This article originally appeared on VICE Netherlands.
Having kids is perhaps not as easy as it once was. Studies suggest male fertility has been declining significantly over the past 40 years (the cause of this drop is still unclear), while women are choosing to have kids much later in life, and having a harder time conceiving as a result.
On the positive side, celebrities and regular people are finally breaking the infertility taboo and talking about their miscarriages, IVF journeys or their inability to conceive on social media. But this public interest has also prompted companies to exploit our fertility focus by offering at-home, over-the-counter tests which claim to check for leading causes of infertility.
According to startup news site Sifted, the fertility industry has boomed during the pandemic. Swiss startup Legacy, which tests sperm quality, has seen a tenfold increase in orders, and its Danish counterpart ExSeed is another success story. Demand has also shot up for Apricity, a digital fertility clinic offering at-home blood tests and consultations for women, which can be followed by in-person treatments with partner clinics in the UK.
Dutch company Grip Fertility, founded this year, sells blood tests that analyse hormone levels associated with four of the main causes of infertility in people with a uterus: irregular ovulation, thyroid problems, blocked fallopian tubes and low egg count (usually connected to age).
For example, high testosterone levels are a tell-tale sign of Polycystic Ovarian Syndrome (PCOS), a condition that stops or delays ovulation. Another hormone analysed by the test is AMH, considered one of the best indicators of how many eggs are left in your ovaries. Finally, Grip also tests your TSH levels, which can indicate thyroid issues.
Interested in my own fertility, I decided to try out one of these tests as a healthy 22-year-old. I ordered a test from Grip, which costs €129 (£118) if you use hormonal contraception and €159 (£145) if you don’t. According to their website, the latter is more expensive because they test for two more hormones that are suppressed by hormonal contraception. To take the test, you prick your finger, squeeze a few drops of blood into a tube and send it off to the lab – all from the comfort of your own home.
A few days later, Grip contacted me and said my egg count was normal for someone my age and that I will probably start menopause around the age of 51. I did feel special to know this about my body, especially because you usually only find out about your fertility after you’ve had issues getting pregnant.
Grip implies in their FAQs that their product fills a gap in the healthcare system. “Doctors are (understandably) instructed to only deal with patients who are ill,” they write, “and so healthy women wanting to do a blood test are usually not supported, let alone referred to a specialist.”
But the truth is, neither Grip nor any of these other tests can completely accurately predict your ability to conceive. Frank Broekmans is a gynaecologist and Professor in Reproductive Endocrinology and Surgery at the University Medical Center Utrecht, who helped develop the Grip test.
Dr Broekmans said in a (since-removed) interview on Grip’s website that fertility is actually “pretty complex”, and that these tests have limitations. “A test like Grip can say something about your egg count by looking at the hormone AMH,” he said. “But it doesn’t describe the actual quality of your eggs.” And even if it did, egg quality changes from month to month.
According to a 2017 study, the hormones tested by fertility kits don’t actually predict a person’s ability to conceive. For instance, the study explained that people with low AMH levels (or fewer eggs) can still conceive normally as long as their remaining eggs are released regularly. There are also non-hormonal reasons for infertility, such as the shape of your uterus or conditions like endometriosis, where the uterus lining grows in other parts of your body. Your age and whether you lead a healthy lifestyle are important, too.
Experts have raised similar questions about at-home sperm count tests. Even if your sperm count is normal, there might be other issues that make conception difficult, like how far your swimmers can swim, how concentrated they are or their shape.
Gynaecologist Annemiek Nap, from the Rijnstate hospital in Arnhem, can’t see the value in testing at home. “People might feel reassured about their prospects after taking the test, but that might turn out to be false,” she said.
Unfortunately, there aren’t many tests that can be done to determine whether you will have a hard time getting pregnant. “The most efficient way to have kids is to start trying on time,” she said. And for heterosexual couples: “Conceiving from the comfort of your own bed is much more fun than going through a taxing process in the hospital.”