Can I Trust the Accuracy of At-home Fertility Tests?

Infertility is usually defined as the inability to become pregnant after 1 year — or after 6 months in you’re over 35 — of having sex regularly without using any birth control. Infertility is a common problem that affects as many as 1 in 8 couples in the U.S.

Traditionally, at-home fertility tests have been used by the person who would carry a baby during pregnancy to help predict the likelihood of ovulation (when the body releases a mature egg). These at-home tests are typically used to determine the best time in a monthly bleeding cycle to have sex and boost the chances of becoming pregnant.

More recently, additional at-home tests have become available for both partners to analyze many potential fertility factors. But with multiple — sometimes expensive — at-home testing options available, it can be hard to know which is worth using.

In this article we’ll discuss the available types of at-home fertility tests, how accurate they are, and when it might be time to talk to your healthcare provider.

What types of at-home fertility tests are available?

Some forms of at-home fertility tests have been available for many years. However, some newer tests are more sophisticated and test for things that at-home tests couldn’t in the past. Some can give instant results, while others have to be sent out to a laboratory to be analyzed.

Some at-home options also include services that virtually connect you with a healthcare provider to order appropriate tests for you. Due to the greater use of telehealth services during the COVID-19 pandemic, virtual fertility consultations may be more desirable for some compared to scheduling an appointment and having tests done at a healthcare provider’s office.

Are at-home fertility tests available for both partners?

It’s believed that about 33% of infertility is due to female reproductive issues — such as polycystic ovary syndrome (PCOS) or endometriosis — and about 33% is due to male reproductive issues — such as low sperm count or past injury to the testicles. Because the reasons for infertility could be stemming from either person, at-home fertility tests exist for both partners.

What do at-home fertility tests measure?

At-home fertility tests work differently, depending on if you’re the potential birth parent. Many tests for the potential birth parent focus on hormone levels. At-home tests for people assigned male at birth test sperm samples.

Tests for the potential birth parent

For the potential birth parent, most available at-home tests collect a small blood, urine, or saliva sample. Some samples may need to be sent to a lab to be analyzed after collecting them at home. Most of these tests check for different hormone levels that could affect fertility. Knowing that one of these hormones is not in the typical range can help you know when to see a healthcare provider.

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Some at-home fertility tests can also check anti-müllerian hormone (AMH). This hormone can be used to help predict the number of eggs remaining in the ovaries (also called ovarian reserve). Other ovarian reserve hormones that at-home tests may check include follicle stimulating hormone (FSH) and estradiol (a form of estrogen). 

At-home tests may also look for hormones linked to ovulation, such as luteinizing hormone (LH). These are often referred to as ovulation predictor kits and are the most readily accessible at-home fertility test since you can find them at your local pharmacy. It’s not uncommon to see companies that make home pregnancy tests also marketing ovulation tests that measure the amount of LH in your urine.

Lastly, some at-home fertility tests may also check for thyroid health by measuring thyroid stimulating hormone (TSH) — which can tell you how well your thyroid is working. Certain thyroid problems can be connected with infertility. If your TSH is too high or low, you may have a thyroid condition and should see a healthcare provider about it.

Tests for people assigned male at birth

For people assigned male at birth, different tests are available or being studied for at-home semen analysis. Some of these need the sample to be mailed in, and some give you results within a few minutes. These tests generally check for the amount of sperm present in your semen or how well your sperm are moving. Sometimes they also check for sperm viability (the amount of live sperm in a sample).

Regardless of which type of sperm test is being done, the sample you would provide has to be obtained during ejaculation (sexual climax). Some tests may recommend you go without ejaculating for a few days prior to providing a sample — this helps your sample to be as concentrated as possible for the sperm test. Be sure to follow the test’s provided instructions.

How long do you have to wait for fertility results?

The length of time depends on the test you’re using. Some tests may give you results within a few minutes, such as ovulation predictor kits or certain at-home tests for semen analysis. Others can take a week or longer because they have to be sent to a laboratory to be analyzed.

How are at-home fertility tests different from what you can receive at a healthcare provider’s office?

If you are receiving care for fertility at a healthcare provider’s office, your work-up (exam and blood tests) will likely be more comprehensive than at-home testing options. This is because your provider will be looking at your overall health instead of just certain lab tests. It’s also typical for the potential work-ups for each partner to be different. 

