Knowing more about your individual fertility is a good thing, especially given the general lack of awareness – often among young women – about the age when fertility starts to decline. This lack of knowledge has real-life implications if women make decisions based on the mistaken idea they can easily get pregnant and deliver a healthy baby in their late 30’s/early 40’s.
Young women thinking about their fertility are the focus of the new trend of fertility start–ups offering infertility test home-kits, apps to track fertility, and pop-ups in trendy neighborhoods. The often stated goal of such start-ups is to educate women about fertility and in turn help them feel more in control of their bodies and the choices they make. These companies are also upfront that “fertility can’t be predicted with a single test” writes Huffington Post’s Anna Almendrala in The Problem with Trusting a Start-Up to Monitor Your Fertility.
For some women wanting to know more about their own fertility, there’s an appeal to being able to directly and conveniently access personal health information in the privacy of their own home rather than start at the doctor’s office or clinic. That’s supported by the focus groups of one start-up that found many women felt intimidated or overwhelmed about starting the process to learn more about their individual infertility.
Being able to gather some information about your fertility – whether through a home infertility test or app – can be a step in the right direction if it means paying attention to the issue at an earlier age and seeking medical care before age becomes an issue.
Start-ups offering home infertility tests measure a variety of hormones that affect reproduction. The anti-Mullerian hormone (AMH) is considered the most critical: it measures ovarian reserve and the assumption is that the higher the level, the more eggs and the more likely they will respond to treatment to stimulate egg production for freezing or in vitro fertilization (IVF). However, AMH results can be misleading: research shows that a woman with a low AMH level is just as likely as a woman with high reserve to get pregnant within a year. And, a high AMH level might leave women “falsely reassured” according to Lisa Grossman Behct, MD, Director, Egg Freezing and OncoFertility at New York’s Columbia University Fertility Center as there may be “other fertility issues that make it harder for them to get pregnant.”
Hormonal analysis is just one of the many tests that might be part of a fertility work-up you’d receive in a doctor’s office or a fertility clinic. Evaluation might also include ultrasound and saline tests to confirm the uterus is normally-shaped and fallopian tubes are not blocked, both necessary for the egg and sperm to meet and fertilize. Together, these tests offer a more complete picture of a woman’s fertility to inform any decisions on fertility procedures or treatment.
The appealing marketing by many of these start-ups has garnered media attention and celebrity endorsement. Just as fertility experts expressed concern over heavy marketing to young women and misconceptions about egg freezing, they worry that some start-ups market their services to single young women with the promise that a single blood test can provide “actionable information.”
Fertility is complicated, affected by multiple factors so decisions on procedures or treatment should not be based on simple infertility tests taken at home. If male fertility is not considered, a woman only has part of the information needed to gauge whether she’ll be able to get pregnant. Forty – fifty percent of the time, infertility issues are due to male factors. A man may need a sperm analysis to determine the quantity and quality (shape and speed, for example) of sperm; there are home kits for that, too. And while it may be popular, the process of egg retrieval for egg freezing is neither inexpensive or easy, so talking to your doctor is a good idea.
If at-home fertility kits, apps and do-it-yourself services get women and men to pay attention sooner rather than later to their own fertility as they consider having children, that’s a good thing. It shouldn’t be a substitute for medical diagnosis or advice to determine infertility care and treatment. Most start-ups don’t have equal expertise or ability to interpret test results in the context of other influential factors including reproductive and family history.
ARC Fertility supports the idea that women and men who are thinking of starting a family should be well-informed about the issues that affect their fertility including lifestyle habits and age. For that reason, we’ve created The ARC Fertility Marketplace which offers a choice of products including at-home fertility kits, a sperm tracking kit, and a home test to measure testosterone in both men and women and more. While these are not a substitute for expert medical care, consider them first steps – or baby steps – on your journey to becoming parents!