Negative Lh Surge And Pregnancy

Jenny asks…

how do i know when i will be ovulating?

hi all just need abit of help. i bought a fertility thermometer and i read the instructions but it told me that it wont tell me when am ovulating but after i ovulated that’s no good for me because i have pcos and don’t have a regular period so i just need to know how can i tell that i am ovulating with this thermometer i have got.

Pregnancy Advisor’s answers:

You may be able to pinpoint your most fertile days by recognising the signs of hormonal change in your body. Some women can actually feel ovulation happening. The condition, called mittelschmerz, is sometimes described as a “one-sided back ache” or a particular tenderness in the lower abdomen, which may last a few minutes to a few hours. You may not have noticed such an obvious sign of ovulation yourself, but there are other changes to look out for.

As your menstrual cycle progresses check your cervical mucus daily. You may notice that it changes in consistency depending on where you are in your cycle. Around the time of ovulation, your cervical mucus becomes clear, slippery and stretchy. The position and feel of the cervix also changes around the time of ovulation, from hard, low, closed and dry to soft, high, open and wet.

Try our fertility calculator to give you an idea of when your “fertile window” is likely to be. Start to familiarise yourself with the changes in your cervical mucus and cervix around this time.

There are other techniques that you can also use to pinpoint ovulation including tracking the rise in body temperature that occurs just before ovulation and using kits to predict when you are ovulating.

Measuring your basal body temperature

Following ovulation, your temperature can increase by 0.5 to 1.6 degrees. You won’t feel the shift but you may be able to detect it by using a basal body temperature (BBT) thermometer. This temperature spike indicates that you’ve ovulated. This is because releasing an egg stimulates the production of the hormone progesterone, which raises body temperature.

You’re most fertile in the two or three days before your temperature rises. A few experts think you may have an additional 12 to 24 hour window of fertility after you first notice the temperature creep up, but most say at that point it’s too late to make a baby.

That’s why some experts recommend that you chart your temperature (taken each morning) for a few months to detect a pattern and pinpoint your likely ovulation date. Then you can plan to have sex during the two to three days before the day your temperature normally rises.

Some women find temperature charting, along with assessing cervical mucus, useful. Others find it hard to detect any temperature changes. Also your lifestyle may make this method impractical as you have to take your temperature every morning, before you get up and after you’ve had at least three hours of uninterrupted sleep.

Ovulation predictor kits (OPKs)

Available at chemists without a prescription, in supermarkets, or by on-line shopping, ovulation prediction kits (OPKs) detect the surge in luteinising hormone (LH) just before ovulation. They look similar and work in the same sort of way as home pregnancy tests in that the tests detect an increased level of a hormone in your urine. OPKs are easier to use and often more accurate than the BBT method. They can predict ovulation 24 to 36 hours in advance and, unlike the BBT method, they can help you identify when you may be ovulating the very first month you use them.

But they’re not foolproof. They can measure LH (you get either a positive or a negative result, not a number), but they cannot indicate whether you ovulate after a positive response. LH can surge with or without the release of an egg. False LH surges can also take place before the real one.

For maximum accuracy, follow the kit’s directions to the letter. If you have a 28-day cycle, start the test on day 11 and use it for six days (or however many days are recommended by the manufacturer). If your cycle is longer, say 35 days, start on day 14 for nine days. The women most likely to buy the kits, those with irregular cycles, may end up being least satisfied with them. If your cycle runs between 28 and 40 days, ovulation may range between days 14 and 26. The kits generally provide five to nine days’ worth of tests. See our article for more information on how to use OPKs.

Saliva ovulation tests

These tests work by detecting what is called “salivary ferning”. An increase in the hormone oestrogen leading up to ovulation increases the salt content of saliva. This can be detected under microscope by the way saliva crystallizes when it dries. When the salt content is high, the saliva dries in a fern pattern. In the 3-4 days leading up to ovulation salivary ferning is visible and also for a couple of days after ovulation. When you are not in the fertile window the saliva dries in shapeless blobs.

This test involves an initial outlay to buy a mini-microscope to enable you to see these changes. Once you’ve got this vital bit of equipment, this method of ovulation testing is relatively inexpensive as the microscope can be used again and again. However, it isn’t the best method of ovulation detection. A review of different home-use methods of predicting ovulation concluded that salivary ferning was not as accurate as L

Sandy asks…

i was taking clearblue ovulation tests and the control line always shows up but there is no result line. why?

the instructions indicate that a result line should always show up. if it is light there is no LH surge. if it is the same color as the control line, there is a surge. i never get a result line. ive taken pregnancy tests but they are negative.could i still be pregnant? are there any better tests?

Pregnancy Advisor’s answers:

Call the manufacturer or refer to the directions. It sounds like a defective monitor or you are not doing it correctly.

