Are At-home Fertility Tests Worth It?
In today’s society, pretty much everything we want or need can be shipped and delivered to us within a click of a button. But, are at-home fertility tests worth the hype and do they actually give you the information you need in order to optimize your fertility? Whether you are just thinking about starting a family or have been trying for a while, chances are, you have seen a variety of ads, influencers and social posts about at-home fertility testing.
So are at-home fertility tests worth the hype? Let’s dive in.
No All At-Home Fertility Tests Are Created Equal
Direct to consumer lab companies are popping up everywhere and although they may have amazing marketing, it is extremely important to make sure if you do decide to use a direct to consumer lab company that you find out exactly how your lab results are processed and who is reviewing the results. Make sure the company you are using is CLIA certified. The Clinical Laboratory Improvement Amendments (CLIA) is a unique agency that regulates laboratory testing and upholds clinical laboratory standards involved in human sampling for diagnostic testing. Must direct to consumer lab companies will be proud to share that they are CLIA certified. If you can’t find it on their website or if you call them they can’t prove they are CLIA certified, this is a huge red flag. A CLIA certification is extremely important when it comes to the accuracy and efficacy of the results provided by the lab company.
Just a Piece of the Puzzle
If you are considering at-home fertility testing, understanding what testing can really offer you in terms of diagnosis and treatment options is important. There are a variety of testing options available on the market but, even by taking a variety of tests, this doesn’t guarantee that you will be able to pinpoint any (let alone all) of the challenges that may be preventing you from getting pregnant. Comprehensive testing is just one piece of the puzzle. Some testing companies also market that they are “comprehensive” but often provide limited understanding in terms of the exact root causes of your potential hormonal imbalance. For example, some lab companies will include evaluating for ovarian reserve using a common test known as a Anti-Mullerian hormone (AMH) test. Now although even in our clinic we use AMH testing, it is very important to understand that this particular test was designed to help reproductive endocrinologists estimate their success rates with IVF based on a guesstimate of ovarian reserve. Not only is AMH a guesstimate of ovarian reserve because there is no current test that can provide us an exact reading of your ovarian reserve but, this test was based on IVF cycle rates not natural conception. This means that just because your AMH levels using an at-home fertility test are suboptimal or listed as low, doesn’t mean you’ll never be able to get pregnant naturally. It should however prompt you to meet with your doctor for further evaluation.
Not all Tests Are Perfect
Although we would like to assume all testing is always accurate, the reality is it’s not. There are absolutely laboratory errors, as well as, common factors that can influence the accuracy of certain lab tests. For example, LabCorp, a well known American laboratory company used by both medical clinics and consumers alike, has warned that high intake of biotin-containing supplements (i.e. your hair, skin and nails supplements or prenatal), can influence the accuracy of some of their tests including Thyroid Stimulating Hormone (TSH), Vitamin D, Ferritin, as well as Parathyroid Hormone (PTH). Patients are recommended to discontinue all biotin-containing supplements at least 48 to 72 hours prior to testing.
Let me guess, your direct to consumer lab company didn’t mention this.
It’s also important to understand that especially with hormone testing, our hormones fluctuate hour by hour and day by day, which means timing is really everything. If you are testing your hormones at 3pm vs. 8am in the morning, this alone can produce a variation in your results that could look abnormal when in fact, this is a normal occurrence of your hormones. Now although this may be more obvious in women, if your partner is undergoing at-home testing, this absolutely applies to him as well. In fact, studies have shown that testosterone levels can be reduced by up to 30% when labs were drawn in the afternoon versus first thing in the morning. The best time to test hormones, including not only reproductive hormones like estrogen and progesterone, but hormones involved in adrenal and thyroid health, is generally between 7-9am. So again, although direct to consumer lab companies like to promote that their tests can be done at any time of the day, making sure you are performing the test during optimal hours is best.
Tests can also be influenced by particular disease patterns as well as medications you are currently taking. For example, if you have been diagnosed (or even undiagnosed) with Polycystic Ovary Syndrome, PCOS, your AMH, as well as, Prolactin levels may look elevated due to your disease state and aren’t an accurate reading in terms of ovarian reserve. This is a huge impeding factor to at-home testing and may provide you a false sense of comfort when in reality an elevated AMH level may be a sign you may have an underlying hormonal disorder like PCOS.
