While everyone practices social distancing to help stop the spread of the coronavirus (COVID-19), more and more people are looking for ways to get their medical care without leaving the house. Many are turning to options like telemedicine and at-home diagnostic testing to get the healthcare they need without risking exposure to the virus.
Breakdown of the pros and cons of at-home fertility tests
May provide insight into the state of your fertility and your overall health when comparing your hormone levels against “normal” ranges
Does not paint the full picture since other factors may affect your fertility; a doctor may run multiple tests to examine other variables
May be more affordable than getting the tests done at the doctor’s office
Results may be difficult to interpret without the help of your doctor
May help reveal signs of treatable conditions, such as thyroid disorders and PCOS, that could make getting pregnant more difficult
Can't provide a diagnosis
At-home fertility tests that measure hormone levels may be the answer if you can’t schedule a doctor’s appointment—due to the coronavirus or any other reason, such as financing or simply wishing to get answers about your fertility in a non-clinical setting. However, these tests aren’t a perfect substitute for getting care from a healthcare professional. In this post, we’ll break down exactly what you can expect from at-home fertility tests to help you decide whether they’re worth the cost.
Which hormones do at-home fertility tests measure?
The hormones measured by at-home fertility tests are as diverse as the companies that sell them. Some tests measure your body’s levels of a single hormone, while others measure two or three (or more) at a time. At-home fertility tests commonly look at the hormones progesterone (or, in our partner, Proov’s, case, PdG—a progesterone metabolite), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2), and anti-mullerian hormone (AMH).
These hormones are all associated with fertility in one way or another, and measuring them may help you get a better picture of your chances of conceiving naturally. As with all health issues, knowledge is power. The more you know about what’s going on in your body, the more you can make informed decisions and find treatment options if necessary.
You can also find at-home tests for hormones that aren’t directly tied to your menstrual cycle and ovulation but still may have an impact on your fertility, such as thyroid-stimulating hormone (TSH) and free thyroxine (FT4). These hormones can give you insight into your thyroid health, which can indirectly influence your fertility. When your thyroid isn’t functioning normally, it can decrease your chances of getting pregnant and having a healthy pregnancy (1).
These tests aren’t made to give you a firm medical diagnosis. Instead, their purpose is to help you identify any hormonal abnormalities that may need to be addressed by a healthcare professional. If the tests show that your hormone levels may be affecting your fertility, you’ll be able to bring in your results to your next doctor’s appointment to discuss your options and form a plan with your doctor.
What can the fertility tests tell you?
Determining your fertility hormone levels is great, but it doesn’t mean much until you know how changes in certain hormones affect your fertility. Most at-home testing companies will explain just what their tests can tell you about factors that may affect your fertility. For example, when you test for AMH, FSH, and E2, the results may be able to give you and your doctor an idea of how many eggs you have left in your ovarian reserve (2).
You’re born with anywhere from 500,000 to one million eggs, but less than 1% of them are ever released during ovulation. Most of your eggs are broken down throughout your life through a perfectly normal process called follicle atresia. As you get older and your ovarian reserve gets smaller, your fertility starts to decrease (3). That’s why doctors will do ovarian reserve hormone testing before you undergo fertility treatments to try to determine your chances of success (4).
At-home fertility tests can also help you figure out if you potentially have any underlying health issues that may be affecting your fertility, such as the thyroid issues we discussed in the previous section, or polycystic ovary syndrome (PCOS). PCOS is one of the most common, but treatable, causes of infertility in women, affecting about 10% of women of childbearing age (5).
What can you expect from the at-home testing process?
There are two main types of at-home fertility tests. Some, like Proov’s PdG test, analyze hormone levels in your urine. With these tests, you can get results at home within a matter of minutes. Other options, like Modern Fertility’s ovarian reserve test, check the hormone levels in your blood. These tests typically come with a kit that includes a sterile lancet to prick your finger and a card or test strip that you use to collect a few drops of your blood. You have to mail your sample to the testing company and they contact you when your results are ready. (Turnaround times are relatively quick, and you’ll typically get your results within a few days of the company receiving your sample).
No matter which test you buy, it should come with a guide to interpreting your results. Some companies even have a staff of fertility experts to discuss your results with you and answer any questions you may have. Though the process is similar across different companies that offer at-home fertility tests, the specifics can vary, so it’s important to look over each company’s procedures before purchasing your test.
What are the downsides to at-home fertility tests?
At-home fertility tests can be an empowering way to learn more about your body, but they’re not without their shortcomings. First, they can only give you a small peek into the state of your fertility because they only look at one component, leaving many factors out of the equation. For example, ovarian reserve hormone tests—both at-home versions and those you’d get at the doctor's office—can give you an idea of how many eggs you have, but they don’t tell you anything about the quality of those eggs or of other conditions that may affect your fertility, such as fallopian tube obstructions or uterine abnormalities (6).
Additionally, there’s conflicting information on how well your ovarian reserve can predict your ability to get pregnant. One 2017 study looked at AMH and FSH levels for 750 women between the ages of 30 and 44 and found that women who had abnormal levels of these hormones were not significantly less likely to become pregnant than women with normal hormone levels. The study’s authors concluded that ovarian reserve hormone tests might not be as useful for women who don’t have a history of fertility and have been trying to conceive for less than 3 months (7).
Costs of at-home tests range from around $40 to close to $200. How does this compare to what you’d pay to have your doctor administer the test? It depends on factors such as whether you have health insurance, if fertility testing is covered by your policy, and if you’ve met your yearly deductible. For many women, at-home fertility tests can be significantly more affordable than going to the doctor. The results can then be used to determine whether further, more costly, fertility tests and treatments should be pursued.
Fertility is complex. Though at-home fertility tests may make it easy for you to see your hormone levels, they don’t necessarily make it easier to understand what your results mean for your fertility and overall health. You’ll still need the help of a medical expert, whether it’s your doctor or a physician that works for the testing company. However, these tests can give you valuable insight into the state of your reproductive health, and that understanding can help guide you while you navigate your fertility journey.