Multiple Positive OPKs

It's not uncommon for women to have two positive OPKs (ovulation prediction kits). But what about three, four, five...? This has happened to me too. When trying to conceive my first two children, I would usually get one or two positive ovulation tests and the rest were negative. However, when I started trying to conceive a third child, I kept getting close to / positive ovulation tests while waiting for my postpartum menstrual cycle. Every test looked about the same.

 The more close to positive / positive ovulation tests I saw, the more confused I got. Had I ovulated? Was I in my two-week wait? Did my body fail to ovulate and keeps trying to? What was going on? This prompted me to do some research about ovulation prediction kits (OPKs) and LH surges. Here are some tips I have learned about multiple positive OPKs.

1. Chart Your Cycles with BBT (basal body temperature) + OPKs (ovulation prediction kits)
The BBT will confirm that you ovulated. It's harder to determine when you may ovulate with just using OPKs alone. According to FF (Fertility Friend), you could miss your LH surge, but still be fertile. Fertility Friend: OPKs

2. Avoid Testing in the Mornings with Your OPKs
Rumor has it FMU (first-morning urine) can give false positives on OPKs. Now that might just be a myth, but more literature says FMU is most likely going to give you a false negative.

• What if my ovulation tests say use first-morning urine?

That's fine if the manufacturer says to use urine at a certain time of day. However, my statement was about ovulation tests, in general, that morning urine is said to give false positives. That doesn't mean it gives false positives 100% of the time. It's similar to the statement that blue dye home pregnancy tests give false positives more than pink dye. It doesn't mean it 100% of the time, but it has happened enough times for it to be stated.

3. Test Until You Get 2 Negative OPKs in a row
According to FF (Fertility Friend), if you have multiple positive OPKs, the first positive OPK means that you are likely to ovulate and the last positive OPK may mean you just ovulated. Fertility Friend: OPKs

4. For Dates, Go off  Your First Positive OPK
Unless you know you ovulated on a day of a different one of your many positive OPKs, some literature suggests just going by the date of your first OPK. Medical Health Tests.com

5.  Continue Intimacy For A Week Pass Your Last Positive OPK
To increases your chances of catching your egg, some literature recommends being intimate up to a week after your last positive OPK. Some fertility apps and online charts may even suggest to consider yourself fertile 5-7 days before your positive OPK and 5-7 days after.

6. Change How You Read Your OPKs
For some women the test line on their OPKs can be equal to the control, however, it is not a true positive until the test line is darker than the control.

One of my mommy friends was kind enough to share one of her personal photos. To protect her identity, we will call her Rosie*.  Rosie* is a mom of 1 expecting her 2nd child. These are the ovulation tests from her cycle that she became pregnant with baby 2 and a perfect example in my opinion about reading OPKs differently. Many women stop testing after getting a seemingly positive test and they do not bother to see if the test gets darker or starts to fade and sometimes do not test to see if they have a clear negative for several days indicating ovulation has indeed occurred and ended. Some women have said they ovulate after the ovulation positive test turns negative, so that could be a several hours to a couple of days after the negative ovulation test that they ovulate. So you want several days of negative ovulation tests to indicate you really did ovulate. Notice in Rosie's * photo how her tests go from negative / low fertility, to close to positive /  high fertility (her close to positive looks like what may be a true positive for some women) to positive / peak. Her positive / peak, the test is actually darker than-than the control. Seeing this peak may help a woman with many multiples determine which are her true positive.

7. Confirm Your 2 Line OPKs With A Digital
If you're getting multiple OPKs, test line is equal in color to the control or the test line is darker than the control, you may want to confirm your 2 line OPK with a digital. You may find that all of your OPKs that have lines equal to the control, maybe negative on a digital. Often when I used testing strips where I thought the 2 lines on the strip looked positive, I would confirm with a digital and only record positive on the days where my 2 Line OPKs and digital both said positively.

8. LH  Keeps Trying to Surge
According to peestickparadise.com, some women catch the beginning of their surge with the first positive OPK and the end of their surge with the second positive OPK. However, other women may have a case where the body is gearing to ovulate, but for whatever reason does not and tries to start again until it may or may not ovulate. Pee Stick Paradise.com: FAQ OPKs

9. Anovulatory Cycle
Some anecdotes out there that I have read suggested, some women who did no ovulate in a cycle, had cycles notorious for positive ovulation tests. So this would occur if your LH somehow starts, but never finishes. Another sign that you might be heading towards an anovulatory cycle is if, in addition to the multiple positives, your crosshairs constantly keep appearing and then disappearing throughout your cycle. Or your cross hairs never appear throughout your cycle.

