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Can You Actually Test Your Fertility At Home?

Whatever your reason for wanting to take an at-home fertility test, here’s what you need to know about what your options are, how they work, and what you can expect to learn.

Can you test your fertility from the comfort of your own home? The answer is a bit complicated. Isn’t it always when it comes to fertility? Yes, there are some tests that both men and women can take at home to get a better idea about some aspects of their fertility. But are they an acceptable substitute for an individualized appointment with a fertility specialist?

Unfortunately, no—while these tests are often fairly accurate, that’s not really the issue here, says Dr. Jaime Knopman, a board-certified reproductive endocrinologist. It’s all the medical expertise you’re missing out on when you test your fertility at home.

“The tests we run in our clinic are much more accurate because our job can’t be done completely by machine,” she explains. “It’s not just the tests, it’s the person interpreting them.”

But you still might not live close to a fertility clinic, have insurance that covers fertility appointments or testing, or even feel like you’re really at the point yet in your fertility journey where you need a formal eval from a specialist. We get that.

So whatever your reason for wanting to take an at-home fertility test, here’s what you need to know about what your options are, how they work, and what you can expect to learn.

How can I test my fertility at home: for women

When it comes to the ladies, there are two main varieties of tests you can do at home: you can check your ovarian reserve and you can do a broad panel screening for several different hormones that play a part in fertility health. Here’s the scoop.

Ovarian reserve tests measure the amount of follicle-stimulating hormone (FSH) in your blood with a pinprick. Typically, you collect a sample yourself and mail it back to the company so they can read and deliver your results. Very high levels of FSH can be a sign that you don’t have a lot of eggs, that they’re poor quality, or both, because your body is working overtime to produce enough FSH to release a healthy egg.

Taking this test feels like a typical finger prick. It hurts for a sec and then you’re over it. You will have to squeeze out some blood into designated spots on a testing card, though, so if you’re blood-averse be prepared.
The tests themselves can accurately check your FSH level, but there’s more than one way to figure out what your ovarian reserve looks like. Only measuring FSH will give you a piece of the puzzle...but could also cause you to unnecessarily panic about your fertility. Try not to do that! Remember, these tests are useful, but not foolproof.
FSH levels alone may not be a great way to assess your fertility in the first place. A 2017 JAMA study found that biomarkers like FSH aren’t the best predictors of future fertility in women with reduced versus normal ovarian reserves.

Fertility health screenings capture your FSH level but also a bunch of other hormones that impact your fertility in one way or another. The exact hormones measured in an OTC fertility test differ between companies, but you can usually find out your FSH level and any or all of the following:

thyroid-stimulating hormone, or TSH a marker of thyroid health)
estradiol (helps with ovulation)
anti-mullerian hormone, or AMH (an indicator of egg reserve)
prolactin (makes breast milk after birth)
luteinizing hormone, or LH (regulates your cycle, especially ovulation)
testosterone (helps make follicles, but too much may mess up your fertility)

These tests all work like the ovarian reserve test: you prick your finger, collect some blood samples, send the samples back to the company, and then wait for your results to come in. Usually, you’ll get factual data (like, “your TSH is off”) but also an explanation of what that might mean for your fertility.

Most companies allow you to see your results online and consult with an on-staff medical professional if you have questions or don’t understand your results. They’re pretty easy to order online, but many aren’t cheap—they’re usually about $150—and you’ll have to pay out of pocket.

How can I test my fertility: for men

The only kind of male fertility test that can be done at home is a sperm analysis. About half of all couples’ infertility problems can be caused by male infertility, so knowing if your swimmers are strong or not is a good place to start if you’ve been trying to conceive for a while.

There are actually several different kinds of sperm analysis kits; sometimes you collect a sample and send it through the mail for testing, sometimes you put some sperm on a slide and insert it into a testing device, and sometimes you can even use your smartphone (yes, for real!).

Testing at home is private and confidential. You don’t have to worry about being unable to provide a sample at an unfamiliar clinic or doctor’s office.
The kits you send off to labs via mail can be more accurate, but at the same time, there’s a lot that can go wrong here—like failure to keep the sperm stored at just the right temp, which can cause damage to the sample. At-home tests, while giving quicker results with no middle-man, have a lot of potential for both user and technology errors.
Male fertility is about more than just the amount of sperm: there’s motility, shape, concentration...the list goes on. If your at-home kit is only looking at the number of sperm, your results may not be that helpful. Try to choose a test that looks at more than one type of factor—this will give you the most bang for your buck.

