Nowadays, there’s seemingly an at-home test for anything and everything you can imagine. Genetics, food sensitivities and allergies, STDs, glucose levels . . . the list just keeps going. And, of course, there’s the OG: the pregnancy test. There’s also at-home fertility tests, which have become popular in recent years and are marketed primarily to women and those assigned female at birth who are trying to conceive.
But the “how” surrounding at-home fertility tests remains confusing for some – and even more confusing is what to do with the results. Here, two leading doctors weigh in on at-home fertility tests, how they work, and what they can and cannot do.
At-Home Fertility Tests Explained
“At-home fertility tests are tests designed to determine if there are significant obstacles to conception,” says Eric Flisser, MD, ob-gyn for RMA of New York. He explains that most at-home tests are limited to noninvasive testing – using urine, saliva, or cervical mucus – but that blood is also used in some tests, whether that’s a prick you do yourself that’s sent to a lab or blood drawn by a pro at a specific location.
At-home fertility tests rely on these blood, urine, saliva, or cervical mucus samples to help users either a) understand their fertility picture (aka if they may have trouble getting pregnant) and/or b) try to capitalize on the best time in their cycle to get pregnant. Some results (primarily those from urine, saliva, and mucus tests) can be interpreted and acted on entirely at home, and others (primarily those from blood samples) need some level of lab or testing facility involvement.
How Do At-Home Fertility Tests Work Exactly?
“At-home fertility tests for women include assessments of egg numbers and tests that track women’s cycles for determining ovulation and timing intercourse,” says Barry Witt, MD, medical director at Win Fertility.
“At-home testing that tracks women’s menstrual cycles are meant to estimate the time of maximum fertility during a menstrual cycle,” Dr. Witt explains. Ovulation detection devices may use urine, saliva, or cervical mucus. “These include kits for monitoring urinary luteinizing hormone, electronic monitors, and devices for assessing cervical mucus or skin temperatures and pulses.”
Blood, on the other hand, is often used to test for ovarian reserve through the detection of the anti-mullerian hormone (AMH). (Blood can also be used to test other hormone levels that impact fertility, such as follicle-stimulating hormone estrogen and thyroid levels.) “[AMH is a] substance produced in the ovarian follicles where the eggs are, and is released into the blood – so higher levels of AMH indicate more eggs,” Dr. Witt explains.
While you can garner valuable information from these tests, both Dr. Witt and Dr. Flisser explain that at-home fertility tests have a limited use – in fact, it may be more accurate to describe them as infertility tests, though that sounds much scarier to a user (and probably wouldn’t go over well with marketing teams).
“There is truly no test that can predict fertility except a positive pregnancy test,” Dr. Flisser says. “There are literally no tests that can tell you if you can get pregnant. There are only ‘infertility tests’ to assess whether there are unusual obstacles to achieving successful pregnancy.”
So, Are At-Home Fertility Tests Worth It?
Both experts emphasize that these at-home fertility tests can only give you a small snapshot into your fertility, and they aren’t meant to be diagnostic tools, but rather helpful additions to your fertility journey. A low number of eggs, for example, may be related to fertility issues, but it does not predict future pregnancy, nor does it address other potential causes of infertility, including male factors, problems with the fallopian tubes or uterus, ovulation disorders, or other hormonal problems, Dr. Witt says.
“Similarly, there is no substantial evidence that monitoring for ovulation, with or without an at-home fertility test or app, increases the chance of pregnancy in the cycle when compared to frequent intercourse,” Dr. Witt says. “There is a common misperception that the timing of intercourse is crucial and that some form of technology must be employed to time intercourse.” For those couples having infrequent sex (meaning once or twice a month), Dr. Witt notes that these ovulation detection devices and tests may prove more useful. (Though he also notes that low-tech methods of monitoring the menstrual cycle, like using a calendar or app or tracking cervical mucus, may work as well as at-home ovulation testing, and at a much lower cost.)
Both doctors also agree that while testing may give users some peace of mind, for others, it may cause anxiety and stress – so while there isn’t a cap on how many times you can use at-home tests, it’s recommended to do so in conjunction with talking to a doctor who can give more context and recommendations based on your own medical history. This is particularly recommended for those over the age of 35 and for those with irregular periods or long menstrual cycles, for whom ovulation is happening very infrequently or not at all, as at-home testing may not provide a clear picture of hormones and fertility windows.
“The major pitfall of at-home testing is the lack of a trained physician to help provide context and interpret the results,” Dr. Flisser says. “Frequently, concepts such as ‘ovarian reserve’ are poorly understood and can lead to erroneous assumptions about a person’s health or fertility (or lack thereof).” Dr. Witt also emphasizes that while fertility tests are helpful, they’re probably most helpful to those who are just starting to try to conceive to help identify potential problems early on, but for those who have been trying to have children for over a year or are over 35, you’ll want to talk to a doctor.
The TL;DR: at-home fertility tests should be used with an understanding that they are simply helpful additions to understanding one’s ability to have children, but they do not tell the whole picture. Consulting your doctor is always the best course of action when it comes to assessing your ability or inability to conceive.
