More than 6 million American women struggle to become pregnant or stay pregnant, according to the Department for Health and Human Services. For many, simply having access to understandable information and being proactive about fertility could result in an easier time conceiving a child.
That's where at-home fertility testing comes in. Several companies allow women to test their fertility and gain insights into how they can conceive. Here's everything you should know about at-home fertility testing.
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Why you should try an at-home fertility test
At-home fertility tests, such as those from Modern Fertility, EverlyWell and Let'sGetChecked, provide women with a convenient, proactive and relatively inexpensive alternative to traditional clinic tests. These hormone-based fertility tests are designed to give women a picture of their general reproductive health, and to encourage proactive decisions rather than reactive ones.
Dr. Robert Penney, an OB-GYN in Holmdel, New Jersey, looks at these tests as a way for women to drive discussions about reproductive health.
"Much like the birth control pill gave women control of their reproductive choices, proactive fertility hormone testing gives them some control over their reproductive success," Penney told me.
Federal insurance plans don't cover proactive testing, and most state insurance plans only cover fertility tests if you can prove that you weren't able to conceive after trying for an entire year. If you're 35 or older, your insurance may cover fertility tests if you can prove you've been trying for six months or more.
Without insurance, the cost of a test from a lab or clinic can be prohibitively high. When Modern Fertility co-founder Afton Vechery underwent traditional clinical fertility testing herself, she ended up with a $1,500 bill.
You can always take a trip to a fertility clinic or your regular OB-GYN to get tested for these hormones if you feel more comfortable taking your test with a board-certified doctor present. Keep in mind, though, that the cost of a basic fertility test can soar upwards of $800 at a clinic.
If a patient takes an at-home test and receives concerning results, Penney notes that doctors should provide supportive -- but deliberate -- counseling to encourage them to see a reproductive endocrinologist. Doing so allows the patient to explore reproductive possibilities.
How fertility tests work
Generally speaking, fertility tests measure levels of different hormones in your body that are thought to be good indicators of reproductive health. Female fertility hormones include:
- Anti-Müllerian hormone: a good predictor of your ovarian reserve, or how many eggs you have in your ovaries
- Follicle-stimulating hormone: responsible for beginning the ovulation process
- Estradiol: a sex hormone that impacts follicle stimulation
- Luteinizing hormone: helps regulate your menstrual cycle
- Thyroid-stimulating hormone: impacts your thyroid and general health
- Free thyroxine: provides a good overall picture of thyroid function as it relates to reproductive health
- Prolactin: stimulates milk production and pauses ovulation after childbirth
- Testosterone: a sex hormone both men and women produce
These hormones are tested via a sample of your blood. To take an at-home fertility test, you'll need to self-administer a finger prick. Your test will come with the equipment you need to do so and detailed instructions to follow.
Always wash your hands thoroughly before attempting a blood draw. Then, clean your selected finger with an alcohol swab and dry it with a clean tissue or towel. Your test should arrive with a small tool called a lancet that makes the prick easy: Just place it on your finger and press down. After you prick your finger, a small droplet of blood will appear. Use your other hand to gently squeeze your pricked finger and collect the blood in the small vial that comes with your testing kit.
All fertility tests, regardless of brand and location performed, take a few days to analyze. Your results include a report with personal explanations about all of the hormones you tested for, and their potential impacts on your fertility status.
What a fertility test can (and can't) tell you
Vechery and Leahy are quick to point out that their test -- and others like it -- won't tell you if you're fertile or infertile. Instead, they act as a starting point to help you figure out whether you need or want to seek additional fertility consulting and treatment.
