Re: OPK

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• In reply to: Brandie: "OPK"

OPKs (Ovulation Predictor Kits) detect LH (lutenizing hormone) rise. The LH rises before ovulation, around 34-36 hours prior to rupture of the follicle. The follicle is a tiny cyst on the ovary that contains the ova (egg) prior to release of the egg for travel down the fallopian tube. Ovulation actually occurs about 10-12 hours after the LH peak, but for OPKs purposes, just the detect of the rise is enough.

Just prior to the LH surge there is a rise of estrogen. This estrogen actually changes the cervical mucus from a thick, viscous, opaque mucus to a clear water mucus that facilitates sperm transport. This usually occurs about 24-26 hours before the LH peak or 12 -24 hours before the LH is detected in the OPKs.

Clomid is an estrogen modifier. It works in the brain, specifically in the hypothalmus, by increasing the FSH (follicular stimulating hormone...remember the follicle?) and LH so there are more estrogen receptors on the follicles, and more follicles are stimulated to produce an egg. If someone has trouble ovulating (producing and releasing an egg) then Clomid accentuates the process to help in ovulation. It does not directly stimulate ovulation but supports the sequence of events that are the physiologic features of a normal cycle.

My advice to my patients is thus:

1. Have intercourse 2-3 time per week after menses has stopped.

2. Use OPKs in conjuction with number (1) but not to determine when to have intercourse othewise it causes too much stress. ("Honey, come home from work NOW!!! I'm ovulating" is not the most romantic statement I've ever heard.)

3. Use Basal Body Temperature Thermometers. They cost much less than OPKs and work almost as well.

If no pregancy in 12 months, or no evidence of ovulation (if less than 35 years old,) then add Clomid. If over 35 years old and no pregnancy in 6 months or no evidence of ovulation, see a Reproductive Endocrinologist, because time is at a premium.

--
Richard Chudacoff, MD
Baylor College of Medicine
BaylorMedCare
Houston/Sugar Land, TX

Advisory Board-OBGYN.net
http://www.obgyn.net/board/chudacoff.htm

*Note:  Opinions expressed here are for educational purpose only.
This information is not intended to supplant the need for you to
consult with your physician prior to choosing therapeutic options.

• Next message: Richard M. Chudacoff, MD: "Re: When is Amnio Performed?"
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• In reply to: Brandie: "OPK"