Using Ovulation Test Kits When You Have PCOS

Your condition can affect their accuracy

If you're trying to conceive, you may already know that ovulation test kits have their pros and cons.

But if you have polycystic ovary syndrome (PCOS), you should know upfront that using a kit to help pinpoint fertile times for conception may fail to produce reliable results.

Here's why, in a nutshell: The most popular type of ovulation test kit uses a urine dipstick to measure luteinizing hormone (LH) levels, which spike right before ovulation.

But when you have PCOS, you may have a constantly high level or multiple peaks of these hormones. So the results may falsely reflect that you've ovulated.

This article explains how PCOS affects ovulation and how two common ovulation testing methods work. Other, more traditional methods are worth considering, too, since women who eventually conceive say it's important to remain positive and keep trying.

You're Not Alone

PCOS can feel like a lonely, isolating condition. But many women can probably relate to the frustrations you feel: Between 6% and 10% of childbearing age have PCOS.

How PCOS Affects Ovulation

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

During a normal menstrual cycle:

  • 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 (your at-rest 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 as vaginal mucus changes as well.

Hormonal imbalances are common in women with PCOS, meaning that eggs don't always mature or get released as usual. Instead, they collect on the ovaries as small, immature follicles referred to as cysts.

These irregularities mean that a woman with PCOS may have a sporadic menstrual cycle, a long one, or not even have one at all. Further complicating the issue are the persistently high levels of LH or multiple hormonal peaks that some women with PCOS experience.

These factors can make ovulation testing all the more challenging in women with PCOS since the tests work by detecting surges in LH levels.

Unfortunately, few choices exist among home ovulation tests.

Woman looking at ovulation testing kit.

Verywell / Lara Antal

Hormonal Ovulation Testing Kits

Ovulation tests that rely on detecting changes in hormones are less likely to be accurate:

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 be unreliable.

Tread Carefully

Any test kit that relies on a urine dipstick to predict ovulation may not be accurate if you have PCOS. Plus, keep in mind that an ovulation test does not actually test for ovulation. "It only tells you that your body is trying to ovulate."

Still, all hope is not lost. You may be able to count on an ovulation kit if you adjust the timing, based on your menstrual cycle.

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

If you get a positive result, it's time to take the cue and begin having sexual intercourse every day for two or three days to improve your chance of conceiving.

Saliva Ferning Tests

Some ovulation test kits are essentially saliva tests. They rely 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.

The U.S. Food and Drug Administration (FDA) cautions that saliva tests may produce inaccurate results for many reasons, even in individuals without PCOS. If you have a consistently high level of estrogen due to PCOS, this test may be even less accurate than a urine dipstick test.

Other Options

It helps to be resourceful if you have PCOS. Like many women who are determined to conceive, you may wish to turn to more traditional means of predicting ovulation:

Tests are available that include a basal body temperature thermometer and tracking mechanism. 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 well-known apps include Kindara, Fertility Friend, Ovia, Glow, Flo, and Clue.

They offer a fascinating merger between tradition and technology—and could play a role in delivering the news you've been hoping for.

Summary

Women with PCOS encounter their share of monthly problems: Their menstrual period may be late, stay longer than normal, or not show up at all. The imbalance in their reproductive hormones can make it even harder to get pregnant since it's tricky to predict an ovulation date. Two types of ovulation tests dominate the market, though they're not known for producing wholly accurate results. Many women turn to natural family planning techniques that have been around for decades to track their ovulation.

A Word From Verywell

The potential inaccuracy of ovulation testing kits may be particularly distressing for women whose PCOS is already making it difficult for them to get pregnant. In fact, PCOS is one of the most common causes of fertility struggles in females. It's easy to get frustrated, but don't give up. Your healthcare provider should function as a treasure trove of suggestions to help you conceive.

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5 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. Centers for Disease Control and Prevention. PCOS (polycystic ovary syndrome) and diabetes.

  2. U.S. Department of Health and Human Services. Polycystic ovary syndrome.

  3. American Pregnancy Association. Ovulation tests.

  4. Center of Reproductive Medicine. Ovulation induction: What you need to know.

  5. U.S. Food and Drug Administration. Ovulation (saliva test).

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