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Pregnancy and Ovulation Test Kits

Pregnancy and Ovulation Test Kits. Dr. Ed Randell. The female reproductive Cycle. What happens at the Pituitary What happens at the ovaries What happens at the uterus What happens to the hormones. What happens at the pituitary. What happens at the pituitary. Hypothalamus. GnRH.

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Pregnancy and Ovulation Test Kits

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  1. Pregnancy and Ovulation Test Kits Dr. Ed Randell

  2. The female reproductive Cycle • What happens at the Pituitary • What happens at the ovaries • What happens at the uterus • What happens to the hormones

  3. What happens at the pituitary

  4. What happens at the pituitary Hypothalamus GnRH Anterior Pituitary Positive feedback On days 12 to 14 Negative feedback Over most of cycle FSH/LH Ovary Estrogen And Progesterone Uterus

  5. Anatomy of the female reproductive system.

  6. What happens at the ovaries

  7. What happens at the Uterus

  8. What happens to the hormones

  9. The Menstrual Cycle

  10. Fertilization and Implantaton Fallopian tube Day 2 Day 3 Day 1 Day 4 Zygote 4 cells 2 cells Morula Fertilization Day 0 Blastocyst Day 7 Implantation of blastocyst Uterine wall Egg released by ovary (DAY 0) Ovary

  11. Home Pregnancy Test Kits • Measure Urinary human Chorionic gonadotropin (hCG) levels. • Can detect urinary hCG as low as 25IU • Maximum Sensitivity: 1 to 4 days post MMP • Reason for use • Detects pregnancy at very early stage • Earlier prenatal care

  12. How the Test Works • First introduced in 1976 • Hemagglutination inhibition • Earliest Sensitivity 4 days post-MMP • Most recent methods • Use monoclonal antibodies • Much more sensitive ~ day of MMP • Accuracy quoted >98% • Various Formats: test stick, test well, test solution, colored line • Time involved and # of Steps vary

  13. Latex Agglutination

  14. Home Pregnancy Test Kits Dip Strip Cassette

  15. Home Pregnancy Test Kits

  16. Completion of the test • Supplies • Kit • Pipette • Urine

  17. Completion of the test • Steps • Add 3 drops of urine into sample well • Wait

  18. Completion of the test • Interpret Results

  19. Home Pregnancy Test Kits 2nd hCG-specific antibodies 1st hCG specific antibodies Sample window Antibody against Antibody to hCG

  20. Home Pregnancy Test Kits hCG

  21. Home Pregnancy Test Kits Positive Test Negative Test

  22. Patient Consultation • 1st AM voiding; > conc. of HCG • Run test immediately, or store sample in refrig. • use within 24 hrs; • allow to come to room temp. • Follow timing and sequence of steps. • If negative, repeat in 7 days. See MD regardless of result • If negative - may require amenorrhea workup • If positive - will need prenatal care follow-up.

  23. Interpretation • Negative Result • HCG is not present at detectable concentrations • Positive Result • Pregnancy • False Positives • Drugs: Antiparkinsonian, anticonvulsants, phenothiazines. • Medical Conditions: Tumors, Recent completed pregnancy or miscarriage. • False Negatives • Testing too early, Urine not at room temp.

  24. Accuracy • 97% sensitivity • In 100 pregnant women • 97 will be positive • 3 false-negative. • 95% specificity • In 100 non-pregnant women • 95 will be negative • 5 false-positives. • Accuracy similar to laboratory tests. • User and technique dependent.

  25. Home Pregnancy Test Kits

  26. Predicting Ovulation • Pattern of Menstrual Cycle with Calendar • Cervical Mucous • BBT • LH Surge

  27. Detecting Ovulation Measures Urinary LH • Best indicator is 50%  over mean basal plasma LH •  in urine follows. • Ovulation usually within 12-24 hours. • (Basal body temp change follows ovulation)

  28. How the Test Works • LH increases sharply prior to Ovulation • “LH Surge” • Causes ovarian follicle rupture and release of mature egg within in 1 to 2 days. • Occurs 8 to 12 hrs later in urine • ~6 consecutive days of testing will detect LH Surge in about 66% of ovulating women • ~10 consecutive days of testing increase probability to 95%. • Intensity of color on test strip is proportional to LH in Urine

  29. Kit Comparison

  30. Ovulation Prediction Kits

  31. Monitor device • Measure LH and E3G • E3G indicates when to start testing for LH • Gives readout according to fertility • Low • High-E3G detected • Peak-LH and E3G detected

  32. The Menstrual Cycle

  33. Monitor device

  34. General Procedure • Calculate cycle length of 3 most recent menstrual periods. • Calculated average cycle length determines day to start testing. • Begin testing 2-3 days before expected ovulation • Urine collection is product dependent :follow specific instructions.

  35. Precautions • Timing • Sample Storage before testing • LH surge not detected • Test not performed properly • Ovulation did not occur • Testing begun to late

  36. Factors influencing Results

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