Helen asks…

28 Day cycle, LH day 18, missed period of 3 days, negative pregnancy result?

Ok – My husband and I are trying for a baby –

With the help of an ovulation kit we found that my LH levels were highest on day 18……

My period was due this weekend – I am now 3 days late – but this morning….a negative on the pregnancy test – do I have to wait to do a test as my LH surge is so late in the cycle?

Pregnancy Advisor’s answers:

I didnt get positive until 12 days or so into my missed period :) i also know women that didnt get pos. Until like 4-5 weeks.. Crazy, huh? Good luck :) you very may well be.

Betty asks…

Can a positive ovulation test show you are pregnant if you didnt know you were? Not just Ovulation?

Pregnancy Advisor’s answers:

OPK’s as HPT’s:
using an ovulation test to confirm pregnancy

Overall– yes, it can be done. Ovulation predictor tests (known as OPK’s because they are normally sold in a set of tests known as a “kit,” thus the K) will show a positive result when a woman is pregnant, as well as when she’s ovulating.

Specifically– while it works most of the time, there are good reasons to avoid using an OPK as an HPT for diagnostic purposes. If you want to pee on any stick that will stand still after you know you’re pregnant, just for fun, have at it. But I would not recommend using an OPK in place of an HPT overall.

Reasoning– OPK’s detect LH (luteinizing hormone) which is the hormone associated with ovulation. Pregnancy tests detect hCG, the hormone associated with pregnancy. LH and hCG are, at a molecular level, nearly identical. HCG has a beta subunit, meaning it has an extra little “doodad.” To use a stupid but easy to understand example, LH and hCG are identical twins, except that hCG wears a funny hat.

An OPK tests only for the part of the molecule that LH and hCG have in common (the “face” or “body” of the identical twins.) Essentially an OPK is saying:

So an OPK will turn positive when it detects either of the “identical twins”– ovulation or pregnancy hormone.

The reverse is not true, however, because an HPT tests for the part of the molecule that is unique to hCG (the “hat.”) So an HPT would say:

Therefore, a pregnancy test will turn positive only in the presence of hCG, whereas an OPK will turn positive in the presence of hCG or LH.

Now, it’s important to note that OPK’s work differently than HPT’s. A pregnancy test will develop 2 lines only if hCG (pregnancy hormone) is detected. Thus, “a line is a line” when determining a positive HPT. OPK’s work differently. An OPK has a “control” line and a “test” line, just like an HPT. Unlike an HPT, however, the mere presence of a “test” line does not mean the test is positive. The test line must be as dark as, or darker than, the control line to be a positive result (meaning that a surge was detected, rather than the ordinary amount of LH usually found in your urine every day.)

This means that there is already some ambiguity involved in reading an OPK’s results. Sometimes the line is almost as dark as the control line, but perhaps not quite as dark. Sometimes only the edge turns dark, or the top half of the line is darker than the bottom.

Additionally, OPK’s are not as sensitive as a lot of HPT’s are. This means that, if pregnant, you are likely to get a positive HPT earlier than you would get a positive OPK.
Most importantly, OPK’s are not purified as well as HPT’s are. Therefore, they are more prone to “errors” and positives do not always mean that either LH or hCG was detected. In other words . . . They’re simply cheaper, shoddier tests.

Finally, research has shown there are actually different kinds of hCG. In some cases (most common in early pregnancy, or in pregnancies with chromosomal abnormalities) the hCG molecule may become “nicked” or “cleaved” (partially or completely separating into its alpha and beta units.) Ovulation tests may not recognize (cross-react) with all types of hCG molecules, and may be falsely negative during pregnancy. (An in-depth explanation of this is coming soon!)

At the end of the day, a positive result on an HPT means you are pregnant. A positive result on an OPK could mean you are near ovulation, pregnant, or the test is picking up an entirely different hormone or element. Or it may be negative even if a woman is pregnant. With a positive HPT there is no doubt; a positive OPK may provide a clue, but doesn’t really give you an answer for sure.

So, my personal rule of thumb: use HPT’s for pregnancy detection, and OPK’s for ovulation.

If you already have your positive HPT and just want to “play” with tests, of course, that’s something else entirely ;) So, for fun, ogle my OPK’s. (They are Inverness brand cassette tests.) The one on the left is negative. It was taken at 9 DPO. I was pregnant, but my baby had not yet implanted (it was therefore too early for a positive test of any kind.) The one on the right was taken at 13 DPO, the day after I got a positive pregnancy test. The test line is clearly darker than the reference line, and is therefore positive.

