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There are many at-home diagnostic tests

There are many options for detecting ovulation or pregnancy. These tests can be used by women who choose to test their fertility. Pharmacists can help them select the right test and ensure that they are properly used.

Ovulation Prediction

Ovulation prediction devices monitor natural hormonal changes in a woman’s cycle. OTC products are available to predict ovulation. These include fertility microscopes, urine tests, saliva tests and thermometers that measure basal body temperature (BBT). When choosing a test method, you should consider ease of use, preference and cost.

Basal Thermometers

Many women use BBT to predict their ovulation times. BBTs can be viewed digitally for ease of reading. Most BBTs can be viewed digitally. The BBT monitoring is a valuable tool for evaluating the women’s menstrual cycles month by month. It can help to identify fertile days and patterns.

Urine-Based Ovulation Tests

Monoclonal antibodies that are specific to luteinizinghormone (LH), can be tested in urine to determine if there is a surge.1,2 These tests should only be performed 2 to 3 days before the estimated date of ovulation. After the LH surge is detected, testing should stop. The best time to collect urine is in the morning, when the LH surge is most evident.1,2 However, it is better to wait until the next day before testing. Before testing, the sample should be brought back to room temperature.1,2

Before beginning the test, women should read and follow the manufacturer’s instructions. False-positive results can be caused by medical conditions like polycystic ovarian Syndrome (POS), menopause, and other conditions that are associated with high levels LH. False-positive results can also be caused by patients who have stopped using fertility medication or those with impaired liver and renal function.1,2

Fertility Scopes

For detecting ovulation, fertility microscopes can be used. These reusable devices allow women to examine dried saliva samples with an illuminated microscope that is about the same size as a lipstick container. The saliva electrolyte levels are directly affected by hormonal changes. These hormones can be triggered before, during and after ovulation. When dry saliva samples are examined under a microscope, fern-like patterns can be seen. The fern pattern is visible in test samples around 3-4 days before ovulation. It continues for 2-3 days after ovulation. Nonrandom dotted lines and bubble patterns may appear during a nonfertile period.

Women should be informed to have their teeth checked every day before they eat, brush their teeth, or drink. Women should wait at least two hours after drinking or eating to ensure that the test results are not altered if the test is done later in the day.

Saliva Electrolyte Test

OvaCue Fertility Monitor (Zetek Inc.) measures the level of electrolytes within the saliva to predict ovulation. It measures saliva, sodium, and potassium using an electrochemical method.1,2 Patients apply a spoon-sized sensor on their tongues for five seconds each morning. The monitor displays and records the individual’s fertility for that day. The OvaCue stores the measured data in memory. It also indicates when ovulation was confirmed by purchasing a vaginal sensor. This will confirm ovulation and measure electrolyte changes within the vaginal mucus. You can download the data from your monitor to a computer for further analysis.1,2

If a woman uses ovulation monitors, she should seek medical evaluation. Patients with a history or medical condition (e.g., amenorrhea and endometriosis) should be referred for medical evaluation.

Pregnancy Tests

Home pregnancy tests can detect the presence or absence of human chorionic Gonadotropin (hCG), hormone in urine samples (Table 2). These home pregnancy tests are based on monoclonal and polyclonal antibodies that are used in an enzyme immunoassay. Patients should be reminded that home pregnancy tests are only performed by professionals. Unless otherwise stated, it is best to use the first morning urine. This is when hCG levels are highest. Patients should avoid drinking for at least 4 to 6 hours before testing. Digital tests allow for easier interpretation and show the readings of “pregnant” and “not pregnant”.

It is important to warn women that a premature test after a missed period can result in false-negative results. Women are advised to wait at least one week before testing again. Patients who receive a negative test result need to be advised that they retest in the event of a missed period. They should also be advised to consult their primary care provider to have a serum hCG and physical exam.

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