10. Rule out Waiting for a Postpartum Menstrual while Breastfeeding
My OB said OPKs can be less reliable while waiting for postpartum menstrual and it's better for one to start using OPKs once they have had a postpartum menstrual.  { However, I will say there is an exception to this rule because there are some breastfeeding women who have charted while waiting for their postpartum menstrual and caught their first egg, documenting positive ovulation tests as well. } 

11. Waiting for Postpartum Menstrual / First Few Postpartum Menstrual
A midwife I know says, sometimes while waiting for your postpartum menstrual or after having your first or a few postpartum menstrual, your body could do that for months depending on the woman, charting with no clear pattern and produce positive ovulation tests, but not actually ovulating. She says while there might not be ovulation, it seems like the body is probably trying to. This same midwife is the one who said my fertility charts while trying to conceive my second said many of my charts where Fertility Friend gave me cross hairs and a short luteal phase, she feels I did not actually ovulate until my 3rd, 6th, 8th and 9th menstrual cycle out of the 9 periods I had. To take a look at those charts, click here: 2nd: Fertility Charts

12. Rule Out Poly Cystic Ovarian Syndrome (PCOS)
Frequently having multiple OPKs could be a sign of PCOS, because some women with PCOS tend to have raised LH levels. My OB says 1-2 is normal, 3 max. 5-6 + is abnormal and probably could mean you are not ovulating.

Bonus. 
Popular Claim: Ovulation Tests Might Confirm Pregnancy

Some say OPKs (ovulation prediction kits) can detect pregnancy. Do not substitute this method for considering yourself pregnant or not pregnant.  Always take a pregnancy test to help confirm if you are pregnant or not and visit your health care provider for prenatal care if you are. 

OPKs are designed to look for LH (luteinizing hormone) and pregnancy tests for hCG. OPKs detect both hormones, while pregnancy tests only detect hCG, making it more reliable to confirm pregnancy.

Also, LH is always present in our system, while hCG is present when "the fertilized embryo burrows itself and attaches to the uterine lining" (OPK as a HPT).  *However, there can be other reasons where hCG may be detected that are not related to pregnancy: "biochemical pregnancy, pituitary hCG, malignancy, and interfering antibodies" (Grenache).

According to Pee on a Stick Freak's article, OPK as a HPT, "If you’re getting multiple positive ovulation tests so many days past ovulation and nearing the end of your cycle, YOU MUST BE PREGNANT" (OPK as a HPT). If you're getting positive OPKs at the end of your cycle, you should probably be far enough along that you can get a positive pregnancy if you are really pregnant. 

From an online forum, I found a comment of a woman who said that she tested from 6-13 days past ovulation with OPKs. At 9 days past ovulation, she started getting positive OPKs again. At 14 days past ovulation, she had a positive pregnancy test. One thing she noticed was her OPKs never went back to negative, picking up the HCG for pregnancy. A lot of this probably has to do with the sensitivity of both the OPKs and pregnancy tests she used.

Another reason OPKs aren't a great way to test for pregnancy is some women have tried but did not get positive OPKs picking up on pregnancy until they were getting dark lines on their pregnancy tests. Which may have to do with the sensitivities of the test they are using, how much hCG is present in the urine at the time of testing and how far along the pregnant woman is while testing.

Finally,  a positive OPK during your two-week wait could mean nothing in terms of pregnancy. Another comment I read was a woman who said she had 10 positive OPKs in a row, but she was not pregnant.

One of my mommy friends was kind enough to share one of her personal photos. To protect her identity, we will call her Naomi *. Namoi * is a mom of 3 expecting her 4th child. She is currently 4 weeks and 6 days along in her pregnancy. She did confirm her pregnancy with an early home pregnancy test but also has been taking OPKs still. I have posted her photo below. 

The green is testing for LH (OPKs) and the pink are testing hCG (home pregnancy tests). She said her OPKs were steadily becoming darker again. She originally was just testing for ovulation in the beginning of her cycle. Her OPKs became blaring positives during 13-16 days past ovulation. Notice that her OPKs are dark like a positive OPK would be and her pregnancy tests are equally dark. 

HPTs (home pregnancy tests) and OPKs differ a little for a positive test. For HPTs, even a faint test line means positive, while with an OPK the test line has to be equal to or darker than the control to be considered positive.

Bibliography

"OPK as a HPT?" Pee-On-A-Stick-Freak. Pee On A Stick Freak & Word Press, 15 Mar. 2015. Web. 03 Jan. 2017. <http://peeonastickfreak.com/opk-as-a-hpt/>.

PhD, Grenache, David. "Four Reasons for a Positive HCG Test in the Absence of Pregnancy." The Pregnancy Lab. The Pregnancy Lab, 17 Oct. 2011. Web. 03 Jan. 2017. <http://www.pregnancylab.net/2011/10/four-reasons-for-positive-hcg-test-in-the-absence-of-pregnancy.html>.

Last Edited: January 3, 2017