Today Danielle Kline Haber, of Hamilton, New Jersey, is the proud mom of a 3-year-old daughter. Rewind a few years and, like many women, once she decided the time was right to try for a baby, she turned to at-home ovulation tests to help her conceive.
“I had a friend who used them and I had not been pregnant before. I thought, ‘Well, I just like to be informed,’” she explained. “I felt like (the tests) would give me more information about my body.”
The "femtech" industry, which merges technology and algorithms to track reproductive health, is tapping into that innate desire for knowledge by providing a plethora of products that track ovulation days, basal body temperature, sleep patterns and more.
Now 39 and ready to soon try for another child, Kline Haber plans to use Easy@Home’s ovulation test kit, which also provides women the option to upload photos of their results to the Premom app and chart their monthly cycles.
“We live in an age where there is data behind everything. There’s a natural interest in wanting more data about your body,” she said.
Dr. Sigal Klipstein, liaison member to the American College of Obstetricians and Gynecologists Committee on Ethics and physician at InVia Fertility Specialists in Chicago, agreed. “That’s human nature. You want more information. You want reassurance. You want data and numbers. I think these apps and products do provide that.”
Ovulation predictor tests: What to know about LH surges
The most straight-forward method for identifying a woman’s peak fertility days (usually just 24-48 hours each month), these test sticks (which can cost as much as $2 each) identify a surge of luteinizing hormone in urine. This hormone triggers the release of an egg, so detection predicts that ovulation will occur in the next day or two.
However, ovulation tests may not provide any additional benefit for someone with a regular 28-day cycle. Days 11 through 14, which you can easily count, are usually the most fertile, though each person's cycle can vary.
“You have to ask yourself as a consumer, ‘What information am I trying to get?’” Klipstein continued. “If she tends to have slightly longer or shorter cycles, (ovulation kits) can be helpful in telling her that her window is a bit shifted ahead or behind. It does help in that sense … but you could also take a different strategy and have intercourse every one to two days and not use the kits at all. It just depends on how frequently you want to have intercourse and how much you want certainty that you’re having sex at the most optimal time.”
Dr. Jennifer Nichols, a reproductive endocrinologist at Sincera Reproductive Medicine in Pennsylvania, also noted that the cost could quickly add up when using these prediction kits. “The ovulation sticks become expensive because you’re using them every morning to determine if you’re ovulating.”
People with polycystic ovary syndrome should also avoid using them. “Women with PCOS tend to have high LH levels and it’s a constant high … It’s not worth spending your money if you always get a positive.”
Do fertility apps work?
Clue, Flo, Fertility Friend, Natural Cycles and Ovia are a few of the many apps available for people wanting to get pregnant. Clue boasts more than 30 tracking options, including predictions for cramps. The apps are usually free to download, and then there are various fees associated with different features or products.
While the apps provide various insights surrounding fertility and natural family planning, Klipstein warns they could potentially increase anxiety as well. As an example, a small rise in basal body temperature can be difficult to detect. “If a woman has a regular cycle but doesn’t have a basal body temperature rise, it doesn’t mean that she hasn’t ovulated … using the apps (could) increase concern when there isn’t a need for concern.”
Apps also cannot detect a multitude of medical issues pertaining to reproductive health, such as egg quality, problems within the fallopian tubes or polyps in the uterus. Whether using femtech products or not, people under 35 with regular cycles who have not conceived after 12 months of having intercourse every two to three days around ovulation times should see a physician. People over 35 should see their OB/GYN or a fertility specialist after six months of trying, while those with irregular cycles should seek medical advice sooner.
At-home fertility testing
Due to pandemic-related concerns and wanting to avoid doctors’ offices, some women may be drawn to these kits, which provide an in-depth personal analysis about your health after mailing back a finger prick blood sample.
For $49 each, Everlywell provides at-home tests for checking one’s vitamin D and folic acid levels (both important components of a healthy pregnancy) and ovarian reserve. A more comprehensive women’s fertility test is available for $149 and looks at estradiol, testosterone, LH levels and more. For men, Legacy offers an at-home sperm analysis, examining volume, count, concentration, motility and morphology, for $195.
Nichols noted that frustrations may arise with at-home testing if consumers are unable to easily interpret their final results. She recalled a recent patient who received her anti-Müllerian hormone and follicle-stimulating hormone levels, but wasn’t clear on how the data was actionable toward helping her conceive.
“Yes, it’s giving the patient knowledge, but to be able to use that knowledge the right way is key.”
Similarly, Klipstein raised a concern, “Someone who might really benefit from seeing a doctor (uses) these tests and the tests come back normal, and now she waits for another year, another three years. Maybe that window is critical … You don’t want to have a false reassurance based on these tests … Why would you use this product instead of going to your physician?”
Instead, she encourages simplifying the process of conception — about 80% of couples without any fertility issues will become pregnant in six months — by taking a prenatal vitamin daily and just trying. “You don’t necessarily need to go high-tech. Pregnancy has been a low-tech pursuit for millennia.”
