- Your menstrual cycle is lead by the interplay of the four fertility hormones
Estrogen (Inito measures E3G)
Luteinizing Hormone (LH)
Progesterone (Inito measures progesterone metabolite-PdG)
Follicle Stimulating Hormone (FSH) - Your cycle begins on the day you start bleeding. This is Cycle Day 1 (CD 1).
- You bleed for about 2 – 8 days. All your hormones are usually low during this time. Inito takes CD 6 as your reference day for marking your baseline hormone levels.
Ideally, you should start testing with Inito from CD 6 so the app has your baseline hormone levels. - From days 5 – 7, your FSH levels start rising to stimulate your ovarian follicles to start growing. In some cases, the FSH rise is not visible as the rise is very insignificant. Your hormones fluctuate throughout the day and through the entire cycle.
- Of these, one follicle matures and forms the dominant follicle.
- The dominant follicle releases estrogen 3-4 days before ovulation. As your E3G levels start rising above the baseline levels, the app will start indicating ‘High Fertility’ which means, the app is predicting LH peak in the next few days. You are most likely entering your fertile window during High Fertility – the four days before ovulation. It’s best to have intercouse/baby dance 🤗 (BD) on those days.
- Rising estrogen signals your anterior pituitary gland to stop producing FSH and starts preparing your uterine lining to get ready for an oncoming pregnancy.
- Rising estrogen levels signal the pituitary gland to release LH that then triggers ovulation. This is when you get your LH peak which is shown on the app as ‘Peak Fertility’. Your LH levels can stay high for a few hours to 1-3 days, which is called the LH surge, and it’s completely normal.
- LH rises 24-36 hours before ovulation and surges to its peak levels about 10-12 hours before ovulation.
- The surge in LH, signals the rupture of the dominant follicle triggering the release of the egg.
- Once the egg gets released, the ruptured follicle leaves behind a corpus luteum.
- This structure (corpus luteum) then produces progesterone to support the implantation of the fertilized egg by building the uterine lining and making it thicker. (Please note, Inito measures progesterone metabolite PdG)
- PdG (Progesterone metabolite) levels peak around 6-8 DPO (Days Past Ovulation) along with a rise in estrogen levels. If your PdG levels take a few days to start rising after the LH peak, that is completely normal. With a consistent rise in PdG for a few days, the app will confirm ovulation.
- If the egg was not fertilized, the corpus luteum starts disintegrating at 9-11 DPO.
- This causes a drop in PdG levels resulting in AF (Aunt Flo – Period). But if you see a drop in PdG days before your AF is due, you should keep testing if the app asks you to. As PdG fluctuates during the luteal phase, it can drop and rise back up the next day.
- If the egg gets fertilized after ovulation, then the fertilized egg gets implanted into the thick uterine lining at about 6-12 DPO, most commonly at 8-10 DPO.
- With the implantation of the fertilized egg, the placenta starts forming that produces progesterone and human chorionic gonadotropin (hCG) to support the pregnancy.
- From CD 1 till your ovulation day forms the follicular phase. The duration of this phase is variable, and it can be different in each cycle for an individual.
- From your ovulation day till your next AF is the luteal phase. The duration of this phase is fixed at 12-14 days.
How to understand your Inito results?
- You may have received one or more of these results on your Inito app at any given time in your cycle.
- Let’s understand what each of these results mean and how they can help you in your TTC journey.
Low Fertility
Before your Fertile Window starts, your estrogen and LH levels have not risen yet. You are yet to enter your fertile window. Your chances of getting pregnant are low during low fertility. Keep testing to track your progress and you will be able to see a rise in estrogen and LH levels.
After the Fertile Window ends – Your fertile window has ended and Inito now looks for a rise in progesterone metabolite PdG levels. Your estrogen and PdG levels fluctuate during the luteal phase. Since the chances of conception are low during this phase, Inito gives you a result of “Low Fertility” during this phase.