Additionally . . . Some women have experimented with the principle that an OPK, even if it’s negative, will become increasingly darker if she is pregnant. (I did have a woman send me pics of this– she took an OPK and HPT with the same urine during the “two week wait”– 2WW– and her OPK’s did become increasingly dark. The HPT turned positive on the same day the OPK did. I am trying to find these pics because they were given to me before my old computer died . . . Files are backed up, but not sure where! :-/ Anyway.) However, the question remains– will an OPK always become increasingly dark if a woman is pregnant? Do increasingly dark OPK’s always indicate pregnancy? In an effort to find out, I have been performing this experiment myself.

Remember: an OPK is only positive if both lines are equally dark (or if the TEST line is darker than the CONTROL line.) An OPK may show a faint test line in the presence of very little LH or hCG.


Donna asks…

when should a woman have sex in order to become pregnant?

Pregnancy Advisor’s answers:

If you’re reading this article, chances are you’re not pregnant yet but would like to be soon. For approximately 85 percent of American couples, conception happens fairly easily, and we hope you’re among them. During the times in your life when you’re trying not to have a baby, you know that having unprotected sex just once can result in pregnancy. But the truth is, conception doesn’t happen quite as quickly as you may think, particularly when you’re 35 or older. Even if you’re younger and you time intercourse perfectly, “you have only a 20 percent chance of getting pregnant each month,” says Bryan D. Cowan, M.D., a reproductive endocrinologist and chairman of the department of obstetrics and gynecology at the University of Mississippi Medical Center in Jackson. In the following pages, you’ll learn how to improve your chances of getting pregnant “naturally,” and find expert information on what to do if you don’t.

Before you start trying

Cut out caffeine, alcohol and cigarettes Caffeine may increase the risk of endometriosis, a known cause of infertility. (It also can damage sperm.) Having as few as five alcoholic drinks a week can impair conception, according to Resolve, an infertility association. And smoking can speed the loss of eggs, affect sperm quality and may even accelerate menopause by several years.

Stop overexercising Women who regularly do vigorous aerobic exercise may stop ovulating. While most doctors believe moderate exercise is fine, some disagree. “For certain women, even moderate levels of exertion may contribute to infertility,” says Alice D. Domar, Ph.D., director of the Mind/Body Center for Women’s Health at Boston IVF. She recommends that women who are not conceiving take a three-month break from any exercise that raises the heart rate to more than 110 beats per minute.

Achieve your ideal weight Having too much or too little body fat can cause irregular or infrequent ovulation. “Women whose body mass index [BMI] is between 24 and 30 are most fertile,” Domar says.

Reduce stress and depression There’s evidence that negative emotional states can make it harder for a woman to conceive, Domar says.

What to do first

>See your OB-GYN Your doctor will test for infections, including fertility-harming sexually transmitted diseases; monitor any chronic health problems; give you a prescription for prenatal vitamins containing folic acid; and review any medications you take.

>Discontinue using birth control pills Stop taking them at least one full cycle before you start trying to conceive, advises Marian Damewood, M.D., chairwoman of the department of OB-GYN at York Hospital in York, Pa., and president of the American Society for Reproductive Medicine.
>Determine when you’re ovulating “When used correctly, [all three of the following methods] are relatively reliable in telling time of ovulation, but none is perfect,” says Lee C. Kao, M.D., co-director of the Center for Reproductive Medicine at Cedars-Sinai Medical Center in Los Angeles.
Body temperature Take your temperature first thing every morning before you stir; it drops about a half-degree when you ovulate. Be aware that false readings are common, and the method can’t predict ovulation, only tell you that it’s happened, Damewood says.
Cervical mucus When you ovulate, cervical mucus increases in volume and becomes thinner and “stretchier.” Some women may notice the change.
Ovulation-predictor kits Over-the-counter urine tests such as First Response (about $28) and Answer (about $18) monitor levels of luteinizing hormone (LH), which surges 24 to 36 hours before ovulation. “I consider this method most reliable, based on clinical studies,” Kao says.
>Time intercourse Have sex every other day beginning a few days before ovulation until a few days after. In a 28-day cycle, this would be from day 10 to day 18 (the day your period starts is day 1). Having sex more often may cause sperm levels to fall too low in a man with an already low count.

If it’s not happening

If you are under 35, seek medical advice if you’re not pregnant after a year of unprotected sex. If something in your medical history may impact your fertility, such as a sexually transmitted disease or pelvic surgery, see a doctor after six months of trying. Same if you’re over 35; egg quality declines quickly then. “Age has a dramatic effect on ability to conceive,” says Gilbert Haas, M.D., of the Center for Reproductive Health in Oklahoma City. If you’re 35 or older, the longer you wait to seek help, the less likely it is that a doctor will be able to help you conceive.

