Why LH Strips Aren’t Enough: How to Accurately Confirm Ovulation When TTC
When it comes to trying to conceive (TTC), you already know that identifying ovulation is KEY. Otherwise, you’re just guessing at your fertile window — and no one wants to waste time guessing.
One of the most popular tools for identifying ovulation is ovulation prediction kits (OPKs), also known as LH strips, which measure luteinizing hormone (LH). Many women desperately use LH strips month after month to try to identify ovulation, hoping for a clear sign of fertility — but are these strips enough to accurately confirm ovulation and maximize your chances of conception? Maybe not.
As a naturopathic doctor specializing in female fertility, trust me — I get wanting to take total control of your reproductive health. And ovulation tracking is a powerful tool, but relying solely on LH strips can leave pretty large gaps in understanding your cycle.
In this article, we’ll explore the limitations of LH strips and the best methods to track ovulation accurately.
What the heck is LH (Luteinizing Hormone)?
Luteinizing hormone (LH) is a hormone produced by the pituitary gland in your brain. It plays a crucial role in the menstrual cycle and ovulation process because it signals the ovary to release a mature egg, making ovulation even possible.
In simplest terms? — Think of LH as your brain’s signal telling your ovaries to ovulate.
How Do LH Strips Work?
LH strips are designed to detect the presence of LH in urine, helping women pinpoint their LH surge. LH typically rises 24-36 hours before ovulation, so by identifying this surge, women can time intercourse to maximize their chances of conception.
The problem: They Predict, But Don’t Confirm Ovulation
A positive LH strip result indicates that an LH surge has occurred, meaning ovulation may be approaching, BUT (and this is a big but), it doesn’t guarantee that ovulation will actually take place or that if ovulation does occur, that the egg will be viable for fertilization.
Potential Issues
Some women may experience an LH surge without ever actually ovulating — a condition known as luteinized unruptured follicle syndrome (LUFS). Other women, especially those with polycystic ovarian syndrome (PCOS) may experience multiple LH surges in a single cycle, making it difficult to pinpoint the most fertile window. And some women have a shorter and more subtle LH surge that isn’t as easily detected by low sensitivity LH strips. In short, LH strips don’t always provide the clear, reliable guidance many hope for when trying to time intercourse.
Understanding Ovulation Confirmation
When trying to conceive, it’s easy to focus solely on ovulation, but the process is much more complex. Ovulation isn't just about the surge in luteinizing hormone (LH) that LH strips measure—it's about ensuring the egg is fully matured, released at the right time, and ready for fertilization. Unfortunately, LH strips can’t confirm whether these crucial steps are happening correctly.
While LH strips predict when ovulation is likely to occur, they don’t tell you whether the egg is actually released, whether it’s of high quality, or if your body is producing enough progesterone to support implantation. Without understanding the full picture, you could be timing intercourse based on inaccurate information, potentially lowering your chances of conception
Anovulatory Cycles: A Leading Cause of Female Infertility
What is Anovulation?
Anovulation occurs when ovulation doesn’t happen, even if a woman has regular periods. It’s one of the most common causes of female infertility.
Anovulation can be caused by hormonal imbalances, stress, nutritional deficiencies, or underlying conditions like polycystic ovary syndrome (PCOS). Without proper tracking, many women may not realize they aren’t ovulating at all.
If you rely solely on LH strips and they show a surge without ovulation, you may miss signs of anovulation. This can delay diagnosis and treatment, making conception more difficult.
What Can You Track Instead to More Accurately Confirm Ovulation?
Basal Body Temperature (BBT)
Tracking basal body temperature (BBT) is one of the most reliable ways to identify your fertile window and confirm ovulation. After ovulation, progesterone causes a slight, but sustained rise in body temperature. By charting BBT daily, you can track this temperature shift and confirm when ovulation has occurred.
Cervical Mucus Changes
Cervical mucus is a key fertility sign. Leading up to ovulation, it becomes clear, stretchy, and slippery, resembling egg whites. After ovulation, it becomes thicker and drier, signaling the end of the fertile window. You can learn more about it here.
Mid-Luteal Progesterone
Because progesterone is produced as a result of ovulation, measuring progesterone levels 7-10 days after suspected ovulation can confirm whether it actually took place. You can either get a blood test for progesterone, or test pregnanediol (PdG), a urinary metabolite of progesterone, at home in your urine.
Ultrasound or Blood Work
For more precise confirmation, a fertility specialist can use ultrasounds or serial blood tests to track follicle development, egg release, and progesterone levels.
How to Track your Fertility like a Pro:
Use LH strips to identify an LH surge and predict ovulation.
Track BBT to confirm that ovulation occurred.
Observe cervical mucus for additional ovulation signs.
Consider progesterone testing in the mid-luteal phase to confirm that ovulation occurred.
Taking Control of Your Fertility
If you're ready to stop second-guessing your cycle and start tracking with confidence, my course The Fertility Code will guide you step by step. You’ll learn how to interpret your body’s signals and take back control of your fertility journey.
If you’d like a more personalized approach to your fertility that includes, but goes beyond tracking ovulation accurately, let’s get you on my calendar. Together, we can create a tailored plan using natural, evidence-based methods to support your fertility journey and I’d be honored to support you.