High Fertility
Your estrogen levels have started rising above the baseline levels and the app is predicting that you would ovulate within 3-4 days. This marks the first 4 days of your fertile window before ovulation. You should time your BD during ‘High Fertility’ as your partner’s sperm can remain in your body for about 4-5 days. (You will see this on your chart as a green highlight.)
Peak Fertility
Your LH levels have started rising and you would ovulate within 24-36 hours. This marks the 5th day of your fertile window. Peak day and the day before are the best time to try and conceive. (You will see this on your chart as a purple highlight.)
Ovulation Confirmed
When your progesterone metabolite-PdG levels are rising consistently for a few days, after your LH surge, you can confirm that you actually ovulated.
Sometimes, PdG levels take a few days to start rising after the LH peak, which is completely normal as it usually peaks around 6-8 DPO. (You will see this on your chart as a blue highlight.)
Waiting for Progesterone metabolite-PdG rise
When your progesterone metabolite-PdG levels have not yet risen steadily and consistently above your baseline levels after the LH surge, you may need to wait for the consistent rise to confirm ovulation. This can take up to a few days after your LH surge and it is not the same for everyone in every cycle. Inito gives you results based on your past values and compares them to your average baseline levels to give an accurate result.
Not Ovulated
When your progesterone metabolite-PdG levels have not risen after your LH surge and you are nearing the end of your cycle, you may get a result of “Not Ovulated”, since the egg was not released from the follicle. This is known as an Anovulatory Cycle. Having 1-2 anovulatory cycles in a year is common. However, if you have more than 2 consecutive anovulatory cycles, we recommend you consult your OB.
What if your chart looks different?
Multiple LH Surges
As you know, not everybody falls in the textbook definition of menstrual cycles where you get a single LH spike.
Almost 50% of cycles have a biphasic or a double LH surge. Don’t worry, you are not alone. When you have multiple LH surges, Inito shows “Peak Fertility” results for two LH surges. However, you can confirm that you ovulated only after you get a PdG rise following the LH surge.
Continuous High Fertility with no Peak Fertility
Due to high levels of E3G, if you don’t get your LH peak, the app will show ‘High Fertility’ for 8 days and will go back to ‘Low Fertility’, that means this was not your actual fertile window and you still need to keep testing.
Direct Peak Fertility with no High Fertility
In some cases, you might not get ‘High Fertility’ and you directly get ‘Peak fertility’ which is completely normal. As the app might not have enough reference tests of your baseline levels, it could not predict your fertile window; or your E3G levels were low, as our body doesn’t fit textbook definitions every cycle. Keep testing, as it takes 2-3 cycles for the app to understand your patterns.
Peak Fertility immediately after High Fertility
When your E3G levels have taken too long to rise, you may get a “High Fertility” result closer to your LH peak. This may show up as a “Peak Fertility” result right after 1-2 days of “High Fertility”. BD during this time to ensure you don’t miss your fertile window.
Average Range of Fertility Hormones
The suggested range of hormones in urine is as follows –
Normal Ranges that Inito measures
FSH
- Follicular Phase: 0-10 mIU/ml and peaks up to 25 mIU/ml
- Luteal Phase: 0-10 mIU/ml
E3G
- Follicular Phase: Rises to 100-600 ng/ml from baseline levels of 20-80 ng/ml
- Luteal Phase: Rises to 80-300 ng/ml
LH
- Follicular Phase: 0-5 mIU/ml and peaks at 10-50 mIU/ml
- Luteal Phase: 0-5 mIU/ml
PdG
- Follicular Phase: 0-3 ug/ml
- Luteal Phase: Rises to 6-40 ug/ml from the baseline values
Disclaimer – You can get pregnant outside of these levels as well, these are just references.
Inito measures up to the following limit for each hormone:
- FSH – 40 mIU/ml
- E3G – 600 ng/ml
- LH – 40 mIU/ml
- PdG – 40 ug/ml
FAQs
Why should I test using the first morning urine (FMU)?
