In order to accurately time inseminations and endometrial biopsies, the pituitary hormone "LH" will be measured in the urine. It is the pituitary gland's LH secretion that controls the release of a mature egg at ovulation. This brain hormone is excreted into the urine from the blood. This hormone will slowly increase in the urine as ovulation approaches. Twenty-four (24) to 36 hours prior to ovulation, there will be a sudden and sharp rise in the amount of urinary LH. Ovulation is then triggered. Therefore, insemination is performed 24-48 hours after this urinary LH surge is recognized. The endometrial biopsy is scheduled 12-14 days after the surge.

Instructions

• Urine specimens should be collected approximately 3 days prior to the anticipated day of ovulation. You should start on day 10 unless otherwise instructed. The recommendation test kit is the Clear Blue Easy Kit. This can be purchased at most local pharmacies. This kit will provide for testing for 7 days. Follow the directions for testing in the kit. Test each day in the evening for best results. Be aware that excessive fluid intake on the days that you are testing your urine may dilute the urine so that detection of the LH surge is difficult.
• If you are performing urinary LH testing in order to time an insemination, please call the office at (610) 374-2214 ext. 3071 on the morning after you detect a surge. When you have surged, you should stop testing your urine and save any unused sticks for future use. Inseminations are usually scheduled for 36 to 40 hours following the urinary LH surge. For example, if you experience your surge on Monday evening, please call the office on Tuesday to inform us so that you can be scheduled for an insemination on Wednesday morning.
• If your surge occurs on a Saturday evening, please report to the office at 7:30am on Monday morning for insemination unless previously informed of a timing change due to the type of semen processing needed. We will take care of you when you arrive since there is no way to inform the receptionist of a Monday insemination in advance. If you surge on a Sunday evening, call on Monday so that you can be scheduled for an insemination on Tuesday.
• If a weekend is approaching and you feel that there is any chance that you may have your LH surge on a Friday evening, you should report to the office on Friday morning between 7:30am and 9:00am for blood work. The LH surge is detected in the blood 8 to 12 hours before it is noted in the urine. This blood work will give us the ability to predict your urine LH surge and schedule an insemination for you appropriately over the weekend, if necessary. If you do not come in for blood work on Friday morning and you do have an LH surge on Friday evening at home, there is unfortunately no way for the office to make appropriate arrangements for personnel to be available for you over the weekend. These arrangements must be made by Friday afternoon.
• If you are performing urine LH testing in order to time an endometrial biopsy, simply call the office and inform us when you detect your LH surge. The endometrial biopsy is not performed until 12 to 14 days after the LH surge occurs. Therefore, if your surge occurs on a Friday evening or over the weekend, call the office on Monday morning to inform us of the date of your LH surge.
• Basal body temperature charting must be utilized along with the urine LH testing.
• Occasionally, an LH surge will not occur, or will not be detected. Generally, you should stop collecting urine on day 20 of your cycle and call the office for further instructions. You should likewise call the office if there is no LH surge but there is a distinct rise in the basal body temperature and ovulation is suspected.