Don’t forget about ovulation!

While ovulation predictor kits only tell you if and when you’re ovulating, this can be very helpful if you’re actively TTC.

These kits work by detecting the presence of LH in the urine, says David Diaz, MD, reproductive endocrinologist and fertility expert. When your LH rises above a certain level, the test strip you’ve peed on will let you know that an ovary is just about to release an egg. This is a good time to get it on, since there’s a good chance that egg could become fertilized.

According to Dr. Diaz, these tests are about 85 percent accurate and available as digital and non-digital tests. If you have fairly regular menstrual cycles, an ovulation predictor kit can be a useful tool in identifying exactly when your fertile window is, but if your cycles are irregular (because of PCOS, pre-menopause, or even just your personal biology), it can be harder to rely on them unless you’re taking a test every day.

Next steps

Okay, you took an at-home test and got your results back...now what? Well, you might not like our answer, but here it is: you should probably still go see a fertility doctor. Yes, even if your results are “normal.” Why?

Because, like we told you upfront, a test you do at home gives you important data — but not the expertise and counsel of a doctor who has met you in person and knows your medical history. You’ll have the info, just not necessarily the context...and the context is super important when it comes to your fertility. At-home tests simply can’t paint the same kind of comprehensive picture that doctor-interpreted lab tests can.

But you’re here because you want to take an at-home fertility test...and TBH, we kinda don’t blame you! We’re curious, too! Just make sure you know what you’re buying, (Dr. Knopman says that you should make sure any OTC test you buy comes from a legit manufacturer with a fertility doctor on their medical review board), what the tests can tell you, and what you’re going to do with the results.

“Even if you don’t want to do fertility treatments [right now], there is no harm in coming in to talk to us about it,” says Dr. Knopman. “You can make better decisions when you have that information than when you don’t…[and] the worst thing to do is sit at home and ruminate, trying to interpret your own results or diagnose yourself.”

What’s the takeaway here? After taking an at-home fertility test, you might want to plan to make an appointment with a fertility specialist. It can be a simple introductory or informational appointment, and even a virtual one. But hopefully, it will give you peace of mind and — most importantly — answers.

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Egg Freezing

Do I Need to Stop Taking My Antidepressant to Freeze My Eggs?

If you’re on any medications for your mental health and you’re considering freezing or donating your eggs, you may be wondering if you’ll need to stop your antidepressant during the process. This is a common question and we’ll be answering it in today’s article so read on to find out.

The number of people choosing to freeze their eggs has been rising steadily for the past several years. At the same time, antidepressant use in the US has also been on the rise, especially during and after the peak of the COVID-19 pandemic. It goes without saying that given both these trends, many of the people who are freezing their eggs are also people who struggle with mental health conditions. If you’re on any medications for your mental health and you’re considering freezing or donating your eggs, you may be wondering if you’ll need to stop your antidepressant during the process. This is a common question and we’ll be answering it in today’s article so read on to find out.

What is egg freezing?

Before we dive into the world of antidepressants, let’s briefly talk about what egg freezing even is. In a nutshell, egg freezing (aka oocyte cryopreservation) is a way to collect some of your eggs and preserve them for future use. The process takes about 10-14 days and involves taking hormone medication to stimulate your ovaries to grow mature eggs. The eggs are collected during a 30-minute outpatient procedure called an egg retrieval and then frozen until you’re ready to use them.

Given how expensive egg freezing can get, you might be wondering why so many people are choosing to do it. There are many reasons but most of them go back to the same core issue: egg freezing is a way to keep your reproductive options open for later by preserving younger, healthier eggs for future use.

Research has shown that many people are delaying starting their families for reasons that can be personal, professional, financial, psychological, or all of the above. In our own survey of Cofertility users, we asked over 28,000 gen Z and millennial women about their family planning and goals. The majority of responders (73%) said that building their career or going back to school is the most important thing to them right now. This was followed by traveling (53%), finding a life partner (43%) and cultivating new hobbies (32.1%). Additionally, egg freezing has received more and more media attention over the last several years which has certainly helped to increase public awareness of this intervention as a way to keep future fertility options as open as possible.

