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Do OPK Test Results Accurately Indicate Ovulation While On Letrozole?
Question: have PCOS and was on 5mg of letrizole to induce ovulation. I had a u/s done and doc saw a mature follicle on my left ovary. He told me to do opk's starting that day, March 7. I tested 2x (afternoon and eve)that day and got what I thought was an almost positive opk. The next day(March 8), Itested again, afternoon and eve and they both only had 1 line on so therefore, negative. So would I have ovulated that night (March 7)? And if I did ovulate then, I'm 7-8dpo. I've been having brown/pink/not quite red, spotting/discharge since approx 6dpo. What does all this mean? Should I call my ob? Could it be my period if I didn't ovulate? I have extremely irregular cycles (100+days) what are your thoughts on this?
Brief Answer:
A detailed answer for the questions below
Detailed Answer:
Hello,
There are a few thoughts that I would like to consider related to the results.
1. The LH urge that the opk tests happen 1-2 days before the ovulation so if you ovulated say on March 7th than the opk test would have best results a day or two before that.
Meaning that a later test might affect the results.
2. I am wondering on the opk tests you have and how it reads positive results and also if you read the results within 10 minutes.
Most of the tests should have 2 lines, one on the control and one on the test area to be positive.
Sometimes reading the test beyond 10 minutes might cause a faint second line which in itself is interpreted as positive by patients but is a false positive because of reading it later than the recommended time.
3. It is not recommended to use the morning urine to do the opk test as the best time is around 2.pm which is the time LH urge is on it's highest.
It is also recommended to not drink much the 4 hours before having the test so the urine is not much diluted and give a false negative result.
So to conclude I would say:
- having a follicle in the US on the time the doctor expects it to be present really increases the chance that you have ovulated
- the fainting positive test (almost positive test) is very uncertain of its positivity especially if you read it more than 10 minutes later
- for better result of the opk test try to have it a bit earlier than the expected ovulation as it increases 1-2 days before ovulation and also use the 2.pm urine to have the test and if possible do not drink much from 10 am till 2 pm that day so that the urine can be concentrated and increase the chance of being positive if the ovulation is happening.
- the bleeding, mild brown pink secretions can have many explanations and we can not be really sure of the cause but what should be important is that ovulation itself can cause similar mild brownish secretions but also irregular bleeding due to non-ovulation also.
The best way to know what really happened is to wait and see in the next week or two if your periods come back or not.
If you have no periods, pregnancy can be an option but also irregular menstruation as you might usually have so in 1-2 weeks having a pregnancy test would be recommended to tell what happened.
Not being pregnant does not mean you did not ovulate, many times women ovulate but still do not conceive for a certain period of time and this is still normal.
I have tried to give a detailed answer and to address you concerns in full but please if anymore clarification is needed on this feel free to reply to this message.
Hope I have answered your query. Let me know if I can assist you further.
A detailed answer for the questions below
Detailed Answer:
Hello,
There are a few thoughts that I would like to consider related to the results.
1. The LH urge that the opk tests happen 1-2 days before the ovulation so if you ovulated say on March 7th than the opk test would have best results a day or two before that.
Meaning that a later test might affect the results.
2. I am wondering on the opk tests you have and how it reads positive results and also if you read the results within 10 minutes.
Most of the tests should have 2 lines, one on the control and one on the test area to be positive.
Sometimes reading the test beyond 10 minutes might cause a faint second line which in itself is interpreted as positive by patients but is a false positive because of reading it later than the recommended time.
3. It is not recommended to use the morning urine to do the opk test as the best time is around 2.pm which is the time LH urge is on it's highest.
It is also recommended to not drink much the 4 hours before having the test so the urine is not much diluted and give a false negative result.
So to conclude I would say:
- having a follicle in the US on the time the doctor expects it to be present really increases the chance that you have ovulated
- the fainting positive test (almost positive test) is very uncertain of its positivity especially if you read it more than 10 minutes later
- for better result of the opk test try to have it a bit earlier than the expected ovulation as it increases 1-2 days before ovulation and also use the 2.pm urine to have the test and if possible do not drink much from 10 am till 2 pm that day so that the urine can be concentrated and increase the chance of being positive if the ovulation is happening.
- the bleeding, mild brown pink secretions can have many explanations and we can not be really sure of the cause but what should be important is that ovulation itself can cause similar mild brownish secretions but also irregular bleeding due to non-ovulation also.
The best way to know what really happened is to wait and see in the next week or two if your periods come back or not.
If you have no periods, pregnancy can be an option but also irregular menstruation as you might usually have so in 1-2 weeks having a pregnancy test would be recommended to tell what happened.
Not being pregnant does not mean you did not ovulate, many times women ovulate but still do not conceive for a certain period of time and this is still normal.
I have tried to give a detailed answer and to address you concerns in full but please if anymore clarification is needed on this feel free to reply to this message.
Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by :
Dr. Prasad
if I used letrizole for 5 days at the beginning of my cycle, and I did get a mature follicle but didn't ovulate, when would I expect my period? approximately 28 days later? or could it be a lot sooner than that? I'm currently cycle day 21. never in my life did I have cycles closer than 30 days.
Brief Answer:
Please read below for more details
Detailed Answer:
Hello,
An ultrasound can determine cysts in the ovaries but not necessarily it indicates ovulation or not even though chances are high that ovulation might happen.
If ovulation happens but you did not conceive than it takes an average of 2 weeks from ovulation to the next period.
When women have different length menstrual cycle, it is the first part of the menstrual cycle, from period to ovulation that differs and the second part is the same length in almost all women, 2 weeks from ovulation.
If you didn't ovulate and especially having PCOS makes the periods differ a lot and difficult to foresee the next period.
You are in a time of the cycle that you can check blood progesterone to determine if you ovulated or not.
When a woman ovulates, the remains of the folicle turn into a yellow body and produce progesterone which the best time to measure it is around day 21 of the cycle.
If progesterone is increased in blood on day 21 than ovulation has happened.
If progesterone is increased then and you get no period in 10-14 days please have a pregnancy test.
If progesterone is increased but you get a period in 2 weeks than it means you ovulated but did not conceive.
If progesterone is not increased, you did not ovulate this time and it is hard to know when your next period will be.
Hope I have answered your query.
Take care
Regards,
Dr Zotaj Antoneta, General & Family Physician
Please read below for more details
Detailed Answer:
Hello,
An ultrasound can determine cysts in the ovaries but not necessarily it indicates ovulation or not even though chances are high that ovulation might happen.
If ovulation happens but you did not conceive than it takes an average of 2 weeks from ovulation to the next period.
When women have different length menstrual cycle, it is the first part of the menstrual cycle, from period to ovulation that differs and the second part is the same length in almost all women, 2 weeks from ovulation.
If you didn't ovulate and especially having PCOS makes the periods differ a lot and difficult to foresee the next period.
You are in a time of the cycle that you can check blood progesterone to determine if you ovulated or not.
When a woman ovulates, the remains of the folicle turn into a yellow body and produce progesterone which the best time to measure it is around day 21 of the cycle.
If progesterone is increased in blood on day 21 than ovulation has happened.
If progesterone is increased then and you get no period in 10-14 days please have a pregnancy test.
If progesterone is increased but you get a period in 2 weeks than it means you ovulated but did not conceive.
If progesterone is not increased, you did not ovulate this time and it is hard to know when your next period will be.
Hope I have answered your query.
Take care
Regards,
Dr Zotaj Antoneta, General & Family Physician
Above answer was peer-reviewed by :
Dr. Prasad
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