Positive ovulation test but no egg white cervical mucus

I see lots of pictures on social media of Ovulation Predictor Kits (OPK) and women asking for advice about whether or not they have ovulated.

I’m here to let you in on a little secret: The OPK’s do not tell you if you have ovulated, only that your hormones are surging in anticipation of ovulation.

Let’s take a step back and talk about what the OPK is testing and why it does not tell you that you have ovulated that month.

A little biology

You are a wonderful cyclical being, you are never the same each day, and your hormones are never the same each day.  This cyclical hormone dance that takes place each month in our bodies (when we are not on hormonal birth control), is responsible for the maturation of a follicle into an egg that can be released and then fertilized to create your baby!

What the OPK is measuring is part of that hormonal cycle, specifically a hormone called Luteinizing Hormone which rises and peaks before ovulation and signals the ovaries to release the mature egg.  The OPKs help you predict when you may ovulate and help you to time intercourse around the time of ovulation, which can be extremely helpful if you have irregular cycles.  But, relying solely on the information from OPKs is not the full picture because you can have a positive OPK and not ovulate.

Did you actually ovulate?

Since OPKs only predict when you may ovulate, they do not actually tell you if you did ovulate.  There are two ways to determine IF you ovulated:

1. Get a blood test. Your doctor can order a blood test to check your progesterone levels in the second half of you cycle. After the egg is released, the covering around the developing egg, the corpus luteum, produces progesterone which will help maintain the lining in the uterus so the egg can implant. If you did not ovulate, you will have no corpus luteum, and low progesterone.

2. Track your basal body temperature (BBT) Your basal body temperature is taken first thing upon waking with a sensitive basal body thermometer which can detect small shifts in your temperature. Your body temperature will rise in response to progesterone released by the corpus luteum. One thing to note, this temperature shift occurs after ovulation so it will confirm that you did release an egg, BUT to track when you are about to ovulate, you need to be aware of your other fertility signs.

Fertility Signs

In addition to using your BBT to determine if you have ovulated, you can track 2 other fertility signs that will help you predict when you are about to ovulate.  Those two signs are cervical mucus and the height of your cervix.

Cervical mucus Before ovulation, the cervix produces a specific type of fluid that helps the sperm travel to the fallopian tube to fertilize the egg.  In the 3-5 days leading up to ovulation, your cervical mucus will become an egg white consistency, clear and stretchy.  This is your fertile mucus and keeping track of  it will help you to determine your fertile window.

Height of cervix In the days before ovulation, your cervix will change position and shape to help the sperm travel to the fallopian tubes.  By feeling the tip of your cervix, you will notice is change position from low and closed to a high and open position

Tracking your fertility signs is something anyone can learn, but each of us is unique and we each need to learn our own signs and get to know our own cycles.  

OPKs are a useful tool to help you learn, but gaining more knowledge about your own body is powerful and liberating so that you do not have to seek answers outside yourself, but can become a partner with your body.

Giving yourself time to get to know your cycle before you start trying is a valuable gift.  You can determine any underlying difficulties which may make it harder to get pregnant, and work to heal them.

Are you ready to start tracking your cycle?

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• Identifying ovulation is the most important knowledge you can have when trying to conceive
• The best time to attempt conception is when a woman’s cervical mucus is wet, slippery and of egg white consistency, usually over a 2–3-day period immediately before ovulation
• Timing of sex relative to ovulation is vital
• As sperm can live for up to 3–5 days in good quality mucus it is best to try and have intercourse in the 2–3 days preceding and on the day of egg release (ovulation)
• Couples who have intercourse every one to three days around the time of ovulation, and do not have any diagnosed fertility issues, do not need to time intercourse specifically and this may be detrimental
• Other tools such as temperature recording and ovulation kits can be of some use, but use with caution as they identify ovulation, and the ideal time for conception is prior to ovulation.  When they give it a positive result, the fertile window is nearly over
• Don’t save sperm - fresh sperm is better than aged.  Ejaculation at least every three days is recommended

Women

Intercourse timing and frequency relative to ovulation is possibly the most important factor affecting the chances of conception. It is also the element over which couples trying to conceive have the greatest degree of control.