It is recommended to test with Inito using your first morning urine or the urine after your longest sleep (specifically 6 hours) because your hormone levels are concentrated during this time. You can get more accurate results by testing with your first morning urine since hormones are released in pulses or spurts throughout the day.
Can I start testing in the middle of the cycle if my Inito arrives late or do I wait till the next cycle?
It is recommended to start testing from your reference day, that is day 6 of your cycle. However, you can start testing from the middle of your cycle to get a picture of your hormone levels. Since Inito may not have the baseline reference of your hormone values, you may not get accurate prompts of your fertile window or ovulation getting confirmed. But you will get to see your daily hormone values that are accurate for your cycle.
Should I test on day 6 of my cycle even if I am on my period?
Yes, CD 6 of your cycle is your reference day test and is required for Inito to have an understanding of your baseline levels. With these reference levels, Inito can predict your fertile window and confirm ovulation in a more accurate way. It is essential that you don’t get blood inside the testing cup so as to not skew the results. The best way to go about this is to test while using a tampon or a menstrual cup.
The app is asking me to test for only a few days. What if it doesn’t catch ovulation?
Inito learns about your body over time and can tell you to take more tests depending on your cycle. If you want to keep a track of your hormone values everyday, you can test on the days the app doesn’t ask you to. If your progesterone (PdG) levels don’t rise in time, you will get notified to take more tests so that Inito can confirm ovulation. Inito is optimized to give accurate results with the least amount of tests.
Can I test twice a day?
You will get accurate results with only one test taken with your first morning urine. While it is not required that you test twice a day, you can go ahead and take as many tests as you want closer to your peak.
Which value does Inito consider if you take multiple tests in a day?
The algorithm selects the most accurate test based on all the factors:
Your LH levels are the dominant factor in determining the accuracy of your test results before your high and peak fertility. When you take multiple tests in a day, the result with the highest reading of LH is considered. During the high fertile window, E3G is the dominant factor and post your peak fertile window, PdG becomes the dominant factor. Inito picks up on the highest values of these hormones during the respective phase of your cycle. In case of a significant difference in the values of E3G and PdG, both values for each test are considered for determining the most relevant test.
Can I test every day?
Inito requires you to test from your reference day of CD 6 in the cycle till the day your ovulation is confirmed. But, there is no harm in testing every day of your cycle. This may help you get a full picture of your hormone levels throughout your cycle.
How long after ovulation should progesterone rise?
Progesterone metabolite-PdG levels start rising shortly after ovulation and are known to peak at 6-8 days after ovulation. Inito gives you the result of ovulation confirmed when your PdG levels are rising consistently and steadily after your LH surge.
For more information, refer to our hormone chart guide on Instagram where multiple scenarios of various charts are explained in detail.
How does Inito differ from others?
Measures Beta LH
Your body has various hormones like LH, FSH, TSH, and hCG. All these hormones have two subunits – alpha and beta. The alpha subunits of these hormones are similar in structure. Most ovulation tests measure alpha LH that can misread your FSH, TSH, or hCG levels giving you a false positive reading. Inito measures beta LH that has a lower chance of cross-reacting with the other hormones giving you accurate results.
Measures all four hormones on a single test strip
Easier to use a single test strip to get your result daily. Using different strips means the urine is getting older by the minute and in some cases you may have to pee again to take the test. This means your urine doesn’t necessarily remain your first morning sample. Inito measures all four hormones at the same time on a single test strip giving you accurate results. It is currently the cheapest on the pocket and less wasteful since you do not need different test strips for each of the hormones.
Gives you actual hormone values and plots them on a chart
Inito measures the actual values of your hormone levels and gives you daily values in the form of a chart. This makes it easier for you to track your daily levels without having to decode anything. You may also take your charts to your healthcare provider for understanding your body better before spending a fortune on further tests.
