Peeing on Sticks: A Review of Ovulation Tests

Peeing on sticks: it's not just for pregnancy any more! If you are trying to get pregnant, or just using yourself for a fun science experiment (in which case we should be friends), you can purchase test kits to predict ovulation.

The two most common test brands are Clear Blue and First Response. If you are using the test kits because you want to conceive, you don't want to waste a good egg on a test that's difficult to interpret - every month counts! So, I did you a favor and peed on several sticks to compare products. Ok, I actually dipped the sticks into  my pee, but more on that later.  I was in no way paid (I wish) or otherwise influenced by these companies to review their products. I independently used myself as a guinea pig, for the sake of science and your reproductive success. You're welcome.

First Response Test & Confirm Ovulation Test

Price: $28.99 for 10 tests plus one digital confirmation test
OR $19.89 for 10 tests plus one pregnancy test

How it works: The test predicts ovulation by measuring the amount of luteinizing hormone (LH), which is the hormone responsible for triggering ovulation.

Result interpretation: The result window shows a dark pink line closest to the thumb grip of the test (the part you hold) - - this is the reference line. A second line appears closest to the business end of the stick (the part you pee on) - - this is your result. If the result line is absent or is fainter than the reference line, the test is negative. If the result line is the same color or darker than the reference line, the result is positive. If your test kit includes the digital confirmation test, you can use it to confirm a suspected positive result.

Results: A negative result indicates the absence of an LH surge. A positive result indicates the presence of an LH surge and ovulation is predicted to occur within the next 24-36 hours.

Product notes: First Response also sells a package of daily digital tests, but the cost is greater than the Clear Blue daily digital tests ($47.99 for 20 tests versus $39.99). I elected to use the non-digital test option to compare the effectiveness of a kit with a lower price point.

Clear Blue Advanced Digital Ovulation Test

Price: $29.99 for 10 tests 

OR $39.99 for 20 tests

How it works: This test also predicts ovulation by measuring LH, but it includes an additional feature of measuring estrogen levels. Rising estrogen levels precede the LH surge.

Result interpretation: A blank circles indicates a negative result. A flashing smiley face (emoticons will have a whole new meaning now) indicates a rise in estrogen levels or "high fertility". A static smiley face is a positive result or "peak fertility". 

Results: A negative result indicates the test did not detect rising estrogen or LH levels. According to the test instructions, a flashing smiley face indicates "high fertility" and you should "have intercourse to increase your chances of becoming pregnant". There are a few issues with this claim. For starters, if you are using the test kit to determine when to inseminate, you need to wait until you receive a "peak fertility"result. In the event that you plan to fertilize an egg through sexual intercourse, you may have several days of a "high fertility" result before a positive LH surge. Sex is great and all, but it's a lot of pressure for both you and your partner if you demand baby-making time for days on end. From what I've read, doing it several days in a row is also not ideal for sperm counts.When the test shows a static (not flashing) smiley face, ovulation is predicted to occur in the next 24-36 hours - this is go time!

Product notes: Clear Blue also offers a daily digital test that only measures LH levels ($36.99 for a 20 count package). If you want to cut out the flashing smiley face result, you can purchase this test instead, but there isn't much difference in price. Also, I found the smiley face to be beneficial, which I'll explain more when summarizing my personal results (keep reading, I took pictures of my pee sticks for you!). 

The Testing Process

To compare products, I tested with both brands during the same cycle. The instructions for each state you can hold the stick under your urine stream, or you can collect the urine in a disposable cup (or non-disposable, it's your business - - just don't invite me over for a beverage, ever). I chose what I've termed the "collect and dip method" for logistical reasons. Simultaneously holding two sticks under my urine stream seemed like a challenge I didn't want to face. Also, I have terrible aim. I didn't want to risk peeing all over the wrong part of the test sticks, or worse -- my hand. I tested every morning immediately after waking, which is recommended due to the concentration of hormone levels.

Hint: if you use the First Response Test & Confirm kit, you should opt for the collect and dip method. This way you will have urine left for the digital confirmation test. 

