home testing

OTC exam 4

what is hcg

human chorionic gonadotropin

what happens during the menstrual cycle of a woman who is not pregnant

corpus luteum deteriorates → estrogen and progesterone production decrease → onset of menses and stimulation of GnRH

what happens during the menstrual cycle of a woman who is pregnant

trophoblast cells produce hCG → corpus luteum support → sustained estrogen and progesterone production → delayed menses and development of placenta

when does the placenta begin to produce hCG

as early as 7 days after conception

how much does hCG increase per day and when does it reach its maximum concentration

concentration doubles each day — max concentration at 6 weeks post-conception

how is hCG excreted

through the urine

how do pregnancy tests work

urine hCG forms a complex with Abs capable of changing test strip color by binding to test zone antibody

if the date of the expected period is in a few days, when should the patient take a pregnancy test

should wait, or early result/high sensitivity test may work

if the expected period is in >7 days, when should a patient take a pregnancy test

should wait because results will not be accurate

when are most accurate pregnancy test results obtained

1 week after the date of expected, missed period

what urine is recommended to use to test for pregnancy

first morning urine — concentrated hCG

what can cause a false positive pregnancy test

miscarriage in the previous 8 weeks

post-partum (previous 8 weeks)

ectopic pregnancy

ovarian cysts

perimenopause

menotropin injections, chorionic gonadotropin injections

what can cause a false negative pregnancy test

testing too early

when should a patient retest if their first pregnancy test was negative

if they have not gotten their period in a week since the first test

when does ovulation typically occur

around day 14 of menstrual cycle

what triggers ovulation

LH surge

what happens to basal body temperature during ovulation

increases

what happens to estradiol during ovulation

peaks

what is the basal body temperature during the follicular phase of the menstrual cycle

96-97.5°F

what is the basal body temperature during ovulation

98.6°F

how can basal body temperature be measured

orally, rectally, or vaginally

when should patients take their basal body temperature when fertility testing

first thing in the morning before getting out of bed — at same time each day, using same method each day

what can affect accuracy of basal thermometry

emotions

movements

infections

how does fertility urine testing work

antibodies are specific to LH

ELISA elicits color change to indicate amount of LH present

what conditions can alter a woman’s natural menstrual cycle

recent D/C of oral contraceptives

recent pregnancy

recent D/C of breastfeeding

these patients should wait to fertility test until after they have had 2 consecutive, natural menstrual cycles

when should fertility testing start

2-4 days prior to estimated ovulation date

what can cause false positive for LH

menotropin use to promote ovulation

clomiphene

menopause

PCOS

pregnancy

what can cause false positives for E3G

impaired liver or kidney function

estrogen-containing therapies

breastfeeding

tetracycline

perimenopause

how does sperm count testing work

semen sample is mixed with buffer that releases sperm-specific protein → mixture binds colloidal gold compound and flows through test → if sample >20 million cells/mL, red line appears (positive result)

when should a sample be tested in sperm count testing

within 3 hours of collection

how long should the sample sit before testing for sperm count

20 minutes

how many times should sample be mixed with buffer in sperm count testing

at least 10 times

what medications can interfere with home drug tests

decongestants

DXM

anti-diarrheals

cough medicines containing codeine

CBD products

what drugs does a 6 panel test test for

amphetamine

cocaine

ecstasy

marijuana

methamphetamine

opiates

what does a 12 panel drug test test for

6 panel + barbiturates, benzos, methadone, MDMA, oxycodone, and phencyclidine