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STDWatch
Dr. Patricia Shelton

Dec 02, 20227 min read

How Do Fertility At-Home Tests Work?

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If you’re trying to conceive, or considering becoming a parent, then you may be wondering about your fertility. You may have considered different ways of checking fertility at home. One method is through an at-home fertility test. There are several different at-home fertility tests available for women.

Are at-home fertility tests accurate? Are they really a good way of knowing whether you’re still fertile?

How do at-home fertility tests work?

At-home fertility tests may measure a few different hormones to get a sense of whether you’re likely to be fertile. One of these is anti-mullerian hormone (AMH). AMH is a hormone that’s produced in follicles in the ovary. Each follicle contains an egg. Measuring your levels of AMH gives a sense of how many eggs you have left in your ovaries, which is known as your ovarian reserve. (Because a baby girl is born with all the eggs she’ll ever have, your supply of eggs is slowly depleted over time, leading to a decrease in fertility.)

These tests can also measure follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones are normally involved in the development of a follicle into a mature egg, and the release of the egg from the ovary. In the early stages of menopause, as levels of estrogen decline, the levels of FSH start to rise. Later, LH rises too; in a woman who’s in the menopausal transition, both FSH and LH will be very high. Measuring these hormones can give you a sense of how close you are to menopause. It’s important to do the test on day 3 of your menstrual cycle, as the levels of both hormones will naturally vary quite a bit over the course of a cycle.

 

Another type of test measures progesterone on day 21 of the menstrual cycle. This can give you a sense of whether or not you’ve ovulated that month. Progesterone should go up after ovulation occurs, and if this doesn’t happen, it could mean that you’re not ovulating normally. Doing this test a few times should give you a sense of how often ovulation is occurring. 

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How accurate are at-home fertility tests?

If you choose a reputable company to order your home fertility test through, then the sample should be tested in the same laboratories that a test from your doctor would use. This means that your at-home fertility test will be just as accurate as if you had the test ordered through your doctor. Check at-home fertility test reviews to determine whether you’re ordering a reputable test.

The AMH test is used to measure ovarian reserve. This can give you a sense of how much longer you have before you lose your fertility. Having a low AMH doesn’t necessarily mean anything about your current fertility – you still have a similar chance of getting pregnant naturally if your AMH is lower as if it’s higher. However, if your AMH is low, then you might have a short window left in which you’ll be able to get pregnant.

If you have a high FSH level, this is an indication that you may be getting closer to menopause, meaning that you have a low ovarian reserve (fewer eggs left). Some studies have shown that women with a higher FSH have a lower chance of getting pregnant. If your FSH is starting to go up, then this doesn’t mean that you can’t get pregnant, but your window for conception may be closing. If your FSH is very high, then it could mean that you’re already going through menopause, particularly if your LH is high too.

If you get an abnormal result on a home fertility test, and you’re hoping to conceive, then it’s a good idea to schedule a visit at a fertility clinic for further evaluation. If you’ve been trying to get pregnant for at least a year without success (or for 6 months if you’re over 35), you should also strongly consider visiting a fertility clinic.

Is an at-home fertility test the same as an ovulation prediction test?

There are kits available that can allow you to predict exactly when you’ll ovulate. The tests measure your LH level. When this level spikes, ovulation will occur in 12 to 36 hours. This can help you to time sex during the window when you’re most fertile, to increase the chances that you’ll conceive.

An ovulation prediction test is different from an at-home fertility test. With an ovulation prediction test, you’ll need to test each day around the window when you expect to ovulate, and you’ll need to get the results right away in order for them to be useful. This is intended to predict your immediate fertile window. However, with an at-home fertility test, the goal is to measure your fertility more generally, to allow you to make plans for your family from an informed perspective. Rather than predicting on which specific day you’ll be fertile, the goal of an at-home fertility test is to know whether you’re likely to be fertile in general, or to learn how much time you may have left to get pregnant.

Sources

Anti-Mullerian Hormone Test. Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/22681-anti-mullerian-hormone-test. Accessed 26 Sep 2022.

Follicle-Stimulating Hormone (FSH) Levels Test. National Library of Medicine. https://medlineplus.gov/lab-tests/follicle-stimulating-hormone-fsh-levels-test/. Accessed 26 Sep 2022.

Huang LN, Jun SH, et al. Predictors of in vitro fertilization outcomes in women with highest follicle-stimulating hormone levels ≥ 12 IU/L: a prospective cohort study. PLoS One. 2015 Apr 13;10(4):e0124789. doi: 10.1371/journal.pone.0124789.

Lin C, Jing M, et al. The Value of Anti-MĂĽllerian Hormone in the Prediction of Spontaneous Pregnancy: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne). 2021; 12: 695157. doi: 10.3389/fendo.2021.695157

Sherman BM, West JH, et al. The menopausal transition: analysis of LH, FSH, estradiol, and progesterone concentrations during menstrual cycles of older women. J Clin Endocrinol Metab. 1976 Apr;42(4):629-36. doi: 10.1210/jcem-42-4-629.

The Normal Menstrual Cycle and the Control of Ovulation. National Library of Medicine. https://ncbi.nlm.nih.gov/books/NBK279054/. Accessed 26 Sep 2022.


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