Comparing Ovulation Testing Methods

How does a saliva ovulation microscope method compare to other ovulation tracking methods?

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METHODTOTAL COSTACCURACY OF METHOD*NON-INVASIVEPREDICTIVE**REUSABLEACCESSIBILITY***
Microscope – Saliva Ferning Info IconDollar SymbolFlowery Bullet PointGreen CheckmarkGreen CheckmarkGreen CheckmarkOTC
Test Strips – Urine (LH) Test Info IconDollar SymbolFlowery Bullet PointGreen CheckmarkRed X markRed X mark OTC
Basal Body Temperature Info IconDollar SymbolFlowery Bullet PointGreen CheckmarkRed X markGreen Checkmark OTC
Cervical Mucus Monitoring Info IconDollar SymbolFlowery Bullet PointRed X markGreen CheckmarkRed X mark OTC
Medical Transvaginal Ultrasound Info IconDollar SymbolFlowery Bullet PointRed X markGreen CheckmarkRed X markMedical Visit
Serum Progesterone Medical TestingInfo IconDollar SymbolFlowery Bullet PointRed X markRed X markRed X markMedical Visit
Medical Urine Test (PDG) Info IconDollar SymbolFlowery Bullet PointFlowery Bullet PointRed X markRed X markRed X markMedical Visit

*Accuracy – relative accuracies are based upon proper usage of the product and/or method

**Predictive – indicates a qualitative trend leading up to peak ovulation day as opposed to a single yes or no style result if at peak ovulation. Predictive trending of ovulation is ideal so you can plan ahead for your peak day.

***OTC – Over-the-Counter – Readily accessible by the general consumer, without requiring a doctor’s visit or health insurance considerations

DEFINTION OF METHODS

Described below are various ovulating testing methods that are a combination of at home ovulation kits and some that require visits to your doctor’s office.

Microscope – Ferning Saliva

Microscope-based methods like the OvuScopeTM utilize the effect of higher salt concentrations in saliva as hormone levels rises during ovulation. Looking under a microscope at peak ovulation, you can see crystallization patterns, These patterns are called ferning because they look like fern leaves and the microscopes used to examine them often use a green light to make them easier to see. This predictive approach allows you to track your cycle’s progress from ramping up to fertile window (when some ferning occurs) to the beginning of the fertile window (when ferning is the main pattern visible through the ovulation microscope).

Test Strips – Urine (LH) Test

This is commonly known as a POAS (peeing-on-a-stick) style test, which chemically measures the current level of LH (Luteinizing Hormone) in your urine. Luteinizing hormone is a key hormone that controls your menstrual cycle and ovulation. Similar to a pregnancy test, the POAS test provides a yes/no result, using one stick per test.

Basal Body Temperature

Your resting body temperature is your basal temperature, typically best measured in the morning. Slightly before ovulation, your temperature will take a slight dip, then rise during your ovulation window. Although it’s an easy method to use—since you only need an accurate thermometer—it’s prone to errors, as temperature can be affected by many different factors. It may be hard to determine your ovulation window accurately.

Cervical Mucus Monitoring

The consistency of your cervical mucus will change throughout your cycle. It often is dry or sticky when you’re not ovulating, becomes wet, watery, or creamy near ovulation, and then becomes very wet and stretchy like a raw egg white during peak ovulation. You can monitor your cervical mucus at home, but since you’ll need to collect samples of your cervical mucus in order to do so, it’s a pretty invasive way to track your cycle.

Medical Transvaginal Ultrasound

Getting an internal ultrasound can be an invasive and expensive procedure (especially since it’s not always covered by health insurance). An ultrasound probe is inserted into your vaginal canal by the medical technician and they observe the current state of your ovaries and ovulation. This is typically used in conjunction with IUI (Intrauterine insemination), where a medical professional checks to see if you’re ovulating before they perform artificial insemination.

Serum Progesterone Medical Testing

This is a blood test where your serum levels are tested to measure your progesterone hormone. Your levels have a strong correlation to your ovulation, but you have to visit a doctor or testing laboratory for the blood test.

Medical Urine Test (PDG)

This method chemically tests your urine for PdG, a progesterone metabolite, which is a less invasive comparison to the serum progesterone blood test. Prolonged elevation of PdG indicates that you have been ovulating.

References

  1. H.-W. Su, Y.-C. Yi, T.-Y. Wei, T.-C. Chang and C.-M. Cheng, “Detection of ovulation a review of currently available methods”, Bioeng. Transl. Med., vol. 2, no. 3, pp. 238-246, Sep. 2017.
  2. B. S. Priya, M. Pushpaja, A. V. S. Kumar and K. N. Maruthy, “Does the salivary fern pattern determine fertile period in reproductive female?”, Clin. Epidemiol. Global Health, vol. 8, no. 3, pp. 698-701, Sep. 2020.
  3. World Health Organization Task Force Investigators. Temporal relationships between ovulation and defined changes in the concentration of plasma estradiol-17β, luteinizing hormone, follicle-stimulating hormone, and progesterone. Am J Obstet Gynecol. 1980; 138(4): 383– 390.
  4. Ecochard R, Marret H, Rabilloud M, et al. Sensitivity and specificity of ultrasound indices of ovulation in spontaneous cycles. Eur J Obstet Gynecol Reprod Biol. 2000; 91(1): 59– 64.
  5.  Matijevic R, Grgic O. Predictive values of ultrasound monitoring of the menstrual cycle. Curr Opin Obstet Gynecol. 2005; 17(4): 405– 410.
  6. Cahill DJ, Wardle PG, Harlow CR, Hull MGR. Onset of the preovulatory luteinizing hormone surge: diurnal timing and critical follicular prerequisites. Fertil Steril. 1998; 70(1): 56– 59.
  7.  Eichner SF, Timpe EM. Urinary-based ovulation and pregnancy: point-of-care testing. Ann Pharmacother. 2003; 38(2): 325– 331.
  8. Guermandi E, Vegetti W, Bianchi MM, Uglietti A, Ragni G, Crosignani P. Reliability of ovulation tests in infertile women. Obstet Gynecol. 2001; 97(1): 92– 96.
  9. Ceric F, Silva D, Vigil P. Ultrastructure of the human periovulatory cervical mucus. J Electron Microsc (Tokyo). 2005; 54(5): 479– 484.
  10. Lu YC, Bentley GR, Gann PH, Hodges KR, Chatterton RT. Salivary estradiol and progesterone levels in conception and nonconception cycles in women: evaluation of a new assay for salivary estradiol. Fertil Steril. 1999; 71(5): 863– 868.
  11. Fehring RJ. Accuracy of the peak day of cervical mucus as a biological marker of fertility. Contraception. 2002; 66(4): 231– 235.