,

Expect a 3 cycle trial when you start any test brand, get to know the test and stick with it. Avoid changing brands when you find one that works, changing tests during a cycle will almost inevitable confuse you, comparing 2 brands simultaneously in the same cycle is very likely to give conflicting results and better still use tests from the same batch throughout a complete test cycle. Many testers combine LH testing with BBT monitoring in the trial phase to assist in identifying the peak LH test result for them (helps decide if you should try a more sensitive test)

What’s the sensitivity of Clearblue visual, clearblue digital and First Response ovulation tests ? This has never been revealed by the manufacturers and it is probably tweaked in response to commercial pressures each time a NEW version is released and the previous line goes into generic manufacture for supermarket own brand options.

Click here to see our current range of ovulation tests

Did you know boys have FSH and LH too?

FSH (Follicle stimulating hormone) and LH (Lutineizing Hormone) are usually attributed as female only hormones. But in fact they are just as present in boys as girls.

The two hormones are Gonadotropins, which means that they take action on the gonads (The primary reproductive organs) and they are both released, as you probably know, by the pituitary gland in the brain. A common misconception is that the pituitary gland is the starting point for all hormone secretion. When in fact its in the middle – a respondant: it is triggered by a hormone called GnRH, standing for gonadotropin releasing hormone, which is secreted by the Hypothalamus, which is just above the pituitary gland.

 Anyway GnRH is secreted within the brain`s of both boys and girls, and so consequently FSH and LH are secreted by the pituitary in both sexes – but they have very different affects. In girls FSH and LH are crucial for maintaining and managing the menstrual cycle. However in boys FSH is the hormone which triggers the testes to produce sperm cells, whilst LH causes testosterone to be made and secreted by the testes. Testosterone is the hormone that causes facial and bodily hair growth and muscular development, as well as accounting for male sexuality. But it does not actually cause sperm production!

This is why men who are extremely masculine, can actually suffer from infertility, because although their levels of LH are high – their FSH levels may be low, causing sperm production not to be prevalent enough to achieve fertilization.

Ovulation predictor tests and methods

Ovulation predictor methods are many, and need not be expensive or complex for anyone with a regular cycle

Considering the last 14 days of a menstrual cycle is fixed in most women , ovulation will occur on day 14 in a 28 day cycle and day 18 in a 32 day cycle. Great if you one of the lucky ones who has  a very regular cycle, that is the same length each month.

For the rest of us with more erratic cycles the reliable prediction of the timing for ovulation gets a little more complex, so here is a breakdown of the common methods of ovulation prediction:

Cervical mucous becomes more stringy and will form ribons when opposed fingers are extended. This method is great until you have had sex in the preceeding 24 hrs and mix sperm into the equation !

BBT or basal body temperature measurment, basically get an accurate thermometer are record your temperature at a set time every morning before doing anything else. Detects a rise of 0.3 degrees centigrade at ovulation. Contrary to popular misconception you do not need a 4 decimel place thermometer and it does not have to be farenheit. What you do need is a regular regime and set waking time, so its out of the question for shift workers or the less well organised of you out there who’s days wont give up the 2 minutes you have to lie in bed with a stick in your mouth.

Urine ovulation predictors. Dip test you dip in wee and tell you when you have a surge in the hormone which makes you ovulate. Expect to use 7-10 per month especially if you are irregular or have a long cycle. Buy dip ovulation test strips as they are just as accurate as digital or mid stream test and a lot cheaperas well as being more eco-friendly (less packaging) . Only go for the very low level, higher sensitivity ovulation tests if you do not get positive results with the standard sensitivity tests. Stick with a brand if it works (there are multiple sensivities on sale and comparing results is not possible) These tests give 24-36 hrs advance notice of ovulation.

Ovulation predictor miscroscopes are simple mini microscopes which show the crystal of salt which form in drying saliva when oestrogen levels are high which occur with ovulation. Can be used time and time again, so are cheap & eco-friendly if you end up testing for a long time. Look for models with replacable batteries. Don’t expect to see anything for the rest of the cycle, it takes 2-3 cycles to get confident in using these, so best to start off using while also using another method. They are 99% accurate when combined with BBT. Can also be used in dogs and cats, so popular with pet breaders, no reason why they could not be used in pigs, horses and cattle for insemination assessment, so come on you farmers !

