What is Fertility Testing?

Something we get asked frequently at Modern Fertility is, “What is fertility testing?” It’s a simple but important question, especially considering that the word “fertility” can be interpreted ambiguously and mean different things to different people, like getting your period, your monthly cycle, hormones, eggs, and ability to conceive. Below, we’ll officially answer this complicated and nuanced question, once and for all.

Defining fertility and fertility testing

Let’s start with the basics. What’s the official definition of “fertility,” anyways? Merriam-Webster defines it as, “the quality or state of being fertile.” (So not helpful, MW).

OK — then what does “fertile” mean? “Fertile” is defined as, “capable of breeding or reproducing.” Putting the two together, we land on the following definition of fertility: “The quality or state of being capable of breeding or reproducing.” In human speak, fertility is your ability to conceive, get pregnant, and have kids au naturel, with just a sperm and an egg and no assistance from reproductive technologies or medical interventions. Fertility testing, therefore, tests your body’s ability to do this.

Fertility: Your ability to naturally conceive, get pregnant, and have kids.
Fertility testing: Medical and physical assessments that test your ability to naturally conceive, get pregnant, and have kids.

The world of fertility testing today

Is it just us, or is the word “infertility” used more often and better understood than “fertility” in today’s world? It’s mind-boggling that fertility testing is primarily offered only when someone is already having difficulty conceiving or infertility is diagnosed. At this point, someone’s next steps involve seeking a specialist at a fertility clinic for a variety of tests and, as you may have guessed, spending quite a bit of dough — we’ll dive into this later.

Fertility testing’s inaccessibility, expense, and annoying habit of showing up way too late to the party is why Modern Fertility was born. We want to arm women with information about their fertility before infertility is an obstacle, and make the process of getting this information less of a pain. Since fertility declines with age, tracking it over time means you have more data and power to make choices that align with your goals, whether that’s starting a family earlier, thinking about egg freezing, pursuing adoption, or simply beginning the family planning conversation.

For $199, Modern Fertility offers a fertility testing kit that can be completed in the comfort of your home. All it takes is a simple finger prick to get access to the same physician-approved reports that break down up to nine fertility hormone levels. These are the exact same hormone tests you’d get from a clinic. The reports, which are presented in a user-friendly dashboard and written in a straightforward, non-medical way, also provide you with an age-specific interpretation of each hormone level and how this relates to fertility. If you have questions or need support, a licensed fertility nurse is just a call or email away.

Taking a step back, let’s dig into the relationship between hormones and fertility. Why is getting them tested and tracking them over time relevant?

Hormones are your fertility detectives

Ever wondered, “How the heck does my body know to get its period or release an egg into my fallopian tube during ovulation?” It’s not magic — it’s hormones. Hormones are chemical messengers in the body that are responsible for regulating its functions, including your monthly cycle and reproductive abilities. For example, luteinizing hormone (LH) causes an egg to be released from an ovarian follicle (where the eggs are housed) and into the fallopian tube. In other words, LH triggers ovulation. If your LH levels are low, it may be difficult to ovulate. If an egg doesn’t get released, there’s less of a chance it will meet and get fertilized by a sperm. Hence, spontaneous conception could be tough.

Here’s another example: Follicle stimulating hormone (FSH) is responsible for developing a number of ovarian follicles (which house your eggs) and ultimately maturing a single follicle and egg for ovulation during each monthly cycle. If your FSH levels are high, it may be a sign that your body is having to work extra hard to develop follicles and mature an egg. This can be a sign that your ovarian reserve (that term for the number of eggs left in your ovaries) is low.

One more for you: Did you know anti-mullerian hormone (AMH) is an even better predictor of ovarian reserve than both FSH and actually counting the number of eggs remaining in your ovaries via ultrasound? (The latter is known as an antral follicle count or AFC.) Getting this hormone tested, perhaps along with LH and FSH and pursuing an AFC, is a helpful biomarker for seeing an even clearer fertility picture.

To maximize fertility, it’s helpful for certain hormones to be at optimal levels to keep your cycle and ovaries working as they should. This is why hormone testing is a critical part of fertility testing, regardless of whether you’re trying to conceive or not. But as we mentioned, fertility declines with age. Keeping a close eye on your hormone levels — the same way you would track your savings or cholesterol — lets you keep tabs on your fertility, perhaps alerting you to a red flag or giving you some peace of mind. This is why hormone testing is an ideal first step for those who aren’t ready to start a family but want one down the road.

Hormone testing is one method of fertility testing

It’s important to call out the other types of tests that shed light on your ability to naturally conceive. However, you must visit a fertility clinic and specialist to get them. After an initial consultation (which costs money — more on this in a bit), a fertility clinic will usually administer a physical exam, which might include a gynecological exam and an ultrasound. These can be used to determine your AFC and help detect physical barriers to fertility, like polycystic ovaries, large ovarian cysts, uterine shape and the thickness of its lining, or blocked fallopian tubes.

At the clinic, completing questionnaires and having conversations about your health history, lifestyle, and cycle can also reveal underlying fertility issues, like smoking, sexually transmitted infections (STIs), endometriosis and other diseases, or amenorrhea (an absence of a period).

These clinics also recommend and perform the exact same hormone testing that Modern Fertility offers, but at a much steeper price. We called eight clinics in the San Francisco Bay area to understand how much hormone testing costs. Across the clinics, the initial consultation ranged from $225 to $1050. The cost of blood work ranged from about $800 to $1500, but this can depend on how many hormones are tested, if the clinic relies on a third party lab for testing, and how many tests the doctor recommends or requests. Assuming insurance or your employer doesn’t cover fertility testing, these are out-of-pocket costs.

A powerful first step

At Modern Fertility, we’re dedicated to starting the fertility conversation outside of the infertility clinic and before you ever need to step foot inside one, and making the cost and number of hoops you have to jump through as low as possible. By keeping track of your fertility via your hormone levels, you’re getting information that can help you start planning and creating your desired future. It’s a powerful first step. But it all starts with talking about and truly understanding the basics, like what “fertility” and “fertility testing” actually mean. You’re in the right place.


English Taylor

English Taylor is a San Francisco-based writer and birth doula. Her work has been featured in The Atlantic, Healthline, LOLA, and THINX. Follow English’s work at https://medium.com/@englishtaylor.

Fertility Unfiltered