The Grapevine

DTC Fertility Testing: Boon or Bane?

Before assessing the odds of starting a family, it certainly seems empowering to take fertility testing matters into your own hands and get the information required in the absence of clinicians. But the question remains on how accurate and helpful are these direct-to-consumer (DTC) fertility tests.

Consumers purchase these tests since they are cheap, convenient to use and accessible. A new study published in the journal of Social Science and Medication by the University of Pennsylvania School of Medicine analyzed the advantages and drawbacks of do-it-yourself fertility kits.

A new diagnostic tool that has gained popularity in the Fem Tech is the DTC test, which quantifies the anti-Mullerian hormone (AMH) for the consumer. The hormone indicates the supply of unfertilized eggs available in the ovaries for conception. This particular test is often referred to as the ‘egg timer’ or ‘biological clock test’ since it provides an estimation of the size of the woman’s so called ‘ovarian reserve’. 

The Study

Researchers recruited 21 participants who consented to be followed on their journey with DTC fertility testing. The study's only author is postdoctoral fellow of the department of medical ethics and health policy in the Perelman School of Medicine, Moira Kyweluk.   

Ethnographic research collected through semi-structured interviews and observation of participants explored various factors that influence ovarian reserve testing, such as medical insurance coverage, ethnicities, sexual orientations, relationship status, gender identity and socioeconomic background. 

Either by giving up blood samples directly to a laboratory or using DIY kits with which fingers can be pin-pricked to draw blood, the women collected their blood and later sent it to be examined for hormones. The tests also included follow-up sessions with a designated nurse as part of the testing process of the DTC fertility checkup, presumably hired by the respective company. 

Infertility treatments Direct-to-consumer companies do not provide enough information the consumer needs about her fertility, a new study by Penn Medicine said. Photo courtesy of Shutterstock

Four Observations Made 

  • DTC ovarian reserve testing gave them a unique tool to gain knowledge of their fertility. 
  • The information allowed them to feel empowered because they had the autonomy to check themselves outside of a conventional laboratory setting. 
  • It provides an opportunity to the LGBTQ + community and single women to understand their chances of conceiving, through an alternative means.  
  • Lastly, participants were left confused and uncertain about how to approach the results and were not aware of how to improve or preserve their fertility status further. 

Therefore, this study revealed that DTC fertility checkups only serve to confuse consumers and make them more apprehensive. Hence, the research stresses on educating the consumer on the limitations and purpose of the tests. 

Major Drawback

Originally, AMH levels are checked prior to the woman's  decision of freezing her eggs or undergoing ovarian stimulation in preparation for in vitro fertilization (IVF). Doing a one time only at-home test is not adequate enough to predict the time required for a woman to get pregnant, especially if the woman was not diagnosed with infertility before. It also does not serve as a valid diagnostic tool to predict the arrival of menopause. 

Women still opt for the DTC fertility testing, knowing these drawbacks all the while. Some of the reasons include lack of insurance coverage, high prices and concerns over fertility decline with age. Importantly, these tests should not be used to provide women false hope of conceiving because they could be suffering from other conditions despite having healthy ovaries. To name a few, endometriosis and blocked tubes. 

The information can lead a woman to make the wrong decisions such as the unnecessary freezing of an egg or pushing the woman to get pregnant at the unintentional time. Another major disadvantage of direct-to-consumer testing is that the layperson as well as the doctor find it hard to interpret AMH test results of women on birth control pills.