How to Check Fertility

The Best Ways to Check Your Fertility

How Can I Check My Fertility? Whether you just want to learn more about your body or you have been trying to conceive for months, there are ways you can test your fertility. The best part? For some of them, you don't even need to leave home

For women, one of the first steps you can do to learn more about your own fertility is to make sure that you are ovulating. A simple way to do this is to track when your period comes each month. Anything outside of the 24-35 day range is a warning that your cycle might not be on track.

For men, infertility is nearly impossible to track without some type of at-home or in-office diagnostic test. Fortunately, the process is painless and can be downright enjoyable [wink, wink].

How To Test Your Fertility at Home

Why go to the doctor when you and your partner can have your fertility checked from the comfort of your own home? Well, there are a few reasons. If you think something might be off, a great first step is to check with your primary care physician or OB-GYN. However, some couples prefer to keep things private - especially in the beginning of their TTC journey. Or, perhaps they don’t have an amazing relationship with any of their existing doctors. In either of these cases, an at-home fertility test is one of your best first bets.

You’ll want to use a high-quality at-home test and, brace yourself, pretty much all of them require a blood sample. Fortunately, it’s relatively quick & painless to provide one these days. But can a teeny tiny blood sample actually reveal what’s going on inside your ovaries? Can it really indicate the likelihood of pregnancy? Believe it or not, the answer to this is yes.

Turns out, just one little drop of blood can provide a wealth of information. (Let’s not forget, though, that a man’s sperm is also key in making babies happen.) Here, we break down some of the more popular at-home fertility test kits for women, what they test for, and how to differentiate a good one from a bad one …

What should I look for when shopping for an at-home fertility test kit?

Seek Approval

The CLIA (Clinical Laboratory Improvement Amendments) are federal regulatory standards for all clinical lab tests in the United States. In order to meet these standards, specific levels of accuracy, reliability and timeliness must be met. Look for the CLIA emblem on your test’s packaging.

Also, be sure to search out CAP-Accreditation (College of American Pathologists) which ensures that the lab processing your tests is appropriately licensed. Lastly, ISO 13485 is the highest level of accreditation for medical facilities. If your at-home fertility test features this, you can be sure that the design and manufacturing of your test is up to par.

Ask the Experts

Blood sample results are one thing but at the end of the day who, exactly, is reviewing these tests? What are their credentials? (This, assuming that your labs are not reviewed by some AI-powered machine.)

At the very least, your results should be reviewed by board-certified physicians if not Reproductive Endocrinologists. On top of that, results don’t always translate into actionable next steps. For example, if your AMH levels come back at .5 ng/ml or below, the average person would have no idea what that means. A trained expert, however, can tell you that anything below 1.0 ng/ml might indicate a low ovarian reserve and explain what that entails.

Privacy, Please

It’s always a good idea to work with a reputable company, but when they’re handling your personal health data, this is doubly true. Most people have trouble discussing their infertility issues with their closest friends & family. Imagine if sensitive information was out in public for everyone to see? And, any time you are handing over billing information, health data, personal mailing addresses and more, security is key.

Make sure that the company you are using is HIPPA compliant and that goes for any patient portal you might be signing up for, too. HIPAA (Health Insurance Privacy and Portability Act) compliance, is a set of regulations that health care organizations must adhere to in order for their business to be able to protect the privacy, security, and integrity of an individual’s protected health information.

How Do At-Home Fertility Tests Work?

Most at-home fertility test kits for women require a blood and/or urine sample. For men, little can be done without an actual semen sample. In either case, they are packaged up (by you!) and sent off to the lab for testing.

What do fertility test kits for women check?

The blood sample that you provide will be tested for lots of things but, in particular, a handful of different hormones. Some of the most important ones are AMH, FSH, LH and TSH. A key takeaway here is that all of the hormones involved - either directly or indirectly - in your reproductive health work together to create a miraculous, yet delicately balanced, ecosystem. If just one is thrown off kilter, it can impact the others and result in trouble conceiving.

AMH (Anti-Mullerian Hormone)

When it comes to checking a woman’s ovarian reserve, AMH is the most indicative of all the hormones. As a general rule, an AMH level of 1.0 ng/ml is relatively normal. Anything below that is considered low and cause for concern. And, if you test 3.0 ng/ml or higher, that’s not ideal either as it may indicate Polycystic Ovarian Syndrome (PCOS).

Produced by ovarian follicles, AMH levels decline naturally with age. However, age is not a requirement. Meaning, women as young as 20 years old may test low in AMH due to a condition known as Diminished Ovarian Reserve (DOR), where the number of follicles or inability of follicles to mature compromises fertility. Without proper testing, DOR can go completely undiagnosed. (Note: This is one of the biggest arguments in favor of having your fertility tested even if you are very young and have no plans of starting a family anytime soon.)

FSH (Follicle Stimulating Hormones)

Follicle Stimulating Hormone is released by the pituitary gland in both men and women to control the growth and development of reproductive organs. For women, it is a main driver of the menstrual cycle and stimulates the growth of eggs in the ovaries. Individual levels of FSH can be determined through blood or urine samples.

A normal FSH level for a healthy woman of reproductive age can range between 3.85 to 8.78 mIU/mL. Higher levels may indicate that your body has fewer eggs than normal. Lower levels are typically not seen as a problem when it comes to trying to conceive. It’s important to realize, however, that every fertility clinic, reproductive endocrinologist or lab analysis might have a different definition of what exactly is “normal”

LH (Luteinizing Hormones)

Luteinizing Hormone is released by the pituitary gland. It is responsible for kick-starting ovulation in women - stimulating estrogen and progesterone production. As with many hormones, it’s important to understand that LH levels can go up or down significantly depending on what stage of your menstrual cycle you might be in at any given time.

Typically, levels peak in the middle of the cycle, reaching anywhere from 22 to 56 IU/L, triggering ovulation. Post ovulation around day 14 of your cycle, levels can drop significantly to a window of 0.6–16 IU/L. To evaluate a woman’s fertility, LH testing is typically done around Day 3 of her cycle. Both low and high levels of LH have the ability to impact hormone production elsewhere in the reproductive system, causing ovaries to function improperly.

TSH (Thyroid Stimulating Hormones)

Also released by the pituitary gland, Thyroid Stimulating Hormone is the best way to uncover if you may have a thyroid issue. While it’s primarily known for maintaining metabolism, the thyroid also plays a huge role in regulating a woman’s reproductive health.

Up to 5% of women who have trouble conceiving find that they have abnormally high or low thyroid hormone levels. For women trying to conceive, the NCBI (National Center for Biotechnology Information) recommends preconception levels below 2.5 uI/mL.

Other symptoms to look for that might indicate you have a thyroid issue? Low thyroid function (Hypothyroidism) has been known to cause dry skin, hair loss, brain fog and an intolerance to cold among many other things. An overactive thyroid (Hyperthyroidism) may also show itself through increased appetite, heart palpitations, sweating, anxiety and more. Both conditions may present menstrual irregularities. On the plus side, abnormal thyroid levels are relatively easy to treat.

How much do at-home fertility tests cost?

While the expense of at-home fertility tests can vary greatly, they generally fall in between $100 to $300. As a general rule, the more hormones and other factors they test for, the more money they will cost. And, while this may seem expensive, it really is a drop in the bucket compared to what an actual assessment at a fertility clinic can run you.

One TTC financing hack we love to share? If your health insurance plans includes a FSA (Flexible Spending Account) or an HSA (Health Savings Account), at-home fertility tests may be included. To find out, check with your Human Resources department or Health Insurance representative.