OBGYN and fertility expert Dr. Gleaton shares a comprehensive guide on understanding why you aren’t getting positive ovulation test results. 

 

By Dr. Kenosha Gleaton

Have you been diligently testing for ovulation, but have not gotten a positive test this cycle? 

Negative tests can be frustrating, but before concluding that you’ve missed your fertile window, consider a few other possibilities. The first (and most common reason) is that you may not be testing at the right time. The second is that your body may be experiencing one of many unique LH surge patterns (we don’t all ovulate at the same time!). With just a little detective work and this helpful guide, let’s help understand why you may not see a positive ovulation test result. 

When and how often should I test for ovulation?

Let's start with a brief summary on how ovulation tests work! Basically, an ovulation test is designed to measure your urinary luteinizing hormone (LH) level. When your LH level suddenly spikes, your body is given the signal to ovulate, which is known as your LH surge. So, a positive ovulation test result, or a test line which is as dark or darker than your control line, indicates that you are experiencing your LH surge and within 16-48 hours, you will start ovulating! The graph below shows an example of a common LH level pattern during a 28 cycle. As you can see, the LH surge occurs right before ovulation occurs. So, after receiving a positive ovulation test result, aim to have sex within the next day or so since you are within your fertile window! 

Now, it is highly important that you test during the right days of your cycle so you catch your LH surge. If you test too late in your cycle or stop testing too early, you may miss that window

So, back to our question, when and how often should you test? First, you’ll need to figure out the duration of your menstrual cycle to know when to start testing. To do this, count the day your period starts (the first day of full menstrual flow) as Day 1, and continue counting until the day before your next period starts. The total number of days is your cycle length. For most women, this is around 28 days. If your cycle length varies each month by more than three days, choose the shortest cycle you’ve had in the last six months. Then, use the table to figure out which day of your cycle to start testing and test everyday until the end of your cycle. 

You can test anytime of day, but make sure not to test after drinking a lot of fluid because it can dilute your urine. This is why many women prefer to test first thing in the morning when the urine is more concentrated. Make sure you carefully follow directions to ensure the more accurate results.

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Tracking your LH patterns - an LH surge late in the cycle 

When you first start using ovulation tests, I recommend documenting your first two to three cycles as it will help you understand how your urinary LH levels usually change throughout a cycle. Consequently, it will be much easier to predict when you will likely ovulate during future cycles! 

So, if you have not yet received a positive ovulation test result, there may be a chance that you are testing during a time when your LH surge does not occur.  For instance, here’s a case of one of our customers who tracked her LH starting on Day 10 who did not receive a positive result until Day 17 of her cycle. Had this mama stopped testing on cycle day 14 (which is the most common day for the LH surge), she would have missed her fertile window. 

We created our Ovulation Test Kit to make it easy to track an entire cycle. We provide 30 tests and a helpful tracker to neatly store your results.

We created our Ovulation Test Kit to make it easy to track an entire cycle. We provide 30 tests and a helpful tracker to neatly store your results. 

Other unique LH surge patterns 

Everyone has their own unique urinary LH level pattern. Though the most common is a single peak in the middle of a cycle, you may have a different pattern. 

A 2012 study of 281 cycles found four common urinary LH level patterns: 

  • Single-peaked: occurs in about 48% of women
  • Double-peaked: occurs in about 33% of women
  • Plateauing: occurs in about 11% of women 
  • Multiple-peaked: occurs in about 8% of women

However, there are many other types of LH patterns and your LH pattern may even change from cycle to cycle. To understand your unique cycle, keep testing until you identify your body’s most likely ovulation pattern. 

Fertile Window Takeaways 

  • Ovulation tests detect a spike in urinary LH, known as your LH surge, and correlates with a positive ovulation test result. This means you will ovulate within the next 16-48 hours.
  • If you do not see a  positive result, perhaps you are not testing during the right time of your cycle or the right time of day. To help troubleshoot, reference the table above and the instruction manual.
  • It is super important to log your LH level pattern in order to know when to expect your LH surge during your future cycles.
  • Remember that everyone’s body is different and beautiful in its own way, so we each have different hormonal changes and ovulate during different times. This may cause you to experience a different LH level pattern from the typical single-peaked pattern.
  • Various health issues may cause your body to not receive a signal to ovulate and you should contact your health provider if you are not receiving positive results for multiple cycles.