Body-Observation Monitoring

Temperature, saliva and perspiration monitoring

There are other ways to predict ovulation besides measuring for hormones in your urine. Numerous gadgets have been invented that capitalize on the bodily changes that occur before and around the time of ovulation. They range from thermometers to microscopes to watches. While most do not have as many tests and reviews as the urine-based ovulation tests, we offer examples of them here so that you can understand the breadth of gadgets available on the market.

The fertility gadget that has received the most praise is the OV-Watch Fertility Predictor (*Est. $125). Worn like a regular watch, the OV-Watch has a sensor on its back that measures changes in the salt content of a woman's sweat. The level of salt in a woman's sweat fluctuates with the change in hormones and can be used to predict ovulation. A woman has to start wearing the watch in the first three days of her menstrual cycle, and then it must be worn daily for at least six hours, usually at night. The watch takes measurements every 30 minutes, and will tell the wearer which days are her fertile days and which day she will ovulate.

An article published in 2006 in the US Pharmacist outlines some of the initial clinical testing done on the OV-Watch. Though the research is minimal, it shows that the OV-Watch predicts ovulation as well as a urine luteinizing hormone (LH) test. In addition, like the Clearblue Easy Fertility Monitor (*Est. $170), the OV-Watch is able to predict ovulation three to five days before the urine LH tests. JustMommies.com names the OV-Watch as one of the five best fertility gadgets and says one of its benefits is its ease of use. About.com's pregnancy guide, Robin Elise Weiss, gives the OV-Watch 4 out of 5 stars, but says it has some drawbacks. Esthetically, she finds the watch to be rather clunky, and for it to work, the wearer has to strap it on really tight. She also notes that the OV-Watch has a high initial expense and that the sensors (*Est. $100 for 3 sensors) have to be replaced each menstrual cycle. (Note: ConsumerSearch is owned by About.com, but the two don't share an editorial affiliation.)

Users at Amazon.com have mixed opinions. While some say that the watch is incredibly easy to use and they conceived right away, several say it is nothing more than an expensive calendaring system. That's because the sensors are temperamental, according to reviewers. We found several complaints that they dry out and fall out easily and have to be cleaned, tested and readjusted frequently. Some question the watch's accuracy, saying the results didn't mesh with those from other proven methods such as urine LH tests and basal body temperature monitoring.

The OV-Watch also has limitations. This product isn't recommended for women with menstrual cycles with less than 20 or more than 39 days. In addition, polycystic ovarian syndrome (PCOS), impaired liver or kidney function, pregnancy and menopause can alter the results, as can any medication that affects hormones. According to the manufacturer's website though, clomiphene citrate does not interfere with the OV-Watch.

Saliva tests can be hard to interpret

While the OV-Watch uses changes in sweat to predict ovulation, other devices use changes in saliva. The OvaCue Fertility Monitor (*Est. $250) works by applying a spoon size sensor to your tongue for five seconds every morning. It then displays your fertility status on a scale from one to seven bars, seven being highly fertile. An additional vaginal sensor (*Est. $100) is also offered, as changes in salt levels of vaginal fluid can confirm ovulation. The OvaCue is designed so that it can be used for couples trying to conceive and those who wish to avoid pregnancy without using a contraceptive. A study published in Contraception in 2007 examined the accuracy of the OvaCue at predicting ovulation. When compared with urine luteinizing hormone (LH) and vaginal ultrasound, the OvaCue adequately detected the fertile phase of a woman's cycle.

JustMommies.com also named the OvaCue as one of the top five fertility gadgets. Though the OvaCue has a high initial investment, $250 for the monitor, they note that unlike the urine ovulation tests, the user won't have to continually buy extra test sticks. Amazon.com offers only a handful of reviews on the OvaCue, and they vary widely. One woman notes that she and her husband have successfully avoided pregnancy for close to nine years with the OvaCue, while another says she was able to conceive successfully. However, some reviewers say they find the OvaCue a waste of time and money, and they question its accuracy.

