What to Know About Using Ovulation Kits If You Have PCOS (2024)

For women with polycystic ovary syndrome (PCOS), ovulation test kits can help pinpoint your fertile times for conception. Unfortunately, they might not be reliable due to your PCOS.

The most popular types of ovulation test kits measure luteinizing hormone (LH) levels in the urine or use saliva to assess changes in estrogen levels. These hormones spike right before ovulation when pregnancy is most likely to occur. But when you have PCOS, you may have a constantly high level or multiple peaks of these hormones, so the results may falsely reflect ovulation.

This article explains how PCOS affects ovulation and how these two common ovulation testing methods work. Other, more traditional fertility testing methods are worth considering, too.

How PCOS Affects Hormones and Ovulation

Understanding ovulation and the normal hormonal patterns during the menstrual cycle can help you better understand why PCOS can change the results of ovulation tests.

Normal Hormone Changes During the Menstrual Cycle

During a normal menstrual cycle:

• Follicle-stimulating hormone (FSH) is secreted from the brain into the blood circulation, 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 a fertilized egg. This results in an estrogen peak near the time of ovulation.
• Once the follicle matures, luteinizing hormone (LH) increases dramatically, triggering the release of the egg from the ovary. This occurs around day 14 of the cycle of a 28-day cycle.
• Around ovulation, basal body temperature (your at-rest temperature) also spikes and there is a change in the vagin*l and cervical mucus.
• If pregnancy does not occur, estrogen and progesterone levels will drop dramatically and the uterine lining will be shed. This is menstruation. Basal body temperature and vagin*l mucus return to what they were before ovulation.

Hormones in PCOS

Hormonal imbalances are common in women with PCOS, meaning that eggs don't always mature or get released as usual. Instead, they can 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, some women who have PCOS have persistently high levels of LH or multiple hormonal peaks.

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, there are few choices among home ovulation tests.

Hormonal Ovulation Testing Kits

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

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.

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—around day 12.

If your result tells you that you will ovulate soon, 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 before ovulation.

Saliva Ferning Tests

Some ovulation test kits are 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

You may wish to use more traditional means of predicting ovulation:

• Checking your cervical mucus, which tends to be watery and slippery before ovulation
• Monitoring your cervical position, which is high, soft, and open on fertile days and low, firm, and closed on non-fertile days
• Tracking basal body temperature, on the theory that women are at their most fertile two or three days before their body temperature rises

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.

Using both of these types of methods could be more helpful than just using one alone.

Summary

PCOS can make it hard to become pregnant. And ovulation tests might not be reliable because the hormones they measure might not be consistent and predictive of fertile times or ovulation when you have PCOS. Urine dipstick kits and saliva fern kits dominate the market, though they're not known for producing wholly accurate results. The more irregular your periods are, the less reliable the results of these tests will be. Along with these tests, you can also consider using family planning techniques that have been around for decades, like measuring your basal body temperature, to track your ovulation.

A Word From Verywell

The potential inaccuracy of ovulation testing kits may be particularly distressing if PCOS is already making it difficult for you 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 can discuss your options with you.

By Nicole Galan, RN
Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book."