Similar accuracy and patient experience with different one-step ovulation predictor kits

Abstract

Objective: To examine the accuracy of five different at-home ovulation predictor kits (OPKs), and to understand patient experience with the use of those kits.

Design: Prospective cohort study.

Subjects: Patients with regular menses undergoing monitored natural cycle frozen embryo transfer, timed intercourse, and intrauterine insemination cycles involving daily blood luteinizing hormone (LH) level monitoring between 2022 and 2024.

Exposure: Use of five commercially available OPKs for the first 5 days of blood LH level monitoring with a daily experience survey.

Main outcome measures: The primary outcome was the accuracy of the OPKs defined as concordance between test results (positive or negative) and blood LH level (above or below 25 mIU/mL). Secondary outcomes included positive predictive value, negative predictive value, sensitivity, and specificity of OPK surge detection. We also examined patient reports regarding the clarity of kit instructions, confidence in kit results, and likelihood of future purchase and use.

Results: A total of 23 patients completed 97 total days of OPK testing, and 13 patients had a documented blood LH surge during their testing. Ovulation predictor kit surge detection accuracy compared with blood LH surge was similar across the five kits (Easy@Home, 95.88%; Wondfo, 94.85%; Pregmate, 96.90%; Clearblue, 91.75%; and Clinical Guard, 91.75%). Sensitivity was slightly better for Easy@ Home (75.00%), Wondfo (69.23%), and Pregmate (76.92%) than for Clearblue (61.54%) and Clinical Guard (38.46%). There were no clinically significant differences between the five OPKs regarding positive predictive value, negative predictive value, or specificity of surge detection. Participant experience was qualitatively similar across all five OPKs, with exception of slightly fewer patients reporting that they were likely to purchase and use Clinical Guard again in the future.

Conclusion: All five tested-at-home one-step OPKs were highly accurate and performed similarly regarding patient experience despite variations in price.

Keywords: Luteinizing hormone; menstrual cycle; ovulation; ovulation predictor kit; patient experience.