By Anne Judge, MSN, ARNP
While at-home fertility tests seem like a cost-effective and time-saving way to take the guess work out of trying to get pregnant, do they actually work? SRM’s Anne Judge, MSN, ARNP weighs in on the pros and the pitfalls of trying to conceive with convenience.
Ovulation Predictor Kits
Examples: First Response Daily Digital Ovulation Test, Clearblue Fertility Monitor, Fertile-Focus
Pros: A more accurate way to track ovulation before it occurs in order to time conception attempts (as compared to methods like basal body temperature charting that detect after ovulation has occurred).
Pitfalls: Cost can add up over time, the kits do not work for everyone and can be difficult and frustrating to use if you have irregular cycles.
Are they for you? If you have regular periods, use of an ovulation predictor kit provides a fairly reliable indicator of when your body is expected to ovulate. We do recommend using the basic kits ($20-$40 per box) and not purchasing an expensive ($200+) digital monitor. The more expensive monitors check hormone levels in the early part of your cycle that can be impacted by fertility medications. While they work in a natural (un-medicated) cycle, they will not be reliable if you begin fertility medications.
Fertility Tracking Apps
Examples: Glow, Clue, Ovia
Pros: Provide a non-invasive way to look at cycle length over time and predict patterns of ovulation. Often inexpensive, easy for women to use and can have additional features (ex, Glow allows women and men to link their accounts and both collect information about their health and fertility).
Pitfalls: Work by looking at patterns over time, require several months of use to become more accurate for the individual and will not work well with irregular cycles.
Are they for you? Tracking apps can be beneficial for women with regular menstrual cycles to look for patterns over time and receive reminders of likely ovulation windows. They can be a good first step to understand your menstrual cycle when first trying to get pregnant. However, if you are already having regular intercourse (every 2-3 days) the use of a tracking app is unlikely to increase your chances of success.
Remember there are overlapping windows of time when sperm and egg will be alive in your body and able to meet to fertilize. If you have regular periods (ex. every 25-35 days) with intercourse every 2-3 days and have not conceived after one year (or after 6 months if over age 35) it is time to see a specialist for additional testing. If you are having irregular periods you should seek testing and treatment sooner.
Semen Analysis Tests
Examples: Trak, SpermCheck Fertility Home Sperm Test
Pros: Provide testing at home for a process that often causes men anxiety. 30–50% of couples seeking care for infertility have some degree of what we call “male factor” infertility, however often women complete expensive and invasive tests before the male partner has any testing.
Pitfalls: Home analysis provides a crude estimate that sperm is present in a concentration thought to be able to cause pregnancy. Home tests do not provide information about the motility (movement) of sperm, or the morphology (shape) which can both impact chances of conceiving. Sperm counts can also vary between samples.
Are they for you? A home test is better than not testing at all, and a negative home test provides a clear reason to see a fertility specialist. However, a positive home test does not indicate that male factors are not contributing to infertility. While most men are nervous about the process of collecting sperm for an office semen analysis, we try to make the process as simple as possible.
Our offices feature private collection rooms, movies (if desired), or the option to have your partner assist you in the collection (if desired). You can also schedule for a “home collection” semen analysis where you collect the sperm sample at home but bring it to our offices to be analyzed by a trained professional.
Examples: ZRT Single Panel Hormone Imbalance Home Test Kit, PH Test Kits for Saliva and Urine
Pros: Minimal. I see the appeal in being able to do a saliva or fingerstick test in your home rather than the inconvenience of a blood draw, but as we recently learned with the Theranos scandal there are reasons that minimally invasive testing (saliva and/or blood spot testing) has not yet become a standard of care. Reading the details of what ZRT’s fertility panel tests, it would provide some basic information, but not nearly in enough detail to replace an office visit and traditional blood test.
Pitfalls: To be accurate, many hormone tests need to be done in certain times relative to the menstrual cycle and compared to other labs. Home tests are typically done on a fixed day (day 3 and day 21). This means the tests on day 21 will not be accurate if you are a woman with longer cycles who is not yet post ovulatory. In addition, the day 3 home test measures only two hormone levels (FSH and LH) and claims to tell you about ovarian reserve (how your ovaries are functioning).
However, an FSH level is not considered truly accurate without a corresponding estradiol level drawn at the same time. This is because of hormonal feedback loops, if the estradiol is elevated (either because of an ovarian cyst or early recruitment of the dominant follicle that will produce your mature egg for that month) the FSH level can be suppressed and look falsely low (leading the test to say your ovarian results are ‘normal’ when that is not actually the case). It concerns me that women could be relying on home tests and be misled by inaccurate results.
Are they for you? My opinion is no. If you meet the criteria to consider doing hormone testing, you owe it to yourself to have the most accurate testing. Much like doing a home semen analysis, home hormone testing is marginally better than doing no testing at all, but has the potential to provide false reassurance and potentially miss an infertility diagnosis.
Remember that infertility is a medical diagnosis, there are tests and there are treatments. At home options that increase your understanding and awareness (such as ovulation kits or fertility apps) can be helpful. But when it comes to diagnostic testing like sperm and hormones, I suggest you seek out our expertise in addition to our support, there is no reason to go it alone (or at home). For those who have been trying for more than 6 months, we recommend setting up a fertility checkup as soon as possible. To schedule an appointment with one of our providers, call 206-301-5000.
Photo Credit: Alexandre Chambon