Using Ovulation Test Kits When You Have PCOS

Your condition can affect their accuracy

Using an ovulation test kit to help pinpoint fertile times for conception may not give you reliable results if you have polycystic ovary syndrome (PCOS). The problems with the accuracy of these tests for women with PCOS stems from what all PCOS challenges do—abnormal hormone levels.

The most popular type of ovulation test kit uses a urine dipstick to measure luteinizing hormone (LH) or estrogen for the expected peaks around ovulation. But if you have PCOS, you may have a constant high level or multiple peaks of these hormones. The results can falsely reflect whether or not you have ovulated.

How PCOS Affects Ovulation

Understanding ovulation and a normal hormonal response during the menstrual cycle can help you better understand why PCOS poses the fertility testing challenges it does.

A normal menstrual cycle can be described as follows:

  • Follicle-stimulating hormone (FSH) is secreted in the brain, causing an egg follicle to start growing in the ovary.
  • As the egg follicle develops, it secretes estrogen, which causes the lining of the uterus to thicken in preparation for the egg. This results in an estrogen peak near the time of ovulation.
  • Once the follicle matures, luteinizing hormone increases dramatically, triggering the release of the egg from the ovary (ovulation). This occurs around day 14 of the cycle. At this time, basal body temperature also spikes and there is a change in the vaginal mucus.
  • If pregnancy does not occur, the estrogen and progesterone levels will drop dramatically, and the uterine lining will be shed as menstruation. Basal body temperature also returns to normal, and vaginal mucus changes as well.

But hormonal imbalances common in people with PCOS mean that eggs don't always mature or get released as described above. Instead, they collect on the ovaries as small, immature follicles referred to as cysts.

Further complicating the issue are the persistently high levels of LH or multiple peaks that are seen in some individuals with PCOS. Some also have persistently high estrogen levels.

These particular anomalies can make ovulation testing all the more challenging in people with PCOS, as the tests work to detect peaks of these hormones.

Hormonal Ovulation Testing Kits

With the variations of hormones seen in PCOS, ovulation tests that rely on detecting hormones are less likely to be accurate. There are a couple of different types of these tests.

Woman looking at ovulation testing kit.
Lara Antal / Verywell 

Urine Dipstick Tests

Urine dipstick hormonal ovulation test kits might work for some people who have PCOS, but not all.

There are several variables that can influence their accuracy. For example:

  • If you are having regular monthly periods, there is a good chance that the ovulation kit will work properly.
  • If you are not having regular periods, the kit may still work, but it may difficult to know when to start testing or even what stage of the cycle you're in.
  • If you are receiving persistently positive results, it most likely means that your LH levels are abnormally elevated. In such a case, the kit may have little value.

Any test kit that relies on a urine dipstick to predict ovulation may not be accurate if you have PCOS. These forms of hormonal test kits include those marketed by ClearBlue, First Response, Pregmate, and Easy@Home.

If you fall into any gray areas as far as your menstrual cycle or hormonal levels are concerned, however, you may still be able to use an ovulation kit if you adjust the timing.

Typically speaking, ovulation occurs 14 days before your next period. If you have a 30-day cycle, ovulation will occur around day 16. It is usually best to start testing several days before, say around day 12, to ensure that you catch your ovulation.

That said, it's important to consider the expense of kits that may not prove useful, as well as the emotional impact of testing that may not be reliable.

Saliva Ferning Tests

Some test kits include a microscopic saliva test. This relies on a phenomenon in which dried saliva may form a fern-shaped pattern when your estrogen level is high, as can happen around the time of ovulation.

If you have a consistently high level of estrogen due to PCOS, this test may be even less likely to be useful for predicting ovulation. In fact, the U.S. Food and Drug Administration (FDA) notes that this type of test may be inaccurate for many reasons, even in individuals without PCOS.

Other Testing Options

Given this, non-hormonal methods of predicting ovulation may be useful if you have PCOS. These include:

Tests are available that include a basal body temperature thermometer and tracking mechanism. Examples include the Femometer Vinca and Natural Cycles. The most sophisticated among them include a Bluetooth thermometer and app that allow for easier tracking.

Simply using the thermometer you have at home and an ovulation-predicting app may be a solution as well. Some apps include Kindara, Fertility Friend, Ovia, Glow, Flo, and Clue.

A Word From Verywell

The inaccuracy of ovulation testing kits in people with PCOS may be particularly disappointing for some to hear since many with the syndrome already struggle with getting pregnant due to their condition. In fact, it's one of the most common causes of fertility struggles in females.

Ovulation prediction methods that track basal body temperature and cervical mucus may be useful. So, speak with your healthcare provider who may be able to offer advice based on your specific case and needs.

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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Office on Women's Health. U.S. Department of Health and Human Services. Polycystic ovary syndrome. Updated April 1, 2019.

  2. American Pregnancy Association. Ovulation tests.

  3. U.S. Food and Drug Administration. Ovulation (saliva test). Updated February 4, 2018.

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