Ovulation predictor didn’t work ~ Don’t panic  99% is just that, but not every cycle is ovulatory either, so re-try next month. If you get no positive indicators over 3 consecutive cycles change to another method or seek advice from your doctor. Up to 1 in 4 cycles can miss ovulation, and this increases with age and is a normal physiological finding.

Click here for more info on using ovulation predictors

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Ovulation Kits-which are the best for me ?

I decided to write about ovulation kits today. There is such a huge choice of ovulation kits available now, that it can be quite confusing which one to go for.

What are ovulation test kits ?

They all work by testing urine for the presence of Luteinising Hormone (LH). LH is the hormone that is released just prior to ovulation and the ovulation test kits detect the LH surge.

This is great because it gives you prior warning of when you are going to ovulate. Research has shown that if you have intercourse just prior to ovulation the sperm are waiting for the egg and that this can increase the chances of conception. This also gives you opportunity to have intercourse on the 3-4 most fertile days of your cycle which again increases the chances of conceiving.

Urine LH test kits are not to be confused with other ovulation detectors that tell you that you have ovulated but do not give you prior notice (ie basal temperature monitoring and saliva ovulation microscopes)

What types of ovulation kits are there ?

There are 3 basics types of urine ovulation kit. They are midstream ovulation kits, cassette ovulation test kits, and ovulation test strips.

The midstream ovulation test kit is the most expensive type of kit. In a midstream ovulation test kit the strip is enclosed in a plastic casing and the user urinates directly on to ovulation tester.Advantages of the midstream test kits are that they are discreet. You do not need to collect a urine sample and they can be performed easily (by most women) in any toilet. Only fiddly bit for some can be directing the urine stream onto the tester without getting splashed with urine (I speak from experience-lol)

The urine is then absorbed by the test strip encased in the sampler and the result read after several minutes. Most tests are interpreted using the appearnace of two lines, except the digital ovulation test kits which give a definite yesy you have ovulated rather than two lines for you to interpret.

 Ovulation Test Cassette Kits are a mid price test. They are more complicated to use than the ovulation midstream or ovulation test strips, however there is less likelyhood of user error performing the test as you use a pipette to add exactly the correct quantitiy of urine. They are very popular with research labs or clinics performing multiple tests as they are highly accurate and give consistent results.

Ovulation Test Stips are the cheapest type of ovulation kits and for some the simplest. You simply dip the test strip into a fresh urine sample, and read the result, after the set time, by interpreting the appearance or not of two lines on the test strip.

Advantages to this type of ovulation test kit is that they are much cheaper to manufacture and therefore much cheaper to buy, although usually just as accurate. Disadvantages are that they require you to collect a urine sample into a container. If you are at work or out and about this is going to be trickier unless you have a very big handbag. If you are testing at work it may be simpler to use a midstream ovulation test kit !

My top tips for performing urine ovulation test kits

1) Always make sure you read the instruction for the ovulation test kit that you are using, before performing the test, as they do vary from test to test, and the time at which you read the result is of significance.

2) Use a timer if possible so you read the test at the correct time. This could be trickier if you are doing it in the toilet at work ! Some of those timers are very loud-lol

3) As you will be performing the ovulation tests over several days, try to perform the ovulation test at the same time each day

4) I have found that it is best not to have a drink for 2 hours before I perform a LH test

5) make sure the place you are performing the test is well lit-this helps in two ways-you can see what you are doing so the likelyhood of getting urine all over the floor or all over you is reduced, and it makes interpreting the test much easier if you can see it properly.

6) If you are testing over several months, it may be worth trying different type or brand of ovulation test kits each month until you find the one that suits your needs & your budget the best.

Midstream Ovulation Tests-What are the advantages ?

What is a midstream ovulation test ?

A midstream ovulation test is a simple to use urine test for the detction of the LH surge. In a midstream Lh test the test strip is encased in a long plastic case.

 The midstream format of ovulation test is very simple and popular because the tester is not required to collect a urine sample prior to do the test.

They are usually packaged in boxes of 5 or 7 midstream ovulation tests.

How do I do a midstream ovulation test ?

 The midstream test is performed during urination by simply holding the test pad in the urine stream for the specified time and then reading the result after a couple of minutes. The times vary from test to test so the instructions should always be followed for the specific brand of test that you are using.

Are midstream ovulation tests more expensive than strips or cassettes ?

Yes. The midstream test is encased in a large plastic casing meaning that the tests cost more to manufacture. Some of the midstream tests also have a digital reader giving a definite ‘pregnant’ or ‘not pregnant’ result which also adds to the cost but makes interpretation of the test very easy.