Couples who are aware of their fertile time and have intercourse during this time become pregnant more quickly.  Having sex during the fertile window also makes it easier for couples and their healthcare provider to decide whether not becoming pregnant is likely to be due to infertility rather than poor timing.

The ‘fertile window’ is determined by the lifespan of the sperm in the female reproductive tract and the life of the egg once it has been released at ovulation. Sperm live up to 3–5 days and the egg survives for 12–24 hours.  In fact, there is evidence that egg quality declines after 6–12 hours after ovulation, meaning the fertile window is shorter than commonly thought.  In this regard, it is imperative to have sex prior to ovulation, so there are sperm available when the egg is released.   Based on studies, the maximum fertile window has been determined to include the day of ovulation and the five days preceding ovulation. The most probable days for intercourse to result in pregnancy are 1 or 2 days before ovulation. 

The currently available evidence suggests that methods that prospectively identify the window of fertility are more effective than calendar calculations or basal body temperatures, for optimal timing of intercourse. These include fertility charting of vaginal discharge and using commercially available fertility monitors.  However, caution is advised when relying on urinary LH detection kits alone. The quality of cervical mucus falls rapidly as progesterone rises in response to the LH surge. Hence by the time the LH is detected by urinary ovulation kits, the cervical mucus quality may have already declined in most women.  It is the ‘ovulatory’ type mucus which enables the sperm to enter the uterus and thus reach the egg.

The best time to attempt conception is when a woman’s cervical mucus is wet, slippery and of egg white consistency, usually over a 2–3 day period. The last day of this fertile type mucus is usually the day of ovulation and should be followed by a temperature rise. The temperature rise confirms that ovulation has taken place. As sperm can live for up to 3–5 days it is best to try and have intercourse in the 2–3 days preceding and on the day of egg release (ovulation).

Ovulation Kits

Urine-based Ovulation Predictor Kits test the urine for an increase (surge) in luteinising hormone (LH). This happens 1–2 days before ovulation. A small amount of LH is always present in your blood and urine. But in the days before ovulation, the amount increases several fold. The day before the LH surge until ovulation (12–24 hours after the start of the LH surge) is the most fertile time of your cycle. This is when you are most likely to conceive, so ensure that you do not wait until a positive LH test before having sex for conception.

Timing is important for men, too!

When assisted reproductive technology such as IVF is used, one days’ abstinence is often advised - in this case the quality of sperm is more important than the quantity.   Frequent ejaculation is better for the health of sperm while trying to conceive. Periods of abstinence longer than three days can be detrimental because of the accumulation of aged sperm. These are also the guidelines given when producing a sperm sample to be tested. 

Men may choose to ‘empty out’ 2-3 days before conception attempts, to get rid of aged sperm, then let count build up for a couple of days before conception attempts.  However, avoid this if it makes timing too complex and regimental.

Basal temperatures

Recording temperature is a retrospective tool to help understand your cycle, as it is important to have sperm already present when the egg is released – it will be too late once the temperature rise is detected. 

Your temperature readings confirm whether you have ovulated.   Your temperature rises because the ovaries switch from making estrogen to progesterone after ovulation.   You will have relatively low temperatures from the time of your period until you ovulate. Ovulation will then cause a rise of about 0.2°C. The beginning of the rise in temperature signifies ovulation. Once you have ovulated, the temperatures remain high until there is a dip just before your next period. Temperatures must be taken under the tongue with a digital thermometer first thing in the morning before getting out of bed. It is also important to note that your temperature may fluctuate in response to other factors, such as infections.

When to seek help

Learn when - and where - you should seek help with your fertility

Mucus signs

The nature of your cervical mucus tells you when you are approaching ovulation.  Mucus is stimulated by the rising levels of estrogen made by the follicle growing in the ovary.   The amount will increase as you get closer to ovulation. The texture can vary from none to pasty in the non-fertile phases, to stretchy or raw egg white consistency before and close to ovulation. Post ovulation the mucus generally changes back to the infertile type consistency.  Sperm requires this ‘egg white’ type mucus to swim through in order to fertilise the egg.  Recognising this mucus is therefore key to understanding your fertility.

Can you test positive for ovulation and not release an egg?

Do you always get egg white cervical mucus when ovulating?

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