Best At-Home Fertility Test to Help You Learn About Your Reproductive Health

Modern Fertility Hormone Test is one of the more comprehensive fertility tests available today. It tests up to seven hormones — follicle-stimulating hormone, estradiol, luteinizing hormone, prolactin, thyroxine AMH, and thyroid-stimulating hormone. AMH is a marker of ovarian reserve (levels of the hormone correlate with how many eggs you have) and thyroid stimulating hormone (TSH) can alert you to any thyroid conditions which may prevent ovulation; both of these hormones can be tested even if you have an IUD or are on another hormonal birth control. The other five hormones can only be tested for those who are not on birth control. You will fill out a questionnaire when you order and your test will come customized based on your birth control (or lack thereof).

The test was developed by reproductive endocrinologists, OB-GYNs, and fertility researchers, but it’s designed to be used by the average person thanks to clear step-by-step instructions. If you’re more visual you can watch an Instagram video of Modern Fertility founder, Carly Leahy taking the test.

The test arrives discreetly in the mail in a package marked from Modern Health After clearing a space for your kit and prepping your finger using an alcohol pad, use the included lancet to prick your finger. Squeeze your finger to drip blood onto an included test card, pack up your sample, and mail it in for analysis using a prepaid return label. Within seven to10 days, you’ll receive your physician-reviewed reports showing your levels of each hormone on a private dashboard within the Modern Fertility app (accessible via iOS or Android). In addition to a numerical value, each hormone is labeled with words like “normal” “slightly low” or “high” so it’s very clear where you stand.  If you don’t want to administer the test yourself you can go to a local Quest Diagnostics for a blood draw.

One of the things that set Modern Fertility apart from the rest is that you’ll have the option to consult with a fertility nurse for free who can answer questions, as well as ongoing access to other Modern Fertility users via an online forum.

When trying to conceive, a great place to start is by tracking your ovulation window which helps time intercourse. The Mira Care Fertility Starter Kit tracks LH and E3G  levels, two hormones tied to the reproductive cycle (E3G is an estrogen compound that can help show ovarian function and egg quality while LH controls the release of eggs during the menstrual cycle). LH rises right before ovulation, so when you see a spike in LH it’s a good time to have sex if pregnancy is your goal.

Inside the kit, you’ll find the “analyzer device” plus its storage case and charger, 10 testing wands, 10 urine cups, and detailed instructions. Pee in a cup, then dip the wand into the urine for 10 seconds. Then place the wand into the analyzer and your LH and E3G results for the day will display in your Mira app within about 20 minutes as long as you’re connected to Bluetooth.

The full kit including the analyzer device and 10 wands costs $199. Keep in mind that you will need to continue to purchase wands to use the device, which drives the price up — currently a twenty-pack of Fertility Plus wands (which tracks E3G and LH) retail for $58.94. Wands that track just LH retail for $40. For a more accurate picture of fertility, expect to test between ten and 20 times per month.

Most people assigned female at birth are accustomed to seeing doctors for their reproductive health regularly, and so they’re often the ones who get tested first in a couple when pregnancy is taking longer than expected. But with as many as 40-50% of infertility cases being “male factor”, (meaning there is an issue with sperm that prevents pregnancy) it's important for people assigned male at birth to be tested, too.

For a truly complete picture of fertility health, both partners can seek out at-home fertility screening tests, and the Proov His & Hers Test makes that easy;. It allows them both to get checked in one kit. It’s a good option for those for whom conceiving is taking longer than expected, or for couples just beginning to think about having children.

The fertility test for couples includes pretty much everything a couple with different genders needs to get a snapshot of their fertility. The kit is a bundle of three tests Proov also offers individually: “The Complete Testing System” for people assigned female at birth, a sperm test from the YO brand, and ten early HCG strip pregnancy tests. 

The Complete Testing System for women includes three FSH tests to be used on days clearly marked in your cycle (indicated in the instructions) and 17 multi-hormone tests. FSH is an indicator of egg count, and a low result can indicate low ovarian reserve. 

