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How accurate is the Modern Fertility Ovulation Test? Comparing our test to top-selling ovulation tests

How accurate is the Modern Fertility Ovulation Test? Comparing our test to top-selling ovulation tests

9 min read

The Modern Fertility Ovulation Test helps you pinpoint your luteinizing hormone (LH) levels to predict your two most fertile days. With our test, you’ll get more insight than just a positive or negative result — you’ll be able to see your LH change daily and track low, high, or peak levels. This is key for understanding whether you're in your fertile window and approaching ovulation (when you have the highest chances of pregnancy).

We recently conducted a study comparing the Modern Fertility Ovulation Test with five other top-selling LH-based ovulation tests you can find in stores or online.

Our study provides evidence that our test is as accurate as other ovulation tests, while providing more information about your body and fewer misleading results.

Here, we’ll discuss the lack of published research on ovulation tests, the results of our study, and the magic behind the Modern Fertility Ovulation Test.

Our validation study in a nutshell

  • We compared five top-selling ovulation tests to the Modern Fertility Ovulation Test. We exposed the six tests to eight different concentrations of urine (ranging from 0 mIU/ml to 69 mIU/ml LH).
  • We took photos of each test’s result and they were reviewed by three independent reviewers (who weren’t lab technicians). We then determined how often the independent reviewers got the right answer (since we knew the concentration of the sample).
  • When reviewers were asked to determine if the test results were positive (above 25 mIU/ml) or negative (below 25 mIU/ml), test accuracy ranged from 72% to 89%. The Modern Fertility Ovulation Test scored an 88%.
  • The top-selling tests are “threshold-based,” meaning they only give a positive or negative result. The Modern Fertility Ovulation Test is semi-quantitative, meaning that it can help you identify if your LH is at low, high, or peak levels (which can be key to understanding when you’re approaching your fertile window and ovulation). When we compared the accuracy of low/high/peak results to threshold positive/negative results, our test was just as accurate as the top-selling tests.
  • The Modern Fertility Ovulation Test had fewer misleading results than most top-selling tests.

Why did we do this research?

As we were developing our new Ovulation Test, our clinical team and medical advisory board went deep into researching clinical studies for data describing the accuracy of at-home ovulation predictor kits (OPKs), also known as ovulation tests. And we came up largely empty handed.

We were surprised to find that there weren’t any published studies that measured whether people accurately read the results from different types of ovulation tests at different concentrations — so we decided to do that study ourselves.

Here's what previous work did have to say:

  • The first important finding is that the highest chances of predicting ovulation based on urine LH levels is using a threshold of 25 mIU/ml (Leiva, 2018). That’s why most tests out there use 25 mIU/ml as the cutoff between a positive test result and a negative test result. However this threshold does not work for 10% or more of women because their LH levels never reach 25 mIU/ml (Johnson, 2015).
  • A second important study looked at how frequently a lab technician and a consumer agreed on the results of a test, but they didn’t determine whether the agreed-upon result was the correct result (Johnson, 2011). This study basically shows us that you don’t need to be a lab technician in order to read the results of these tests.
  • No study has compared the accuracy of results of different test types at different concentrations. We found this surprising because there are a lot of accuracy studies out there for pregnancy tests (see Cervinski, 2009, Johnson 2014, Boxer, 2019). And that is what motivated us to do our own.

Before we get started, let’s address the elephant in the room: All tests claim to be 99% accurate at detecting LH, so why does this study show accuracy less than 99%? Every test says their test is 99% accurate, including us, but the reality is this accuracy is based on a review by a trained lab technician under manufacturer-defined conditions.

We aren't all lab technicians, so this study put every test on a level playing field with the same conditions and the same untrained reviewers.

How we conducted the study

In order to test the accuracy of ovulation tests, we had to start with urine that had a high LH concentration. We were able to confirm the concentration with a laboratory machine that reads hormone levels, specifically the Beckman Coulter LH assay. (Fun aside: This is the same machine that determines the concentration of LH in the dried blood spots of the Modern Fertility Hormone Test.)

The last step in preparing the urine sample was to dilute it across the range of expected LH values. We confirmed these dilutions with the same Beckman Coulter LH assay and had samples at 4, 9, 13, 23, 29, 40, and 69 mIU/ml. We also included a sample with approximately 0 LH (0.1 mIU/ml).

Next, we needed a bunch of ovulation tests. We decided to test the performance of five top-selling tests on the market, as well as the Modern Fertility Ovulation Test. At each of the eight concentrations we used, we exposed multiple tests from each test type to the urine sample. In total, we studied over 350 tests, which you can see in the table below.

a. We had less volume of the 40 mIU/ml sample and had to reduce the number of tests.
b. Tests for test F were not included due to an error in the lab.
c. These tests were midstream tests and used significantly more urine than the other dip tests. Due to the limited amount of urine we had, we used fewer of these tests.
d. Some tests of this test type returned an error and were not included. That is why there are not 10 tests for each concentration.

