One of the funny things about planning for children is all the acronyms that you learn – BD for “baby dancing”, or the act of making a baby (also known as DTD, doing the deed); CM for cervical mucus; BFN and BFP, big fat negative and big fat positive on pregnancy tests; and TWW, the two week wait or the time between when you ovulate and when you could expect your next menstrual period. You can even designate whether you are NTNT (not trying not to conceive) or TTC (trying to conceive). Today, however, I’m going to be talking about OPKs.
What is an OPK?
An OPK is an ovulation predictor kit. It detects surges in luteinizing hormone in which it is likely (but not definitive) that a woman will ovulate. Most women can safely assume that they are ovulating if they are getting a monthly period. If there is a diagnosis of a condition that can affect ovulation, a woman has a history of long/irregular/light cycles or it has taken more than six months to get pregnant, OPKs may be very useful working out what is going on.
The type I’m going to use is the midstream ovulation test by Babyworks and they look like this (you pull the green cap off at the end for the strip upon which you need to urinate) :
Women with PCOS can maintain high levels of luteinizing hormone throughout their cycle without releasing an egg – but this does not mean that all women with PCOS do. I plan to identify whether this is the case by testing from the day when my period ends (in almost all cases, far too soon to register a positive) for two weeks, hopefully getting a peak reading around the seventh day of trying – mid cycle.
What will that peak reading look like? Unlike pregnancy tests, simply getting two lines doesn’t mean that it’s positive. Your test line must be as dark as the control line to register a positive. I’m hoping that’s really obvious, and that I’m not sitting there, trying to work it out! Also unlike pregnancy tests, you’re going to get a more accurate reading in the afternoon – LH synthesizes in the morning so is metabolized into the urine by afternoon.
So what if you don’t get a positive?
If you don’t get a positive on OPKs, there may be a minute chance that you have missed the surge or that your urine was too diluted to register the hormone levels. The stronger possibility is that you may have had an anovulatory cycle – always a fear for women on PCOS.
In the simplest of explanations, an anovulatory cycle is one in which you don’t ovulate. Some research I have read states that women without PCOS may have as many as two annovulatory cycles each year, where for whatever reason (stress, illness, etc) they do not ovulate. One of the biggest indicators of PCOS and, in fact, one of the conditions that lead to my personal diagnosis is the persistent lack of ovulation leading to amenorrhea - in other words, no periods. For a year. Yikes.
So can you get your period and have an anovulatory cycle? Yes, and also no. You can experience bleeding that you may not be able to distinguish from a period but it isn’t the same thing hormonally. You can have estrogen withdrawal bleeding – where your hormone levels build up but not to the level required to ovulate and then drop – or estrogen breakthrough bleeding – more common, when your endometrial lining builds up to the point that it can no longer sustain itself and you get a bleed. It may, in either case, be heavier or lighter than your usual period.
So as you can see, although I’ve had my period since I’ve come off the pill, there’s no guarantee that I’ve ovulated. And if women with no fertility issues can have anovulatory cycles too, there’s no guarantee that I will, or will on a regular basis.
So what are my thoughts?
While OPKs aren’t the cheapest, especially not the midstream ones I’ve chosen, it’s part of my plan to be as educated as I can about what is going on with my body. As part of the process (metformin, cycle symptom tracking, diet & acupuncture being the other big components), I feel like it gives us the biggest chance of understanding what is going on and helping us try! I’m also very interested to see how my 17 kg weight loss has affected my body’s ability to ovulate regularly. In addition to this, I’ll also be exploring getting blood tests from my doctor that give me a more complete picture of where my hormones stand.
From a big picture point of view, I wish that health class at high school had focused a little less on showing us ghastly pictures of STIs and had instead taught us more about how the human body actually worked. You’d probably have far less teen pregnancies if teens knew that every woman’s fertile period could be different and how long sperm can linger in the body before ovulation. The amount of new information that I am learning at the moment is ASTOUNDING and I feel like the decisions I made as a teen, while ultimately okay, I may have made differently given the information I have now.
Have you had experience in using OPKs? Would you be tempted to use them in the future?