What hormone-based fertility tests can tell you is:
- How your hormones relate to your general health, for example, thyroid-stimulating hormone affects your metabolism as well as your ability to conceive and sustain a pregnancy
- If you have more or fewer eggs than average
- If you may hit menopause earlier or later than average
- What your egg freezing or IVF outcomes might look like
- If you may be at risk for polycystic ovarian syndrome
- If you have any other hormonal conditions, such as an underactive thyroid, that may impact your ability to get pregnant
Knowing and understanding your hormone levels (and keeping track of them over time) can spark important discussions with your partner, provide you with vital information to give your doctor and influence financial decisions and treatment plans.
Ultimately, fertility tests should only constitute one part of the bigger picture, and they shouldn't take the place of a doctor's advice. Additionally, fertility tests shouldn't be misconstrued to represent notions about what is and isn't possible for you.
If you've been trying to get pregnant and haven't succeeded, you should consult with a physician or OB-GYN. Your doctor may want you to take other blood and urine tests, along with an x-ray of your uterus and fallopian tubes to check for any abnormalities.
Dr. Kecia Gaither, an OB-GYN and Maternal Fetal Medicine specialist in New York, told me that it's best for both partners to undergo a thorough medical history and physical exam if fertility is a concern.
"I don't think that a complete picture of causality for infertility can be had with an at-home test for fertility," Gaither said. "For any patient that elects to do an at-home test [and gets] an unexpected result, I would advise a visit to a reproductive endocrinologist."
Understanding your options
There's a lot to consider when making decisions about fertility testing and treatment. Modern Fertility, Let's Get Checked and EverlyWell are three US services that offer similar tests in a similar price range.
Each EverlyWell test is customized to biomarkers that the company's medical team thinks will be the most useful to you, based on the test you choose and your health survey. Its women's fertility test costs $159, and measures five hormones that influence reproductive health: estradiol, luteinizing hormone, follicle-stimulating hormone, testosterone and thyroid-stimulating hormone. It also offers other women's health tests for less that don't measure as many factors, such as the ovarian reserve test ($79).
You also have the option to subscribe to EverlyWell tests and receive them monthly, quarterly or every six months. This is a great idea for those wanting to test their fertility, because fertility hormones change with age. EverlyWell tests are all physician-ordered and supported by independent research.
You can choose from three at-home fertility tests with Let'sGetChecked: a progesterone-only test ($89), an ovarian reserve test ($139) and a more broad female fertility test ($129) that measures multiple hormones.
Let'sGetChecked delivers your test in discreet packaging with next-day shipping. It's best to take your test in the morning so you can return it the same day. Send it back with the prepaid shipping label and your results will be online in two to five business days. You can take your results to your doctor, or chat with the team of physicians and nurses that Let'sGetChecked has at the ready for customers.
Modern Fertility offers one all-encompassing test for $159 that measures all eight hormones thought to influence fertility and pregnancy. You can opt for the at-home finger prick, or test at a Quest Diagnostics location if there's one near you.
All Modern Fertility customers receive a one-on-one consultation with a fertility nurse at no additional cost and access to the online community Modern Women, as well as access to weekly webinars (aptly nicknamed "Egginars") to learn new information.
With Modern Fertility, you'll also receive a Fertility Measurement Index, a tool you can use to track fertility over time. The FEMI is a flat number that ranges from 200 to 750. Your number is comprised of your age, hormone levels and general health information like your BMI and lifestyle habits. A higher FEMI represents better fertility -- FEMI typically declines with age as hormone production decreases.
Getting a grip on fertility
Because there is no absolute predictor of fertility -- except actually giving birth to a baby -- the founders of Modern Fertility decided that comprehensible information is the best first step to making family decisions.
"We're waiting longer to have kids but our biology hasn't changed, and neither has fertility education," Vechery told me. "Today, one in six couples has trouble conceiving and often, we don't learn about fertility until we're having trouble."
Dr. Douglas told me that receiving unpromising results does not mean a woman is infertile. Rather, the results are just meant to open up a conversation about the different options a woman has.
"You only need one healthy egg (and sperm) to get pregnant, so I make sure [patients] understand that women with lower egg counts can absolutely still conceive," Douglas said.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.