Certain medications, especially birth control, can absolutely influence the accuracy of your lab tests so although we at NMD Wellness of Scottsdale we advocate for proactive testing, if you are currently on birth control, it is not worth your money to complete comprehensive hormone testing. Not only will birth control influence your hormone levels because birth control prevents ovulation but, the estrogen so commonly found in your birth control can interfere with the bioavailability of thyroid hormones impacting your results. Opting for fertility testing about 2-3 months after discontinuing birth control is ideal.
If Something is Abnormal, RETEST!
One abnormal reading is never enough. If you recently completed an at-home fertility testing and got your results back telling you that you might have hypothyroidism or that your prolactin levels are elevated, make sure you repeat the test, or better yet, go directly to your doctor’s office to consult with your doctor. Even in a medical clinic like ours, we know that fluctuations can happen and it is important to retest abnormal values. So please, if you have elevated prolactin levels, for example, don’t assume you have a brain tumor due to one elevated reading. The internet will make you think that either everything is totally fine or you are dying. This is where working with a trained medical profession can not only ease your mind but also help you create a treatment plan that is right for you.
Many at-home fertility test companies will promote that their tests are extremely accurate even promoting that they are 99% accurate for detecting disease; however there is a huge difference between real-world applications and laboratory- proven accuracy. Not to mention, we have to remember that even if you read the instructions prior to completing your sample, there is always the possibility of human error which again can interfere with the accuracy of your results.
At-Home Testing Won’t Usually Save You Money
One of the big reasons why so many consumers are drawn to direct to consumer lab testing is for the accessibility and price. The idea of making an appointment with their doctor may feel daunting or overwhelming. Many people also assume that if they do talk to their doctor that IVF will be their only option. But the reality is that, if you are opting for at-home fertility testing in an effort to save money, the reality is you will likely end up spending more money with limited direction or guidance as to treatment options based on your particular results. Not only can this be frustrating because many of the tests you have completed using an at-home fertility clinic will likely be repeated by your doctor but, without proper fertility evaluation you may continue “trying to conceive” without really getting to the root cause of your infertility, causing you to waste more time. For example, many at-home fertility tests will evaluate your progesterone levels in the first part of your cycle, during the follicular phase. Although this is good to know, this does not give us any information on whether or not you actually ovulated and since ovulation is necessary for conception, you could be told that your hormones look “normal”, when it fact, you are struggling to ovulate and this could be the root cause of your infertility.
One Size Does Not Fit All
Many direct to consumer lab testing options are created to provide care to the masses and do not provide individualized recommendations or testing guidance which means that if you have regular menstrual cycles there is a higher chance these one-size-fits-all tests will provide you more accurate results. However, if you have irregular cycles, many of these direct to consumer lab testing options can provide you limited benefits. We also know that just because you have a regular period, this doesn’t mean you ovulate regularly, so don’t assume that just because you have regular periods that fertility testing is not necessary for you.
What if all your labs are “normal” is that enough to say you shouldn’t have any issues getting pregnant?
In an ideal world, we would all love to take an at-home fertility test, see that are results are normal and assume everything is fine and we just need to “keep trying”, but the reality is laboratory testing is just one piece of the puzzle and does not take into consideration other important factors involved in your fertility include anatomical dysfunctions, chromosomal as well as genetic factors. Hormone testing is just the first step in evaluating your fertility and should always be accompanied with an evaluation by your doctor and fertility team. At NMD Wellness of Scottdsdale, we work with a variety of OBGYNs and reproductive endocrinologists to provide our patients with unparalleled fertility care that involves diagnostic testings, like hormone testing but also imaging options like pelvic ultrasounds and HSG, as well as, functional testing options including thyroid, adrenal and stool analysis that help address underlying conditions associated with factors like recurrent miscarriages and unexplained infertility.
About the Author: Meet Dr. ZenAlissia Zenhausern- Pfeiffer, NMD, FABNE, (commonly known by her patients as Dr. Zen), is a licensed naturopathic doctor board certified in naturopathic endocrinology and the founder of NMD Wellness of Scottsdale, a premier naturopathic medical practice that focuses on helping women to take a proactive approach to their hormone and fertility health. Dr. Zen has been featured as a lead expert in Forbes, Shape Magazine, and Instyle and is deeply passionate about bridging the gap between traditional and natural medicine in the world of fertility. She works with a variety of hormone related issues including PCOS, endometriosis and unexplained infertility. Her goal is to help more women get back into the driver’s seat of their own health to make lasting transformational changes to their health to bring more cute and adorable babies into this world. Read More About Dr. Zen...