Are online fertility tests accurate?

Startup companies are enticing women to order fertility tests online with promises of providing personalized information about their chances of having a baby.

But before grabbing your credit card, you should know more about what these fertility tests are — and what they’re not.

These tests claim to reveal details about:

• hormone levels
• reproductive health
• infertility odds
• chances for polycystic ovarian syndrome

I recommend taking some precautions before ordering one of these fertility tests online.

Fertility tests, in essence, measure the number of eggs a woman still has. Doctors match those results to a woman’s age, medical history and health of her reproductive anatomy to understand how likely a woman may be to conceive.

The critical missing link with a fertility test ordered from the internet is the physician consultation. Your doctor can look at the big picture and take into account many factors that a product purchased over-the-counter can’t.

Below are some things to think about if you’re looking into a fertility test online.

Criticism of online fertility tests as a predictor

A 2017 study showed the imperfection of one of the most common fertility tests that measures the level of anti-Müllerian hormone (AMH). Low AMH levels indicate a woman has fewer eggs left and predicts a low response to infertility treatments.

But women ages 30 to 44 with low AMH results who were just starting to try to get pregnant were able to conceive at about the same rate as women with normal levels, according to the study published in the Journal of the American Medical Association.

This means that other unknown factors contribute to getting pregnant besides AMH.

The bottom line, as I see it: The tests aren’t useful at predicting the chance of pregnancy for the general population of women. The study warns women trying to get pregnant naturally against using the AMH test to measure their current fertility.

On the other hand, if a woman is under 35 and has been trying to get pregnant for over a year — even if she has normal AMH levels — she should consider getting a full infertility evaluation.

Over-the-counter fertility tests can give false reassurance — or false anxiety

Most fertility tests can tell you how many eggs you have left and when you might start menopause, but they can't show the quality of your eggs.

The age of a woman’s eggs are the most important factor in determining whether she’ll get pregnant. When you’re younger, you’re more likely to get pregnant and less likely to have a miscarriage, a C-section or health problems during pregnancy, such as high blood pressure or diabetes.

Over time, the quantity and quality of a woman’s eggs decline.

Even so, a younger woman in her 20s might have a high number of eggs, but if she’s had health problems, such as uterine fibroids or endometriosis, she still might have trouble getting pregnant.

Meanwhile, a woman with low fertility test results who starts trying to conceive might have no trouble.

Consider the factors that affect egg quality

Here are some better predictors for egg quality:

• What’s the sperm quality?
• Have you smoked, had an STD or been exposed to toxins?
• Did other women in your family have trouble with getting pregnant?
• Do you have painful periods?
• Have you had pelvic surgery or gynecologic procedures?

How a health care provider can help you with fertility tests

While there’s nothing inherently harmful about over-the-counter fertility tests, please consider it just one step in the process of understanding your fertility options.

Without a doctor to discuss all aspects of your health, fertility tests results alone can be misleading. Work with an Ob/Gyn or a reproductive endocrinologist to review your outcomes.

Online tests run about $150 on some websites. However, if you make an appointment for reproductive counseling with a physician, fertility testing typically is covered by insurance.