The low-down on antidepressants

Antidepressants are a group of drugs used to treat depression. Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are the 2 classes (or types) of antidepressants that are most often prescribed but atypical antidepressants are another, newer class that are also used in certain cases. Each class of antidepressant has a different mechanism for how it changes neurochemical levels in the brain to improve the symptoms of depression and other mood disorders. When used correctly, they can improve mood, increase energy levels, and enhance overall functioning. Antidepressants as well as other drugs like benzodiazepines have also been found to be effective as anti-anxiety medications, though only two SSRIs are specifically FDA-approved for anxiety disorders.

Use of both antidepressants and anti-anxiety medications has been rising for over a decade in the US. According to the Centers for Disease Control and Prevention (CDC), 13.2% of adults aged 18 and over use antidepressant medications. Women, older adults, and non-Hispanic whites are the highest users.

Overall, during the decade between 2009 and 2018, antidepressant use increased to 14% from 11% and in all age groups, it was higher among women than it was in men.

Based on these stats, it’s fair to ask why women are more depressed than men. The answer is complicated but women aren’t necessarily more depressed than men. While there is some evidence that fluctuating hormones and more sensitivity to internalized triggers (like relationship drama) may contribute to higher rates of depression in women, there’s also the simple fact that women are more likely to actually go see a doctor to take care of their symptoms. As a result, they are more likely to report depressive symptoms, be diagnosed, and be prescribed appropriate medication.

Do antidepressants affect cycle outcomes?

Alright, let’s get into the reason you’re here: do antidepressants affect egg freezing or in vitro fertilization (IVF) cycle outcomes? The most commonly used antidepressant (SSRIs) and anti-anxiety medications (benzodiazepines) don’t have any clear, long-term impacts on egg quantity or quality, ovulation, or chances of conception (though SSRIs do have short-term effects on sperm).

Studies of people using IVF to conceive suggest no effect of SSRI use on hormone levels, number of eggs retrieved, number of eggs that develop into blastocysts, number of embryos rated as “high quality,” or number of embryos transferred. So overall, antidepressants do not appear to affect cycle outcomes.

Let’s dive deeper into this. Since we know SSRIs and other antidepressants often work by changing levels of neurochemicals in the brain like serotonin, there is also the question of whether or not these medications influence reproductive hormones. Unfortunately, there are fewer studies to look at when assessing this (because most studies are done on men in order to avoid the hormonal fluctuations seen in women–lame, we know) but one study did look at almost 1,000 people with ovaries. The study found no differences in menstrual cycle characteristics as a function of SSRI use and no significant differences in pregnancy rates. Other larger studies have had similar findings and showed no differences in chances of conception between people using or not using SSRIs or benzodiazepines.

One thing to note though: there is some evidence that SSRIs increase prolactin levels and very high prolactin levels can mess with your period and prevent you from ovulating. That being said, there are other studies that have not shown this link between SSRI use and prolactin levels and even the studies that do, haven’t shown that prolactin levels are elevated to a high enough level to affect ovulation.

In the context of natural fertility, there is one sneaky, easy-to-miss way that these meds could impact chances of conception — by lowering your sex drive. Having sex less often during your fertile window could definitely lower chances of conception (the general rec is to have sex every 1-2 days in that window). However, how much an antidepressant affects sexual function will be different from person to person and will depend on the specific medication being used.

The CDC and the American Society for Reproductive Medicine (ASRM) consider antidepressant use to be safe during fertility treatments. Other organizations like the American Psychological Association (APA) and the American College of Obstetricians & Gynecologists (ACOG) also recommend that people do not change their SSRI or benzodiazepine use once they’re pregnant unless instructed to by their provider.

Can you donate eggs if you’re on an SSRI?

This is a pretty common question for people considering donating their eggs. Current use of SSRIs or other antidepressants is considered a “relative exclusion criteria” by the ASRM. This means that it does not automatically disqualify someone from being an egg donor, however, it will be reviewed on a case by case basis by the fertility provider or clinic. Current use of antidepressants may be totally fine with one clinic, but not with another. Many providers feel that common antidepressants are overprescribed in the face of more situational challenges, like the pandemic or other big life changes. Some antidepressant use may also point to another medical condition that would disqualify someone.

Here’s a list of rejection criteria from the ASRM that would automatically make someone ineligible to donate:

Having been institutionalized for a mental health disorder
A positive family history of psychiatric disorders
Two or more first-degree relatives with substance use disorders
A history of emotional, sexual, or physical abuse without professional treatment
Excessive stress
Relationship instability

If you’re interested in what the psych screening for an egg donor entails, you can find more information about it here.