My Results

Based on my average cycle length, I started testing on cycle day 6. No surprises here. As expected, both tests were clearly negative. The First Response test showed a faint pink result line and the Clear Blue test showed a blank circle. 

Cycle day 6, Test Day 1

On the second day of testing, the First Response test still showed a faint pink result line. However, the Clear Blue test showed a flashing smiley face, indicating a rise in estrogen levels. According to the test instructions, this result is supposed to occur for about two days before a positive ovulation result (as you'll learn, this was NOT my experience). 

Cycle Day 7, Test Day 2

The third day showed, as expected, a flashing smiley face on the Clear Blue test. For the First Response test, I observed a significant change in the color of the result line. To me, the result and reference lines appeared to be the same color pink. Without influence of the Clear Blue test, this looked like a positive result, so I used the digital confirmation test. The digital results revealed a "NO". 

Cycle Day 8, Test Day 3

Cycle Day 8, Test Day 3: First Response Digital Confirmation

Day 4: another smiley face for the Clear Blue test. At this point, the pink lines of the First Response test still looked the same color to me, but I had already been tricked once, so I decided to wait until the Clear Blue test turned positive before using the First Response confirmation again. 

Problem: because the First Response kit only includes one digital confirmation kit, I had to buy a second kit so I would have another confirmation test. Or so I thought. It turns out I mistakenly bought the kit that includes a pregnancy test instead of an ovulation confirmation test. Fooled again!

Cycle Day 9, Test Day 4

On the fifth day of testing, the Clear Blue test showed yet another day of the flashing smiley face. This was the fourth day of the Clear Blue "peak fertility" result and at this point I began worrying. To compound my worry, the result line of the First Response test went back to being as faint as it was in the first two days of testing.

Cycle Day 10, Test Day 5

Day 6: another day of the flashing smiley face and the faint pink line. 

Cycle Day 11, Test Day 6

On the seventh day of testing, the pink result line was darkening again, which gave me some hope that I might still ovulate. Although I was growing sick of the smiley face by now, it also helped me feel like my body was moving in the right direction.

Cycle Day 12, Test Day 7

Day 8 of testing: more of the same. 

Cycle Day 13, Test Day 8

On the ninth day of testing (cycle day 14), that damn pink line grew faint again. Since my average cycle length is 24 days, every ovulation and fertility prediction calendar says I should have ovulated by now. I was about 90% convinced that I was not going to ovulate this month and would have to resume my experiment again during the next cycle. By now, I developed a love-hate relationship with the flashing smiley face. It seemed to be going on for far too long, but it continued to provide some evidence that perhaps my ovaries would still relinquish an egg . I told myself I would test for ONE MORE DAY. If I didn't see a positive result, I'd stop testing until next cycle. 

Cycle Day 14, Test Day 9

OMG, I can ovulate!!!!!

It's a good thing I gave myself one more day, because on the tenth day of testing, I finally achieved the long-awaited static smiley face, which indicates a positive result for the Clear Blue test.

And look at that brilliant pink result line! What a beauty! It's difficult to see in this picture, but the result line appeared slightly darker than the reference line. As I explained earlier, I didn't have a First Response digital confirmation test, but my best guess is that this shows a positive result. 

Cycle Day 15, Test Day 10

Recommendation

Definitely use the digital tests! There is too much guessing when it comes to those blasted pink lines and the price difference isn't significant enough to justify the difficulty the inconclusive results. 

From the perspective of predicting ovulation, I think the "peak fertility" result is rather worthless (or maybe my hormones are just messed up, who knows?!). That being said, I do think it has value in providing some morale and encouragement. You may think that's silly, but if it weren't for the continued flashing smiley face, I probably would have stopped testing and convinced myself that ovulation wasn't happening this month. There isn't much of a price difference between the non-advanced and advanced tests, so I say spend an extra dollar or two for your own peace of mind. 

Happy ovulating!

