Taking a urine test to detect ovulation (and then having sex when you’re most fertile) may be successful for some couples trying to conceive, according to recent updates on a Cochrane review.
The research showed that the chance of pregnancy using timed intercourse after an ovulation test was between 20% to 28% (compared to 18% in couples who had spontaneous intercourse). But lead author Tatjana Gibbons, a student at the University of Oxford, said more evidence is needed to know for sure whether there is a correlation between using the tests and a greater likelihood of getting pregnant.
The over-the-counter urine tests predict which days a woman is most likely to ovulate. These fertility tests detect increases in your urine’s luteinizing hormone (LH) and E3G, which are high around the time you ovulate. Based on that, people know when to have intercourse.
The technology is in a series of over-the-counter tests. Dr. Gibbons tells Motherly that the study was focused on ovulation predictor tests from Clearblue. Clearblue did not fund the study.
Some urine tests use the strips in combination with data via an app, so you can track everything on your smartphone and then know when your best fertility window is. Other period tracking apps simply help you track your menstrual cycle along with other factors and guess when you are most likely to get pregnant. There are also wearable devices (and even an in-ear temperature monitor) that can measure a variety of physiological parameters to determine the best times to try to conceive. (Here are our favorites.)
Related: Here’s How to Talk to Your Partner About Sperm Testing, According to a Fertility Doctor
While the urine tests showed some promise in Gibbons’ research, there was not as much evidence on conception outcomes for other fertility awareness-based contraception (FABM) methods such as the use of period tracking apps, calendars, cervical mucus analysis or body temperature devices, Dr. Gibbons noted in a statement.
Dr. Gibbons presented the information at the latest meeting of the European Society for Human Reproduction and Embryology in early July.
Urine-based ovulation tests: What we know
Previous research has found some advantages of using urine-based ovulation tests compared to other methods. There isn’t much out there in peer-reviewed journals about the effectiveness of other FABM methods, although we do know that some markers can indicate ovulation, such as basal body temperature and hormone fluctuations. By testing your urine, ovulation predictor tests offer something a little more concrete.
A 2019 study found that evaluating your urine progesterone (pregnanediol-3-glucuronide, PDG) level after an LH surge perfectly predicted ovulation. Urine tests that measure PDG are also already on the market.
Behind the results
The Cochrane analysis involved evaluating the effectiveness of timed intercourse used in conjunction with ovulation detection methods. Researchers looked at digital apps linked to urine monitors, urine ovulation tests and other FABM.
Dr. Gibbons’ team reviewed six studies involving 2,374 women trying to conceive.
The big find: Taking a urine test to track your best time to ovulate — and then having sex during that optimal fertility window — was linked to higher pregnancy rates compared to rates in couples who didn’t plan intercourse would not have (Kills the spontaneity factor, we know.)
Related: How to Make a Baby: The Quick and Dirty Guide to Getting Pregnant
Here’s where the data gets tricky (or in scientific terms, “inconclusive”): It wasn’t clear whether timely intercourse with FABM resulted in a difference in live birth or pregnancy rates, since that data was only available from two studies involving only 160. women. The evidence was not exactly solid.
There was an advantage in couples trying to conceive for less than 12 months. But there was “insufficient evidence” that the results might be the same for couples who had been trying for longer than 12 months.
Data were also insufficient in terms of finding studies that reported on factors such as how long it took to conceive using the ovulation tracker and timed intercourse methods, as well as data on live birth, quality of life and adverse events such as stress.
Just this year, a study published on the Clearblue Connected Ovulation Test System correlated test use with live birth rate. (Full disclosure: This was funded by the test manufacturer.)
Prediction of fertility
Specifically, Dr. Gibbons said she would like to learn more about any adverse effects of timed intercourse and its effectiveness in different groups, such as people with unexplained infertility. This must be in place before doctors promote the practice. She would also like to see more research into the use of fertility awareness-based methods (FABM), she said in a statement.
To sum it up, ovulation predictor tests can be a great way to track your optimal fertility window. Of course, there are no guarantees that this will lead to conception. Still, for those using the tests hoping to conceive, it may offer a glimmer of hope with at least some data to back it up.
Bouchard, T., Fehring, R., Schneider, M. Pilot evaluation of a new urine progesterone test to confirm ovulation in women using a fertility monitor. Frontiers in Public Health. 2019. 7:184. doi:10.3389/fpubh.2019.00184
Johnson, S., Bond, S., Grace, B., et al. Increased chance of live birth after use of linked ovulation testing system: Outcome results of a randomized controlled trial. Women’s Health Reports. 2022.60-66. doi:10.1089/whr.2021.0102
Manders M, McLindon L, Schulze B, Beckmann MM, Kremer JA, Farquhar C. Timed intercourse for couples trying to conceive. Cochrane Database Syst Rev. 2015;(3):CD011345. Published 2015 March 17. doi:10.1002/14651858.CD011345.pub2
Su HW, Yi YC, Wei TY, Chang TC, Cheng CM, et al. Detection of ovulation, an overview of currently available methods. Bioeng Transl Med. 2017 May 16;2(3):238-246. doi: 10.1002/btm2.10058
Yeh PT, Kennedy CE, Van der Poel S, et al. Should home-based ovulation predictor kits be offered as an adjunctive approach to fertility management for women and couples desiring pregnancy? A systematic review and meta-analysis. BMJ Global Health 2019;4:e001403. doi:10.1136/bmjgh-2019-001403