The Scoop on Fertility Tests
An increasing number of women want to test their fertility, and it’s definitely a smart choice to make, even in your 20s. The market has responded by offering home fertility tests that make it much easier than going to the doctor’s office. First Response, for example, now makes a home test that involves peeing on a stick on day three of your period in order to measure your Follicle Stimulating Hormone (FSH), which can be an indicator of the quality of your eggs.
“FSH and Antral follicle tests performed at the doctor’s office can help a single woman or a couple deciding whether to pursue pregnancy or to spend money on repeated IVF cycles determine their course of action.”
But just how accurate are these at-home tests?
Dr. Todd Deutch of the Advanced Fertility Center of Chicago and his colleagues presented a study of 1380 women at a meeting the American Society of Reproductive Medicine that found that at-home tests are not the most reliable way for a woman to predict her chances of conceiving.
“It’s not that they’re bad tests, but they shouldn’t be used in isolation without proper interpretation from a doctor because they give a lot of false positives and false negatives,” says Dr. Todd Deutch, of the Advanced Fertility Center of Chicago.
Dr. Deutch’s study found that medically supervised ovarian reserve testing, which can identify women with a poor prognosis for pregnancy, is the most appropriate route for women age 35 and younger who are looking to assess their fertility. “These ovarian reserve markers [FSH and Andral Follical Count (AFC)] can be used to identify women who will have a difficult time trying to conceive,” he said.
So what can the results of testing your FSH and AFC tell you about your fertility?
“Our study showed that women who had normal results on both clinical tests [FSH and AFC] had a 56% chance of success with IVF,” says Dr. Deutch. “If the FSH level was abnormal, the live birth rate fell to 35%. In women with an abnormal AFC level, the live birth rate was 34%. But if both of a woman’s results were abnormal, she had only a 9% chance of success with IVF.”
Today, one in six couples have trouble conceiving naturally, so FSH and Antral follicle tests performed at the doctor’s office can help a single woman or a couple deciding whether to pursue pregnancy or to spend money on repeated IVF cycles determine their course of action. More recent studies, however, have found that it’s best to test Anti-Mullerian Hormone (AMH). In March, 2012 the ASRM practice committee published a paper in the journal of Fertility and Sterility that said “there is mounting evidence to support the use of AMH as a screening test for poor ovarian response.” The paper also said that FSH, estradiol and inhibin B are only poor to fair measures of how a woman’s ovaries will respond to stimulation or her ability to conceive.
Fertility Tests Options
Antral follicle count (AFC)
FSH and estradiol on Cycle Day 2 or 3
Anti-Mullerian Hormone (AMH)
Age is best predictor
Chromosome Screening (IVF+CCS)
So try a home test, but make sure to share the results with your doctor so he or she can follow-up with some additional blood tests in order to get the best overall sense of your fertility.
Here is the 2015 committee opinion from the American Society of Reproductive Medicine on Ovarian Reserve testing.