Whether you're trying to conceive, prevent pregnancy, or understand your body better, OPKs (Ovulation Predictor Kits) can be pretty darn helpful.  ​Ovulation predictor kits react to the luteinizing hormone that is present in urine, which is at its peak 12–36 hours before the egg is released (or ovulation). While they are not my favorite way of determining ovulation, they are fairly easy to use and have a high accuracy rating. That being said, OPKs come with a few perimeters and a bit of a learning curve.

Below are the basics, pros and cons, tips, brands, and the problems we run across the most in the clinic. 

Which to Choose

Fertility Monitors 
I've found that patients new to tracking their cycle will choose fertility monitors, such as ClearBlue, to track ovulation. These are a bit more high tech because they involve plugging the tests into a small machine that signals low, medium, or high fertility because they track both luteinizing hormone and estrogen levels.
Pros

• The Clearblue ovulation test detects your four most fertile days (most kits usually predict two) by tracking both LH surge and estrogen. Test once per day until estrogen levels rise, indicating high fertility (displayed with a flashing smiley face). Peak fertility happens after the LH surge, and it’s displayed with a static smiley face.
• Considered to be 99% effective

Cons: The reason this is not my favorite:

• women's hormones aren't synced up the way the monitor is programmed to look for, so they never get the high fertility signal and are left confused about when ovulation is actually happening.
• Possibility of the monitor acting glitchy or not working at all.
• Since a majority of women are tracking their cycle over several months, this option can become expensive.
• Not a good option if you are over 40 or PCOS.
• Now this is an Elanita style complaints, the whole smiley face thing feels less scientific to me and kinda patronizing.

Ovulation Strips
These are as basic as it comes, They have one line for negative and two lines for positive, because they only track the rise in luteinizing hormone. When used every day you can see the line get darker and darker until it peaks.
Pros:

• Less expensive, especially the dip strip format, so you can buy a ton in bulk.
  • Some examples are Babi or Clinical Guard

Cons

• You need to pee into a clean cup first before dipping the test strip in depending on where you are when you test, this might require some coordination, or you might opt for the slightly more expensive midstream version (like these).
• Only track LH 

User's Manual
OPKs are designed to test your urine for luteinizing hormone, which peaks mid-day, so I usually recommend testing sometime between noon-5pm.  Begin testing 4-5 days prior to when it's estimated you ovulate, and test every day until after you get a positive.  Some tests also often recommend you stop testing once you get a peak, but some women get at least 2 or 3 days of luteinizing hormone peaking before ovulation actually occurs. You can't know which day was your peak day unless you see another negative test again.

Review!

• You should start taking tests several days before the expected ovulation (with a regular 28-day cycle, you should start on day 11–12).
• Continue taking the tests until the result is positive.
• It is better to do tests twice a day (but do not use the first morning urine).
• Before taking a test, do not drink a lot of water and do not urinate for about 4 hours.
• Follow the instructions closely (collect urine in a clean container, put the test strip in it for no more than 10 seconds, check the result no later than 10 minutes).
• Track this info in your fertility app or on a graph!  This is a great way to get a better understanding of your cycle. 
• To determine fertile days most accurately, you can additionally measure your basal temperature and/or monitor your cervical mucus during the cycle.

5 Common Problems We See In The Clinic

1. OPKs do NOT confirm that ovulation has occurred
Although both urine and saliva kits test for increased hormone levels prior to ovulation, they do not confirm whether ovulation actually occurred. An LH surge can sometimes occur without the release of an egg.  Likewise increased estrogen levels are not always followed by ovulation.

2. It is possible to miss the LH surge
Because the LH surge can be extremely brief, it can be easy to miss. For this reason, some women may need to test their urine twice a day. If you find that your OPK is never positive, you may just be missing the LH surge. However, it could also mean that you’re not ovulating.

3. You may experience a ‘False’ LH surge
It’s possible to have a ‘false’ LH surge before the ‘real’ one occurs. This can result in timing intercourse too early and missing your true fertile time. Women with PCOS (Polycystic Ovary Syndrome) can continually produce false LH surges.

4. Knowing when to test can be difficult (and can end up being expensive!)
If you have irregular cycles, it can be a challenge to know when to begin testing with an OPK. Because the day of ovulation can vary widely between cycles and a urine based kit typically contains a limited number of tests, one kit is sometimes not enough. This can soon become expensive

5. Ovulation predictor kits will NOT alert you to a fertility problem
An OPK can only identify when you might ovulate and will not provide other valuable information about your fertility. This is why we always recommend to collect at least 3 months worth of data before "trying" to conceive and use in tandem with another tracking method until you have a good grasp on your cycle. 
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