During an appointment, the potential birth parent can expect a more in-depth discussion on many topics, such as:

• Health problems

• Medications, including over-the-counter products and dietary supplements

• Menstruation  

• Past and present birth control use

• Past and present sexually transmitted infections (STIs)

• Past surgeries 

• Pregnancy history, including any miscarriages

• Sexual patterns

You may also need to answer questions about your lifestyle and work environment. After this discussion, you will also undergo a physical exam, laboratory testing — sometimes similar to at-home testing— and other procedures that can help your healthcare provider determine a possible cause of infertility.

People assigned male at birth will also have a similar detailed discussion with their provider during their visit:

• Being sick with mumps after puberty

• History of erectile dysfunction or other sexual problems

• History of undescended testicles

• History of urinary tract infections (UTIs)

• Medications, including over-the-counter products and dietary supplements

• Past and present STIs

• Past and present smoking, drinking, or substance use

• Past injuries and surgeries, particularly any in the groin area

• Prostatitis — swelling of the prostate

• Sexual patterns

• Work environment

You will also have a physical exam completed, as well as a semen analysis. This semen analysis is often more in-depth than the at-home testing and looks at more fertility factors than just sperm count or movement — such as sperm velocity, shape, and ability to liquify (essential for allowing sperm to start swimming). All of these factors are important for healthy sperm.

Is at-home fertility testing reliable?

You may be asking yourself if these at-home tests are as reliable as the in-depth tests you would undergo at a healthcare provider’s office. And the short answer is, it depends.

For tests that you send to a lab, consider using FDA-approved tests that use Clinical Laboratory Improvements Amendments (CLIA) laboratories and are interpreted by a healthcare provider. These are usually considered the most reliable.

But even if used appropriately and according to the instructions on the test, at-home tests can still vary in reliability. Everyone’s fertility markers are unique, and these slight differences could cause accuracy problems with at-home tests. So depending on the test, it may be very reliable, but only for certain people — and this accuracy drops even further if you’re not using the test correctly. 

Let’s use the example of ovulation predictor kits. Ovulation tests typically look for the hormone LH in urine. Shortly before ovulating, the body’s LH levels rise — sometimes called an “LH surge.” A positive test means that you should have sex within the next day or two to boost your chances of getting pregnant.

However, the user of these tests must know a lot about their monthly cycles before trying to use these tests. In the average monthly cycle, ovulation usually occurs between days 11 and 21. But cycles can vary between 21 and 45 days in length, with ovulation happening about 12 to 16 days before your next period. That means it’s possible for some people to ovulate as early as day 5 of their monthly cycle.

With that in mind, a person could be testing for ovulation at the wrong time without realizing it and get incorrect results. It’s also possible to have an LH surge and not ovulate — meaning that you could have a positive test result but no egg available to fertilize. And some medical conditions, such as PCOS, can cause inaccurate at-home LH test results.

If you are receiving conflicting or confusing at-home test results, it’s best to reach out to your healthcare provider.

How do you interpret the results of a fertility test?

The label of your at-home fertility test will have specific instructions about how to interpret the results. Depending on the test, the label will say what the different pieces of information mean. If you are unsure how to read your results, it’s best to reach out to a healthcare provider.

Some mobile applications (apps) are available for your smartphone or mobile device to help interpret the results of fertility tests. By inputting different information and at-home test results into the app, it can give you information about an individual’s or couple’s fertility. Many of these apps can also help track monthly cycles and symptoms experienced throughout each cycle to help you watch for trends.

Do at-home fertility tests identify all potential fertility issues?

No. At-home fertility tests only look at certain fertility markers or hormones, compared to a healthcare provider who can look at how your overall health may be contributing to your fertility. This means at-home tests could easily miss potential issues.

For example, most at-home semen analysis tests only give some information about fertility potential — like the amount of sperm in a sample but not if that sperm is healthy.

As infertility has many causes and some tests may only test for a single fertility factor, at-home tests won’t detect all potential fertility issues.

When should you see a healthcare provider about infertility?

If you have been having frequent, contraceptive-free sex for a year — or for 6 months if you are over 35 — and have been unable to become pregnant, you should speak with a healthcare provider about infertility. If your at-home fertility tests show that something may be wrong, this is also the time to head to your provider for a more comprehensive evaluation.

If you are unsure about how to interpret the results of your at-home test, speaking to your healthcare provider can help. It’s important to remember that at-home fertility tests should be thought of as a supplement to more in-depth tests from your healthcare provider and not a replacement.

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Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She was a full-time clinical professor in the pharmacy practice department at D’Youville School of Pharmacy before subsequently joining the faculty of the pharmacy practice department at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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