Hello, I have baby fever

Hello (a parody written from the perspective of 35-year-old Adele)

Hello, it's me.

I was wondering if after all these years you'd like to meet, 

to go over my cycle.

They say my eggs are getting older and my fertility's decreasin’.

Hello, can you hear me?

I'm in California dreamin’ about havin’ your baby, 

while we're young and healthy.

I've forgotten how it felt to want to use birth control.

There's such a difference between us and a million miles.

Hello, I have baby fever.

I must have called a thousand times, 

to tell you our gene compatibility is top notch.

But when I call you never seem to be home.

Hello, I have baby fever.

At least I can say that I've tried, to tell you my ovulation is near.

But it don't matter, it clearly doesn't tear you apart at all.

Hello, how are you?

It's so typical of me to talk about myself, I'm sorry.

I hope that you're well.

Did you ever make it out of that town where nothing ever happened?

It's no secret that the both of us are running out of time.

So hello from my uterus.

I must have called a thousand times,

to tell you our gene compatibility is top notch.

But when I call you never seem to be home.

Hello, I have baby fever.

At least I can say that I've tried, to tell you my ovulation is near.

But it don't matter, it clearly doesn't tear you apart at all.

Oooohh, fertilize.

Oooohh, reproduce.

Oooohh, DNA.

Baby please.

Hello, I have baby fever.

I must have called a thousand times,

to tell you our gene compatibility is top notch.

But when I call you never seem to be home.

Hello, I have baby fever.

At least I can say that I've tried, to tell you my ovulation is near.

But it don't matter, it clearly doesn't tear you apart at all. 

Your Liver: The Ultimate Dextox

'Tis the holiday season and I'm happily imbibing in seasonally appropriate gustatory delights. Is this healthy you ask? To which I reply, I have to eat and drink every day to maintain homeostasis, I may as well ingest pumpkin-spice, peppermint-chocolate, and apple-cinnamon flavored sustenance while I can. With carrots on the side, of course.

Though my "everything in moderation" dietary school of thought keeps me from suffering much angst when confronted with the holiday smorgasbord, I'd say I'm in the minority. Many folks are concerned about overindulgence and unhealthy eating during this time of year. After the holiday decorations are packed away, people everywhere will be seeking retribution for their self-labeled dietary transgressions. So, before you add "go on a cleanse" or "detox" or "juice fast" to your New Year's resolution list, I have excellent news for you.....

You have a liver! And this means, unless you have liver disease, your liver is already working night and day to keep you detoxified. One of the liver's main functions is to break down potentially harmful substances you ingest into excretory products. Take note: these products are excreted.  That means your liver turns waste products in your blood into substances that leave your body through your poop or pee. The waste products don't just sit there and accumulate.No need to trigger the cleansing process by drinking massive quantities of lemon juice and cayenne pepper. Thank you, metabolism.

If you are pooping and peeing on the regular, then congratulations, your body is already doing what it can to protect you from toxins. While you may have completely valid concerns for your dietary habits, don't be fooled into focusing on tasks your liver and other organs are already taking care of. That's just wasteful.


References
http://www.livescience.com/34845-detox-cleansing-facts-fallacies.html
http://www.nlfindia.com/liverZone/functions.asp
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0015941/
http://www.livescience.com/48767-juice-cleanse-myths.html
http://www.theguardian.com/lifeandstyle/2014/dec/05/detox-myth-health-diet-science-ignorance
http://www.bidmc.org/YourHealth/HolisticHealth/DietCenter.aspx?ChunkID=100544

Thanks, Mom! From A Scientist.

Dear Mom,

Like a parasite, I implanted in your uterus and immediately started demanding resources. Your body had to begin adapting quickly, in order to keep up with my rapid cell division. When you discovered what I was up to (and you had to pee on a stick to do this), you felt nothing but excitement and gratitude. Imagine! Even though I was making you feel nauseous, causing you to vomit with little warning, and zapping your energy, you didn't mind.