> Have your partner get an infertility exam The most common causes of male infertility are varicocele (dilated veins in the scrotum) and obstruction of sperm pathways; both usually can be corrected with outpatient surgery. While no medications can improve sperm count or motility (movement), procedures such as intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI) may help bypass the problem. Home tests such as Babystart and SpermConfirm measure sperm count and/or motility. However, a normal result doesn’t necessarily mean that a man’s sperm is not the issue, because these tests don’t check for all the factors that can contribute to problems. Unfortunately, for more than 20 percent of infertile men, the cause is unexplained, according to Peter N. Kolettis, M.D., an associate professor of urology at the University of Alabama at Birmingham.

>See a doctor yourself The older you are and the more complicated your medical history, the better it is to see a doctor with extensive training and experience in infertility. The good news is doctors can correct many problems with surgery, hormones and other medications. The diagnostic procedures you may undergo involve blood tests (including a check of your thyroid and progesterone levels), a biopsy of the uterine lining, a hystero-salpingogram (dye is injected to see if your uterus and tubes are normal) and a laparoscopy, which looks for endometriosis and adhesions in the tubes.
>Investigate infertility centers and costs The Centers for Disease Control and Prevention tracks infertility clinics’ success rates at For a list of the 15 states that mandate insurance coverage for infertility treatment, go to If you’re not covered, you may be drawn to the “package deals” some clinics offer. For example, some promise to provide a certain number of assisted reproductive technology cycles for a fixed fee or to refund money if treatment fails. Although some of these are legitimate, you should investigate them closely before agreeing to a package deal.

Alternative Approaches
“Non-Western” practices to enhance fertility are best used in concert with traditional medicine, says Mark Bush, M.D., of Conceptions Women’s Health and Fertility Specialists in Boulder, Colo. “If a woman has blocked [fallopian] tubes, she can take all the herbs in the world and they won’t get her pregnant,” he says. Once you and your partner have been checked out, here are some approaches you may want to investigate.

Mind/body techniques A study published in Fertility and Sterility in 2000 found that about half of the women in either a support group or a cognitive-behavioral group became pregnant, compared with only 20 percent in a control group. (Cognitive-behavioral therapy involves learning to “reframe” negative thoughts like I will never have a baby to I am doing everything I can to try to get pregnant.) “Women with fertility issues have a high degree of depression, anxiety and isolation,” says Elizabeth Grill, Psy.D., a clinical psychologist at the Center for Reproductive Medicine and Infertility at Cornell Medical School in New York City. Grill offers women a “toolbox” of coping methods, including deep abdominal breathing, meditation, self-care, visualization and cognitive therapy.

Acupuncture “Acupuncture increases blood flow to the uterus and decreases stress hormones, both of which help pregnancy attempts,” says Ann Cotter, M.D., medical director of the Atlantic Mind Body Center in Morristown, N.J. Several good studies report high success rates when acupuncture and in vitro
fertilization are combined.

Herbs Preliminary research has yielded good results with a nutritional supplement that includes chasteberry and green-tea extracts. However, experts say it’s best not to self-prescribe, so seek a qualified herbalist. The American Herbalist Guild sets standards; look for “A.H.G” after a practitioner’s name. Licensed acupuncturists (L.Ac.’s) and naturopathic physicians (N.D.’s) from an accredited four-year school also can prescribe herbs. — MARY JANE HORTON

Is it him or you?
The most common causes of infertility are problems with eggs and ovulation, the fallopian tubes and sperm. According to Resolve, 40 percent of infertility is due to a female factor, 40 percent to a male factor and 10 percent to a combination of male and female factors; 10 percent is unexplained.

Infertility’s Toll On A Marriage
Infertility is one of the most stressful things to befall a marriage, says Kristen Magnacca, author of Love and Infertility (LifeLine Press, 2004). It can trigger arguments, mood swings and feelings of isolation. What’s more, it can take all of the fun out of your sex life. “You’re making a baby, not making love,” Magnacca says. She recommends scheduling enjoyable, non-baby-making sex in the early part of your menstrual cycle and seeking counseling if needed. She also encourages having a written “fertility game plan.” “This ensures that both parties are on the same page,” Magnacca says.

Going the high-tech route
The following commonly performed fertility treatments are roughly listed from least to most invasive (and expensive). Costs depend largely on location, and success rates are very approximate because they vary greatly based on several factors, including a woman’s age, her and her partner’s diagnoses or health history and where the procedure is performed.

> The American Society for Reproductive Medicine provides referrals to reproductive endocrinologists; 205-978-5000,
> Resolve is a national infertility association that provides education, advocacy and support; 888-623-0744,
> Serono Inc., a manufacturer of fertility drugs, offers a free Fertility LifeLines program. Call 866-538-7879 for information about treatment, support groups and specialist referrals.
> The Society for Assisted Reproductive Technology can help you locate a fertility clinic; 205-978-5000,

Go to and put in your period info and it will calculate when you will be fertile and when you will ovulate.

Good Luck

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