Monday, January 11, 2010

How To Use LH Tests

We've established that identifying ovulation is the key to NFP success, but how do we go about doing that? Other methods of NFP recommend tracking all sorts of things like basal body temperature, the position of the cervix, quality of cervical mucus, etc. My advice is to use whatever information is helpful to you. I could never remember to take my temperature, found it really tricky to ascertain just what my cervix was up to, and the nursing woman may not have any cervical mucus(prolactin dries it up). I can attest to the fact that, so long as I was pumping milk for Jack, I had no physical indicators of fertility and had to rely solely on tests. These tests. The ones I ordered off Amazon. There is also the Clear Blue Easy ovulation monitor(which I've used), but it's expensive and it requires the presence of a regular cycle. With the tests I use now, you can test at anytime, with or without a cycle of any kind, even right after having a baby.
They come with handy instructions printed on each little test. Hold the stick in the urine stream for five seconds, or collect a urine sample in a disposable cup and follow the instructions on the test.

Interpreting the results of the test strip can take some getting used so, since it's a little different than using a pregnancy test. In the above picture, the strip on the top is negative for LH. The strip on the bottom is positive for LH. A positive LH test means that the LH Surge has begun and I will ovulate within 24-72 hours. Now that my cycles have normalized, my LH Surge lasts about 24 hours. While I was still nursing Matteas, my LH Surge was sometimes as long as 72 hours. That meant that I might not ovulate until three days after getting a positive LH test.
And now, a close-up. Here's how it works: the pink line on the right(the one closest to the green strip with the letters 'LH' on it)is the "control line." That line shows up no matter what, even if all you do is dip the strip in water. It's for comparison.

The line that's really important is the one next to the control line, the one to the left of the control line. Depending on when in your cycle you test, you may or may not see this line show up. It's mere presence doesn't indicate a positive test; it needs to be darker than or as dark as the control line. If you did one of these tests everyday after your period, you'd most likely see something like this:

Day 7: control line only(negative LH test)

Day 8: control line only(negative LH test)

Day 9: control line only(negative LH test)

Day 10: control line only(negative LH test)

Day 11: control line and very faint test line(negative LH test)

Day 12: control line and faint test line, test line a little stronger than day 11(negative LH test)

Day 13: control line and very dark test line, test line being as dark as or darker than control line(this is a positive LH test)

Day 14: control line and very dark test line, test line being as dark as or darker than control line(still positive)

Day 15: control line and test line growing faint, test line no longer as dark as control line(negative LH test)

That's just a possibility; you may only get one positive test and the test line may fade gradually or rapidly. It will seem confusing at first, but you'll get used to it.

Some Things I Recommend
Keep a calendar. Write everything down. Symptoms, lack of symptoms, when you have sex, any possible symptoms of ovulation. Even if your husband looks extra cute, write that down. You might think nothing of it at the time, but if a few weeks down the road you get a positive pregnancy test, looking back over your notes you will say "Ohhhhh...."

So you've established a positive LH Surge, what now?

The 72-hour Method
For the beginner, I recommend that you continue testing until you get a negative LH test. Since the length of the LH Surge can vary(especially if you're breastfeeding), I recommend testing every 12 hours(once in the morning and once at night) after the first positive test. Next, it's time for some math. Numbers vary on the lifespan of an egg, and range from 12-48 hours. I like to use 48 hours so my bases are covered. Once you get a negative LH test(after establishing your LH Surge), start counting. Assume that you're going to ovulate for 48 hours. So if you get a positive LH test on Monday morning and a negative LH test on Tuesday morning, assume you're ovulating from Tuesday morning until Thursday morning. Then I like to add a 24 hour buffer, just to be safe, meaning don't have sex until Friday morning. I know women who cut it a little closer and haven't gotten pregnant, but it depends on how comfortable you are taking a risk. If you are absolutely committed to avoiding pregnancy(whatever your reason), I recommend using the 72-hour method described above. I've been using it for two years with 100% success.

Test regularly at the same time of dayFeel free to do additional tests in between, but try maintaining a regular testing time(first thing in the morning is generally easiest).

Investigate more than one method of NFP
A friend of mine identified ovulation and further, that she was pregnant using the Basal Body Temperature method. I like my tests, she likes her thermometer. Find something you feel comfortable using.