As I grew, so did my demands. Before I came around, your uterus had a volume of 10 mL. Over the course of my fetal development, it expanded to hold nearly 5 L. That's a 500x increase!! In order to make space for me, your organs had to shift dramatically. That's right, you moved your organs for me!  Your abdominal organs, diaphragm, rib cage -- and even your heart--- were pushed upwards by your bulging uterus. Did you complain? Maybe a little. Mostly you felt overjoyed by my growth and comforted by my bladder-crushing weight and rib-busting kicks and punches.

Your heart rate had to increase to supply me with enough blood. In fact, the amount of blood pumped by your heart during a single minute increased by 30%-50%. Your kidneys lengthened by about 1 cm to accommodate extra fluid. You required about 20% more oxygen, yet all that organ shifting left you with  a 5% decrease in lung capacity. This means you likely suffered from shortness of breath. Much of your glucose intake was used as energy for me or my placenta, requiring you to increase your caloric intake. However, due to hormonal changes, your digestion wasn't quite as efficient. It took 15%-30% longer for contents to move through your intestines (read: constipation). Not to mention, you probably had some nasty heartburn. This sounds like a recipe for feeling rather blah and a great excuse to lay around binge-watching TV. But, no, you didn't let all this discomfort slow you down. Instead, you bustled about preparing for my arrival.

Then came my birthday, triggered by excruciating uterine contractions that probably constitute the greatest pain you've ever endured. You were in labor for hours, but unlike running a marathon, no snacks were allowed! Those nurses would only give you clear fluids and ice chips due to the risk of aspiration and the inability of your digestive system to function well during labor. You were willing to let a surgeon cut through all your abdominal muscles and into your uterus to pull me out, if need be. You risked having an episiotomy (an incision to enlarge the vaginal opening). You endured all this pain so your cervix could transform from a length of 2 cm with an opening of less than half an inch, to a circular opening with a diameter of 10 cm (nearly 4 inches). Through a feat that can be described as nothing short of pushing the human body to its ultimate limits, you delivered me into this world to take my first breath. And if that weren't enough, you also had to deliver my placenta!

The anatomical and physiological sacrifices you made for my fetal development and birth make you a bad-ass superhero. But they only represent a tiny fraction of the love and sacrifice you've shown every day since.

Thanks, Mom. And Happy Mother's Day!

Love,
Your first-born F1 XX

Reference:
Beckmann, CRB, Ling, FW, Herbert, W,  Laube, DW, ,Smith, RP, Casanova, R, Chuang, A, Goepfert, AR, Hueppchen, NA, Weiss, PM. 2013. Obstetrics and gynecology. 7th ed. Philadelphia: Lippincott Williams & Wilkins.

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Break a Sweat, Not Your Bones

Happy 2014! With the arrival of the new year, your local gym is about to get a lot more crowded. If you are resolving to begin or maintain a fitness regimen, here's some motivation to break a sweat ...

While there are plenty of benefits to routine exercise, it's easy to forget that exercise is more than skin - and muscle - deep. Hey, I'll be the first to admit that my greatest motivations for heading to the gym are: 1) visions of Michelle Obama's arms and 2) grand ambitions for a firm bodonkadonk.

An often overlooked benefit of exercise is the tremendous impact it can have on your skeleton. You may feel like you have old bones, but in reality your bone cells are constantly removing old tissue and creating new bone through a process called remodeling (yes, much like home remodeling but without the steep prices) . In fact, bone remodeling occurs at such a rate that the majority of the adult skeleton is replaced every 10 years! Are you feeling younger yet?

It's easy to see how exercise affects your muscles - the more you use them the stronger they get. It may not be as obvious, but your bones respond in a similar way. Engaging in weight-bearing exercise tells your bone cells, "these bones are in high demand, let's build them up and make them stronger so they can withstand all this activity".

Though you can't flex your strong bones to show them off, just remember this: your strong bones can prevent you from developing a hunchback. Now that's a reason to keep your gym membership.