In addition to the OvaCue, small microscopes are sold to detect salt levels in the saliva. When dried, saliva crystallizes because of the increased salt and takes on a fernlike appearance of ferns, hence the term salivary ferning. This pattern can then be detected under a microscope. The entire saliva microscopy kit includes a small microscope and reusable lenses in a container no larger than a lipstick case. The directions also include images of salivary ferning, so the user has something with which to compare to the images they see in the microscope.

Though these microscopes are more affordable than urine LH tests and are portable, scientific studies report conflicting results. One study from 1999 published in Fertility and Sterility compares the accuracy of various ovulation predictors. While urine LH tests correlated 100 percent of the time with ovulation, as verified by ultrasound, salivary ferning correlated only 36.8 percent of the time. In addition many of the salivary microscopy tests had to be excluded because the researchers were unable to interpret the results.

One small study did find the results of saliva microscopy correlated with urine LH tests, but the users found it difficult to fully define when they were and were not fertile. Another study found the false-negative rate with salivary microscopes could be as high as 50 to 73 percent, meaning that on days when the women were fertile, the test indicated that they were not. Salivary microscopy can be finicky. Air bubbles can alter the results as can putting too much saliva on the slide. While there are no scientific reviews on specific saliva microscopes, users reviews at Amazon.com and Drugstore.com put the Fertile Focus Ovulation Microscope (*Est. $30) in the top spot among microscopes. Consumers like that the device is inexpensive and can be reused. Some users report successfully using the Fertile Focus to conceive.  Others say they never detected any salivary ferning and thought they weren't ovulating, but they were able to confirm ovulation with urine luteinizing hormone (LH) tests.

Body-monitoring methods can be of use

Mother Nature offers her own ovulation signs, and if a woman is trained to observe them, they can help her predict when she will ovulate. Cervical mucus changes, the position of the cervix, basal body temperature (BBT) and other symptoms such as mittelschmerz and libido can be charted daily and used to predict when a woman will ovulate. Special thermometers, called basal thermometers, are sold specifically for taking a woman's BBT. More accurate and precise than a traditional thermometer, basal thermometers allow a woman to measure her temperature to a tenth or even a hundredth of a degree. Basal temperatures must be taken first thing in the morning, while still in bed, as any excessive movement can affect the results.

Moreover, temperatures should be taken at approximately the same time every morning and can be affected by illness, anxiety and lack of sleep. The greatest limitation of monitoring BBT is that the rise in temperature occurs after a woman has already ovulated. But if a woman charts her BBT over multiple cycles, she might be more likely to predict when she will ovulate in your next cycle.

Scientific studies report varying results when it comes to the reliability of body changes in predicting ovulation. A 2001 study in Obstetrics and Gynecology determined that following the lowest point of BBT was a poor indicator of ovulation. Another study from 1999 in Fertility and Sterility showed that self-assessment of cervical mucus changes correlated less than 50 percent of the time with ovulation as determined by ultrasound. A later study in 2002, though, determined that the self-determined peak day of cervical mucus occurred on the same day as the LH surge.

If you decide to monitor your body throughout your cycle, you will need a basal thermometer. Basal thermometers are readily available at drugstores and online, but reviews for them are hard to find. We did, however, find positive user reviews at Amazon.com and Drugstore.com for the BD Basal Digital Thermometer (*Est. $11). Reviewers say they love the backlight, which helps them to see the temperature in the early morning hours. The thermometer also stores the last readout, which users say is convenient if you forget to record it in the morning. One feature reviewers either love or hate is the beeping sound; the thermometer beeps to let users know that they are using it correctly, but some say it is disruptive, especially if their partner is still asleep. Though several reviewers say they wish the BD thermometer measured to a 100^th of a degree -- it only measures to one decimal place -- most say they are pleased with the thermometer's accuracy and ease of use.

Body-monitoring methods can greatly help a woman understand her cycle and ovulation patterns. Used in tandem with urine hormone tests or other fertility gadgets, a woman can better track when her fertile window will occur. More information on what changes to look for and how to track your cycles can be found on our Useful Links page.