In order to record the outcome of each of the tests, we developed a custom app (shout out to the Modern Fertility engineering team!) that we used to take a photo of each test under the same, consistent lighting conditions.

Next, each photo was evaluated by three “ovulation novices,” aka independent reviewers who were not involved in the dipping of strips and had no previous experience with the ovulation tests (either threshold or semi-quantitative).

For the Modern Fertility Ovulation Test, each reviewer was asked to match the test line with a color scale that indicated LH level. (Longer description of how this works is below.)

For the five top-selling tests, each reviewer was asked to determine whether the test was either:

  • Positive, meaning the left test line is as dark or darker than the right control line
  • Negative, meaning the left test line is lighter than the right control line

There was one exception in the bunch. Test E was a digital test — it showed a positive or a negative result rather than lines. For that test, the results were recorded at the time of dipping, and reviewers were not required to review them.

Since we knew what the test should display (based on the concentration of the urine sample), we could determine how often the test plus the reviewers were correct.

How accurate is the Modern Fertility Ovulation Test?

Spoiler alert: The Modern Fertility Ovulation Test is just as accurate as top-selling tests, gives you more info than the other tests, and has fewer misleading results.

The Modern Fertility Ovulation Test is just as accurate as other tests on the market

The first thing we found was that the Modern Fertility Ovulation Test is just as accurate as the five top-selling ovulation tests when used to determine if a result is above or below 25 mIU. The range of accuracy, which we defined as the percentage of tests reviewed that agreed with the known concentration, was 72% to 89%.

The Modern Fertility Ovulation Test had an accuracy of 88%.

We’re going to dive into the nitty gritty here for just a second: The Modern Fertility Ovulation Test is a semi-quantitative test. Each test comes with a color chart that indicates the color you can expect with a range of LH concentrations. The reviewers, when looking at the Modern Fertility Ovulation Tests, had to determine the specific concentration according to the color scale.

We then took that numerical response and coded it as positive (the reviewers chose 25 and above) or negative (the reviewers chose 15 and below). We then compared that result to the known value. That is how we determined the percent correct for the Modern Fertility Ovulation Test.

Each Modern Fertility Ovulation Test comes with a color chart that indicates the color you can expect with a range of LH concentrations. 

The Modern Fertility Ovulation Test gives you more info than top-selling tests on the market with equivalent levels of accuracy

Remember when we mentioned that the Modern Fertility Ovulation Test is semi-quantitative? The reason that is important is that you don’t just get a binary positive/negative result from our test. Instead, you can use the color chart to determine if your result is low (0-19), high (20-39), or peak (40+). This is one of the big reasons we decided to create a semi-quantitative test. But does it stack up to the other tests?

When we compared the accuracy of the Modern Fertility Ovulation Test results into buckets of low, high, or peak, the test was still just as accurate as other tests. What this means is that you get the same accuracy as the top-selling tests but you get additional information about your levels and how they might be changing day to day.

The Modern Fertility Ovulation Test has fewer misleading results

In our analysis, no test was 100% accurate. So we wanted to understand when a test was wrong, how was it wrong?

There are two ways a test can be wrong:

  1. False positive: It can give you a positive result when it should give you a negative result.
  2. False negative: It can give you a negative result when it should be positive.

You want an ovulation test that has both a low false positive and low false negative rate — that means you are getting the correct result most of the time.

When we analyzed the data, Modern Fertility’s Ovulation Test had fewer misleading results than most top-selling tests.

How did we determine that? Our test had both a low false negative rate paired with a low false positive rate.

Some tests had a 0% false negative rate, but they were returning false positives almost half the time!

And if you are trying to identify when your LH is surging, a false positive means you might think you are surging sooner than you actually are.

Bottom line: The Modern Fertility Ovulation Test is just as accurate as top-selling tests on the market — and gives you more detail about your LH levels

First, we learned that the Modern Fertility Ovulation Test is just as accurate as the top-selling tests on the market. That means that you can trust the results of the Modern Fertility Ovulation Test when you are using them at home.

Second, the Modern Fertility Ovulation Test has an extra benefit that the top-selling tests don’t have — it’s semi-quantitative and gives you more information about your LH levels. In fact, reviewers were just as accurate at determining whether a result was low, high, or peak LH levels as top-selling tests.

Lastly, you can rely on the results from the Modern Fertility Ovulation Test. The test had both a low false positive and false negative rate — which is a sign of a good test.

Taken together, this study demonstrates that the Modern Fertility Ovulation Test is a reliable option for tracking your LH. And with more information than other top-selling tests, it’s a no-brainer.

Did you like this article?

Dr. Sharon Briggs, PhD

Sharon leads Clinical Product and Research at Modern Fertility. She's a craft beer-loving, soccer-playing, cookie-baking scientist who completed her PhD in Genetics at Stanford University.

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