Have you ever used DTC fertility tests before? DTC stands for “direct-to-consumer” fertility tests, which have become increasingly popular in recent years as women want to take more control of their fertility and gain a deeper understanding of it. More commonly referred to as at-home fertility tests, they are widely considered to be a convenient way of helping individuals understand their fertility levels. But is all as it seems? For women (and couples) who are starting to think about conception (or for those who have been trying for some time without any luck), there are some important considerations to take into account. Let’s take a look at both the benefits and the issues with at-home fertility tests.
The draw of at-home fertility tests
In a world where the fertility rate is continually decreasing, becoming increasingly more self-aware and getting an early indication of your fertility levels is a smart choice. At-home fertility tests benefit from:
- Being easy to use
- Having a quick turnaround time for getting results
- No need to attend a clinic or a consultation
- Being easy to source online
- Being reasonably inexpensive
- Can be carried out in the privacy of own home
At-home fertility tests usually require obtaining a sample of blood by using a lancet on one of the fingers to get a few drops of blood. The sample is then usually returned by post to the laboratory, and results are emailed or sent in the post after the agreed time.
What are the downsides of direct-to-customer fertility tests?
While at-home fertility tests can indeed offer insights into fertility markers, it’s crucial to be aware of their limitations and potential risks.
It’s not the full picture
A study by the University of Sydney, published in JAMA Network Open, examined 27 companies from the UK and other countries regarding their advertising of Anti-Mullerian Hormone (AMH) tests to consumers. It found that only one-third mentioned that the test cannot predict a woman’s likelihood of conceiving, while 40% claimed that the test results would allow women to adjust their reproductive timeline and delay starting a family. Overall, it was determined that marketing of at-home fertility tests was misleading and could give women a false sense of security. What do they mean by that?
Let’s use the AMH test, one of the most common at-home fertility tests for women, as an example. Why? The AMH level is important because it gives an indication of an individual’s ovarian reserve. The ovarian reserve is the collection of eggs a woman is born with. This declines with age and eggs do not get replenished – once they’re gone, they are gone! Understanding AMH levels can indicate if a woman has many eggs remaining or if she has fewer than ‘normal’ for her age. If the levels are shown to be lower than ‘normal’ for her age, this indicates a low ovarian reserve. This is usually caused by an underlying health condition and will need further investigation and treatment is often required to help aid conception.
The issue is that the AMH test alone is not an accurate measure of a woman’s fertility. It simply measures the amount of AMH hormone in the blood. There are many different factors that determine a woman’s fertility and looking at one small piece of a much larger puzzle can give false hope. A much wider view needs to be taken to give an accurate picture.
The AMH test – or any at-home fertility test – cannot detect physiological issues like scarring, fibroids, pelvic inflammatory disease (PID), and other issues with the uterine cavity that may be preventing conception. A woman may have ‘normal’ AMH levels, but if scarring in the fallopian tubes is preventing the egg from travelling into the uterus, then she will not conceive naturally – no matter how great her AMH levels are.
Relying solely on hormone levels is not recommended, and a wider analysis of lifestyle, fertility history, medical history, environmental factors, and physical tests like pelvic ultrasound are required to give an accurate measure of fertility. This requires the expertise of a fertility doctor.
Male partners will also need to have fertility tests, after all, the male factor contributes to up to 40% of all cases of infertility. Men’s reproductive health is just as vital to get an understanding of a couple’s conception potential.
Reliability
Another concern with at-home fertility tests is their reliability. Finger prick tests may be easy but they are not always accurate, and can deliver false positives. The amount of blood collected can be insufficient, samples can easily be contaminated, and false positives given. A fertility clinic will carry out venous blood samples to reduce risk of contamination and get the most accurate blood draw. They are less likely to give false positives, and are more comprehensive.
At home or in-clinic fertility tests?
On the surface, at-home fertility tests certainly seem like a reassuring and convenient choice, but it’s important to bear in mind their limitations. At-home fertility tests should not be considered a replacement for thorough in-clinic fertility testing. Not testing for potential physiological issues can impact an individual or couple’s fertility journey and delay conception.
Given the limitations and potential inaccuracies of at-home fertility tests, for couples and individuals looking for an accurate picture of their fertility, it may be a better idea to invest in advice from a healthcare professional who will be able to provide personalised guidance.
In the UK, fertility tests may be available on the NHS, depending on how long a couple has been trying to get pregnant. However, it’s essential to remember that time is fertility; understanding if there are any issues early on in the conception journey is the fastest way to get peace of mind and ascertain whether any intervention is required. You can also book in a fertility test for women or for couples at a private fertility clinic, which will give you fast and accurate results on your own terms.
Even a basic fertility MOT at a fertility clinic can provide detailed and accurate information, giving clarity as to where you are in your journey towards conception. It’s a great investment in your future family.