Click here for more information on Clearblue Digital Ovulation Tests

Click here to see Special Offer ACON midstream ovulation tests

First Response Home Ovulation Test

What sort of ovulation test is the First Response Home Ovulation Test ?

The First Response home ovulation test is a midstream urine ovulation test that works by measuring the concentration of Luteinising Hormone (LH) in your urine.

LH is always present in your urine and increases just before your most fertile day of the month. This increase, or ‘surge’, in LH triggers ovulation which is the release of an egg from an ovary.

How does the First Response Ovulation test show the LH surge ?

The appearance of two easy-to-read purple lines in the test’s Result Window indicates your LH surge prior to ovulation.

What does the LH surge mean ?

Most women will ovulate within 24 to 36 hours after the LH surge is detected. Predicting ovulation in advance is important because the egg can be fertilised only 6 to 24 hours after ovulation. Your two most fertile days begin with the LH surge. You are most likely to become pregnant if you have intercourse within 24 to 36 hours after you detect your LH surge.

When do I do the First Response Ovulation Test ?

You may test at any time of the day, (you do not have to use first morning urine) but you should test at approximately the same time each day and reduce your liquid intake for 2 hours before testing, since drinking excessive amounts of liquids can dilute the LH in your urine.

To find out when to begin testing, determine the length of your normal cycle. The length of your cycle is from the beginning of one period to the beginning of the next. Count the first day of bleeding or spotting as day 1.

If your cycle is irregular, that is, if it varies by more than a few days each month, take the average number of days for the last 3 months. Use the chart included with the test to work out the day you should begin testing. The day you begin testing is listed below the number of days in your normal cycle. For example, looking at the chart, if your period normally begins every 28 days, you should begin testing 11 days from the beginning of your last period.

How do I do the First Response LH test ?

The First Response Ovulation Test is simple to use – just hold the test in your urine stream for a few seconds. You will soon see the purple colour moving across the Clear Top to indicate that the test is working. Look at the Result Window at 5 minutes to read your result. Follow the full instructions enclosed in the pack before carrying out the test.

When do I read the result ?

After 5 minutes, you can compare the test line to the reference line to read your result.

How accurate is the First Response Home Ovulation Test?

The FIRST RESPONSE Ovulation Test has been shown to be over 99% accurate** in laboratory testing. 60/60 non-surge and 40/40 surge clinical samples showed correct results. For diagnostic specificity and diagnostic sensitivity.

Click here to find out more or to buy First response Home Ovulation Tests

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Clearblue Fertility Monitor-how accurate is it ,is it suitable for me, how do I use it & how does it work ?

How accurate is  the Clearblue fertility Monitor ?

The Clearblue Fertility Monitor was launched a couple of years ago under the Clearblue range of fertility products. The Clearblue fertility Monitor is 99% accurate at detecting the fertile period in each monthly cycle. It identifies peak and high fertility days to maximise the chance of conception and builds up a detailed picture of your unique hormone cycles.
The Clearblue fertility Monitor is unique in that it gives unmistakable results- the monitor interprets the results for you and displays these in words

Clearblue Fertility Monitor can maximise your chances of becoming pregnant by reliably indicating the days of your cycle when you are most likely to conceive.

Most home ovulation tests identify the 2 peak fertility days during a woman’s cycle by detecting the surge in luteinising hormone (LH) that triggers ovulation. The Clearblue Fertility Monitor not only shows these 2 peak fertility days, but ALSO identifies additional ‘high fertility days’ when you can conceive.

Is the Clearblue fertility Monitor suitable for me ?

The Clearblue Fertility Monitor is suitable for women whose natural cycle normally lasts between 21 and 42 days. The earliest you can begin to use the Monitor is the first day of your next cycle (but not before).

Certain medical conditions and medications can adversely affect the performance of the Clearblue Fertility Monitor. Women who have menopausal symptoms, polycystic ovarian syndrome, impaired liver or kidney function, are pregnant or have recently been pregnant (even if not carried to full term), may get misleading results.

Similarly misleading results may be obtained by women using antibiotics containing tetracyclines, hormonal treatments (e.g. hormonal contraception, hormone replacement therapy), fertility treatments containing human Chorionic Gonadotrophin (hCG) or Luteinising Hormone (LH), or any treatment that might affect their cycle. Clomiphene citrate may elevate estrogen levels and this may result in High Fertility being declared early in the cycle and more High Days being displayed, and in some cases the Monitor may not show Peak Fertility even when ovulation occurs.

