Family Planning

Clinic Corner: At-home fertility tests

Believe it or not, the global fertility testing market is projected to exceed $840 million in the next five years, according to the latest research, and over-the-counter tests are part of this trend. While the tests vary, most require a blood or urine sample – you will either receive results at home in minutes or mail in the sample and hear back a few days later. Clearly, these tests are convenient, but are they accurate?

Dr. Erin Stevens and her husband struggled with fertility, and a heartbreaking miscarriage, for more than a year: “It was extremely difficult, frustrating and emotional, and I cried every month when my period came to seemingly remind me that I was never going to be a mother.”

However, when the couple went in for fertility testing at a local clinic, all of their results were normal, falling into the category of “unexplained infertility,” which impacts 5-25 percent of those with an infertility diagnosis.

Dr. Stevens added, “If we had done testing in advance of trying to conceive, it wouldn’t have been helpful and may have been falsely reassuring. Therein lies part of the problem with screening fertility tests. Results need to be interpreted in context and don’t always mean a lot for someone who hasn’t tested the process yet. They may give a false sense of security to some or unnecessarily worry others – potentially leading them down a rabbit hole of further testing, medical treatments and/or trying for pregnancy before they’re truly ready.”

Fertility testing can assess everything from sperm appearance and motility to how the uterus and ovaries are responding as well as check to ensure the fallopian tubes are open. Direct-to-consumer tests, however, only evaluate a portion of this, typically looking at hormone levels.

“While every person absolutely has the right to information about their own body and that information can be empowering, testing like this might give answers without the right questions,” Dr. Stevens said. “Results need to be taken with a little bit of a grain of salt and shouldn’t serve as the sole guidance for decision-making.”

Dr. Stevens has recommended at-home testing for those who have issues with time, finances or access to care. Over-the-counter tests rarely are covered by insurance and fees don’t go toward a deductible, but may be covered by HSA funds. In conclusion, “If someone does pursue this type of testing, whether results appear normal or abnormal, they should always plan to discuss them with their reproductive healthcare provider to best interpret and apply them,” Dr. Stevens said.


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