Chadwick's Sign (or why your cervix might be blue)

Sore boobs, nausea, mood swings, fatigue - no, these are not lyrics to a clever rap song (that I'm aware of), rather these are classic symptoms of early pregnancy. If you have these symptoms, possess functional female reproductive organs, and have had vaginal intercourse with a sperm-bearing partner in the recent past, you could always pee on a stick to find out if there is an embryo inhabiting your uterus. But, wait, there's another early pregnancy indicator that you might not be aware of: Chadwick's sign!

Under usual circumstances, the cervix is pink (cervical pink, now there's a new crayon color just waiting to be invented). With pregnancy, blood flow to the uterus dramatically increases, resulting in the cervix developing a bluish tint. This color change is referred to as Chadwick's sign, which can appear as soon as 6 weeks after conception . Ok, ok, so maybe this is not the most convenient way to gauge whether you might be pregnant, unless you are hypermobile, or have an exceptionally curious partner, but still, it's quite fascinating. Plus, cervical self-exams are completely possible (more info available at: http://www.beautifulcervix.com/participate/).

A woman's total blood volume actually increases 30-50% during pregnancy, so it's no wonder that this can make your cervix a little blue.

Normal Blood Pressure: It's Vital

You can't get through a trip to the doctor without having a blood pressure cuff wrapped around your arm. It doesn't matter if you were at the same office three days ago or if you are coming in for an obvious case of poison ivy - your arm will not be escaping the cuff. Someone will slap that sucker around your biceps, pump it up to give you a nice squeeze, mysteriously listen to your elbow through their stethoscope (it's weird when you think about it), and then mutter some numbers that may or may not be good. If you're lucky, you'll hear something to the effect of: "118 over 72".

Everyone knows that a normal blood pressure is essential to being healthy, but what exactly is blood pressure? What do those numbers actually tell us? Why is blood pressure important enough to be a VITAL sign? Why does everyone freak out when the numbers start to creep up, even slightly? And why, oh why, is high blood pressure associated with so many terrible things (heart attack, stroke, kidney failure, death... you know, those kinds of terrible things). 

To appreciate the importance of blood pressure, we must first understand: 1) pressure and 2) what happens in your body during a single heart beat. Don't be intimidated and stop reading. This isn't going to include crazy diagrams or calculations (it could but that's already been done). 

• Pressure: this is a word we all use and understand, but let's dissect (pun gleefully intended) the meaning as it relates to blood pressure. Pressure, in the world of physics, is a calculation based on the amount of force that is being exerted on a given area. Your blood pressure is the amount of force applied to the walls of your arteries as blood flows through them. Why two numbers? Let's talk about your heartbeat first...

• When your heart beats, it contracts, pumping blood out of your heart to circulate throughout your body. During the fraction of a second between heartbeats, your heart is relaxed and refilling with blood.The contraction phase of the heartbeat is referred to as systole and the relaxation phase is termed diastole. Hence, your systolic blood pressure (top number) is the pressure exerted on your artery walls when your heart is contracting. Your diastolic pressure (bottom number) measures the pressure while your heart is relaxed.

Now that you understand what blood pressure is measuring, it probably makes intuitive sense why high blood pressure (also called hypertension) can be so damaging to your body. First of all, if your blood pressure is too high, it is causing your heart to work harder than normal. Second, the increased pressure can damage your blood vessels and to organs such as your kidneys. Damage caused to your blood vessels can include tears, which are prime areas for build up of plaque, thus causing narrowing of the vessels, in turn leading to stroke or heart attack. High blood pressure can even lead to rupture of blood vessels, as occurs in an aneurysm (basically the pressure can cause an artery to explode... BAD NEWS). 

Unlike low blood pressure, which is symptomatic (dizziness, fainting, etc), high blood pressure is usually asymptomatic until it causes one of the aforementioned terrible things to happen. This is why it is incredibly important for high blood pressure to be treated as soon as possible. Click here for more information on prevention and treatment of high blood pressure. 

So, next time you get your blood pressure measured, don't think "oh not this again" but be grateful for the opportunity to catch high blood pressure before it gets out of control. It's vital!