I've read this whole blog, and I'm still confused
E-mail me! I've spent years researching reproductive health and would be more than happy to share anything I've learned with you. Whether you are a veteran NFP user, just starting out, or simply have questions for a friend, I believe that sharing information is key to NFP success. My e-mail address is


  1. I've used the little strips and was really excited so I did one every few hours or so for a few days. I found my surge was detectable for a short window. I got + at around 4pm, I'd had a negative that morning, and I got a negative that evening. I've continued multiple tests per day each cycle and have noticed similar patterns. Some people might want to do multiple tests until they get an idea of what their pattern is like.
    I also conceived from intercouse 6 days before ovulation. I was still nursing- 1.5 yrs post partum- and having up to 50 day cycles so I was way out from any bleeding. Although I did miscarry at 3 weeks, so something may have been wrong. But I did get a positive pregnancy test.

  2. This is exactly the kind of comment I was hoping for: something I've never heard of. Fertility can be such a different experience from one woman to another, so thanks for sharing. I've only experienced long or average LH surges, never anything as short as you're describing. I forgot to mention that I did test a lot while waiting for my cycle to return, but it sounds like someone with your hormone patterns would need to test even MORE often. If you don't mind sharing, were you able to detect any signs of returning fertility?

  3. To follow up on my comment, I had no typical signs of fertility returning. Not even the "my husband looks extra super cute today", which I find to be a typical indicator. Not thatI donn't normally think that. But sometimes I notice, ususally about 3 days before I get my surge, just a general "wow, guys are really neat" sort of appreciation. I saw a study done where people were able to detect ovulation by how a woman dressed. Its kind of funny but I did notice too I would feel like "dolling up" which for me means jeans nost sweats, and then lo and behold would find I was ovulating.
    Between my other two children I got pregnant, while still nursing for 1.5 yrs, without having cycled and any clues except for the "you look really nice today." Having used NFP for 3.6 yrs I have experienced a lot of the clues, and I often notice not having any.

  4. That is precisely the reason I like the LH sticks; after having a baby, I use them to test randomly. Other methods of NFP require that you notice and track symptoms of fertility, but for several cycles I didn't have any at all. I started doing an LH test about once a week and for months just got a control line. Then one day I planted flowers and organized my linen closet- guess who got a positive LH test?

    I've noticed the "I want to look a little nicer" thing too; I've even read studies where men were asked to pick from a series of pictures of the same woman which picture they liked best; almost without fail, men would pick the picture which corresponded to ovulation.

    That being said, I feel compelled to add that the first ovulation post-baby is, in my opinion, the trickiest part of NFP especially because there's often nursing hormones still involved. I have yet to find a reliable way to navigate that time period, other than random testing.

  5. Oh my GOSH, this is the most amazing thing I have ever read. Why have I never heard of this? Why have I spent six years beating my head against the stupid basal temperature and cervical mucus methods of NFP only to get pregnant every time I was SURE I had the hang of it? Seriously. This is amazing. Can't you work this into a method of use and promote it or something? I know there are lots of women like me who have abnormal cycles, who practice extended breastfeeding, and whose mucus patterns are basically wholly unreliable when it comes to determining fertility who would love this info. Thanks so much for the link...this is truly amazing. Maybe you should even email Marquette University with this post...this seems like the sort of thing they would be very interested in, given that they pioneered the use of the fertility monitor and even have a method to "force cycles" when breastfeeding.

  6. I am so glad I stumbled on this today! I had the very same idea, buying LH tests from Amazon, and some person on an NFP forum where I presented this idea pooh-poohed me. I am now opening a tab for Amazon and ordering an oodle or two of LH tests. I use Creighton and ecological breastfeeding, which got me an amazing 5 weeks of amenorrhea this time. :P Now I have constant fertile mucus and am supremely frustrated and confused. I am not good with temps,so maybe these strips are the magic key to a little more sex for me. Thank you SO much!

  7. I also thought about doing this exact thing! Thank you for doing this! I am almost four months pp and have been stressing about beginning NFP because I didnt really use it before getting pregnant. Question - so you know you will be getting an LH surge soon when you start to get a faint second line? so for those being cautious should begin abstaining, right? I confess to a great deal of nervousness regarding the idea of prolonged abstinence - some something that can tell definitively fertile or not without costing $300 + testing sticks sounds great to me

  8. Is there a source other than Amazon? I don't like to buy from them.

  9. My husband and I have been using Creighton for almost 4 years, I have been exclusively breastfeeding my little boy for 9 months, and I'm about to start using the LH tests in conjunction with NFP to help us avoid pregnancy. I've read some online reviews about when to use the LH tests -- not urinating for 3-4 hours before, not drinking a lot of water, etc. Can you comment on your experience with how long you wait to urinate and your water intake? I'm nursing so I try to drink water throughout the day. Thank you!