The manufacturer recommend that women taking clomiphene citrate consult their doctor for advice before using the Clearblue Fertility Monitor. Always read the manufacturers instructions for any medication that you are taking before conducting a test.

Women who have recently been breastfeeding, using hormonal treatments (e.g. hormonal contraception, including emergency contraception, fertility treatments, hormone replacement therapy), or any other treatment that might affect their cycle, may wish to wait until they have at least two natural menstrual cycles in a row (each lasting 21-42 days), before using the Clearblue Fertility Monitor.

Women who have recently been pregnant (even if not carried to full term) may still have hCG in their bodies. HCG can adversely affect the performance of the Clearblue Fertility Monitor. Therefore they are advised to wait until they have had at least two natural menstrual cycles in a row (each lasting 21-42 days), before using the Clearblue Fertility Monitor.

How do I use the Clearblue Fertility  Monitor ?

The Clearblue fertility Monitor uses test sticks whci are available in packs of 20 tests.

On the first cycle 20 sticks will be used, and in subsequent cycles an average of 10 test sticks are used.

The majority of women will need 10 Test Sticks in each subsequent cycle. However, women with irregular or long cycles may have to use 20 Test Sticks each cycle in order to detect their most fertile time.

How does the Clearblue Fertility Monitor Predict my fertile time ?

The Clearblue Fertility Monitor detects the days in each cycle when you are most fertile, and are therefore more likely to get pregnant.

It monitors the hormones: estrogen and lutenising hormone (LH).

High estrogen is associated with the appearance of ‘fertile mucus’, which is thin and slippery. Sperm can swim more easily through this mucus and can survive in it for several days. If you make love during this time, there may still be sperm present several days later, when you release an egg. When the Clearblue Fertility Monitor detects a rise in estrogen, it displays High Fertility status.

A high estrogen level triggers the surge of LH. Ovulation normally occurs 24 to 36 hours after the LH surge when the follicle ruptures, releasing an egg. Detection of the LH surge indicates that you are about to release an egg, and you are at Peak Fertility.

Where can I buy the Clearblue Fertility Monitor ?

When buying the Clearblue Fertility Monitor make sure you also purchase test sticks and batteries as they are not included with the digital monitor pack.

Click here to Buy the Clearblue Fertility Monitor online from www.buyclearblue.co.uk  

The Clearblue fertility Monitor is also widely available in chemists & pharmacies.

Home Ovulation Tests (LH test)-how do they work ?

Urine Ovulation Tests work by measuring the hormone LH  (leutenising hormone) in a urine sample.

What is LH I here you ask.

LH is a hormone that is produced by the pituitary gland in women of childbearing age. Each fertile month, LH surges or peaks and it it this sudden increase in the level of LH which is the trigger for the ovary to release the egg. After release the egg is able to be fertilised, so by detecting the sudden surge, women can estimate quite accurately when they are fertile in every cycle. This timing is used to maximise the chances of conception by millions of couples trying to concieve each year.

An LH test works by detecting the levels of LH in daily urine samples collected by the woman. Some LH is produced throughout the cycle, so the test cut off has to be set at a level which will only give a positive indicator or positive result, when the peak or surge has occured.

 The WHO (world health organisation) recommend 40 miu/ml urine LH for professional LH urine testing. For some women this level is too high and they never get a positive result. As a consequence most commercial home ovulation tests work to 25 or 30 miu/ml for a positive result.

Performing a home ovulation test is simple and easy. The best time to collect a urine sample for LH testing is probably early evening, as first morning samples can miss the surge in LH which occurs generally later in the day.

Sexual intercourse should be timed for the evening of the first positive result and for the following few days. This ensures the best chance of fertilisation and conception during that cycle.

Does an LH surge occur every cycle  ?  No, especially with increasing age LH can be erratic with one in four cycles missing a detectable surge.

LH surges in some women never result in a urinary peak of 25miu/ml These women may be ovulating normally, but urinary LH detection may not work for them. There is no way around this, and alternative fertility monitoring methods should be sought.

 The fact that a surge occurs is the important factor, not the length of the surge. Stop testing as soon as the surge is detected and save any unused tests for the next month.

Some LH tests cost serveral pounds each, but cheaper test strips are now widely available and branded reliable LH test offer highly accurate, low cost testing with professional levels of reliability.

 Click here to see a range of Home Urine Ovulation Tests (LH Tests)