The multi-hormone tests check levels of the following:

• E1G, which is a byproduct of estrogen that’s detectable in urine. Kind of like a shot fired at the beginning of a race, a rise in E1G signals the opening of your fertile window.
• LH (luteinizing hormone): A sharp rise in LH (often referred to as a “surge”) indicates that you will soon ovulate, and it alerts you to the best time to have sex if pregnancy is the goal.
• PdG, which is a byproduct of progesterone that’s detectable in urine. A rise in E1G signals the beginning of your fertile window, increased LH indicates that you will soon ovulate, and an increase in PdG confirms that successful ovulation occurred. 

Testing for people assigned female at birth must begin on day five of a cycle (day one is the start of your period), and if you receive your test after that, wait until the following month to begin. The sperm kit can be done any time (though ejaculation is not recommended two to five days before testing). It measures Motile Sperm Concentration (how many sperm are actually moving and therefore can implant an egg). Unlike other at-home sperm tests, you do not have to mail your sample in or visit a lab. Instead, there’s a bluetooth device included which analyzes sperm and delivers results to your smartphone; there is also a video of sperm (showing how they move) that you can send to your doctor, if needed. You’ll receive an “MSC” number which is a measurement of the number of moving sperm per milliliter of semen

The ten HCG strip pregnancy tests that are also included in the package detect pregnancy up to five days before a missed period.

Everlywell Women's Fertility Test tests estradiol (a compound of estrogen), follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), and testosterone (a reproductive hormone produced in both genders); together these hormones give a picture of egg reserve, ovulation, and overall reproductive health. While $149 is not inexpensive, it’s a pretty fair price compared to other tests we researched for the amount of data you receive and considering that a similar test would cost much more if done in-office by a reproductive endocrinologist because these kinds of proactive fertility treatments are rarely, if ever, covered by insurance as they are not deemed “medically necessary.”

Once you receive your kit, register it at everlywell.com using the ID number included in your box. Similar to the Modern Fertility at-home test, the Everywell test is done at home with a finger prick. The kit comes with detailed written and video instructions, prepaid shipping both ways, and all the tools you’ll need to collect your sample. After collecting your blood sample using the included lancet (it only takes a few drops), you’ll mail it back to the CLIA (Clinical Laboratory Improvement Amendments)-certified lab, which is a laboratory accreditation that helps ensure laboratories provide precise test results, for analysis using a prepaid label. Results are delivered digitally, and the personalized report shows where you stand on each hormone (low, average, high) in an easy-to-read graph.

This test is great for someone who is thinking about having kids in the future and wants to see certain markers of current and future fertility; for example, if AMH levels are low that could indicate fewer than expected eggs, so someone may start trying to get pregnant earlier than anticipated. If you are TTC and it is taking longer than anticipated, this test also helps to identify any hormonal issues. For example, if your FSH comes back low, it may indicate a smaller egg reserve which is something you can then discuss with your doctor.

Legacy Semen Analysis offers a truly holistic insight into semen health as well as the more unique option to freeze your samples for later use in IVF and artificial insemination. It tests key metrics of sperm health including: 

• Volume: How much is produced
• Concentration: How many sperm are the semen
• Motility: How many of your sperm are moving (this is very important for fertility)
• Total motile sperm count: A calculation of sperm quantity and quality
• Sperm morphology: How many of your sperm are the proper size and shape
• Post-thaw analysis: Freezes a small amount of semen to see if it would be a good candidate for sperm freezing

After ordering, you can use the app to schedule your preferred delivery date. The kit comes with everything you’ll need including a sample cup, a foam storage container, a vial for a sample, a seal for tamper-proof shipping, and an ice pack that you can discard. There are clear instructions for how to collect your sample. You have seven days to use the kit and you should plan to return your sample Monday through Thursday so that it doesn’t get stuck in transit over the weekend.

After your sample is analyzed by a CLIA-certified lab, you’ll receive your results within the client dashboard in the accompanying app.  The test is backed by a peer-reviewed study, so you can feel confident in the results you receive. Along with clear results in chart form, you’ll also receive tips for how to improve fertility health, plus the option to book a virtual appointment with a male fertility specialist. There’s even a downloadable semen analysis summary report to share with your doctor. Sperm regenerates about every three months, so you’ll want to test more than once if you’re looking to improve sperm health naturally and want to track your progress.

Long-term ovulation tracking is often what people assigned female at birth have to do when they’re trying to figure out the best time to conceive. The ovulation confirmation tests from MyLAB Box check for the presence of PdG in urine. PdG is a metabolite of the hormone progesterone, a hormone that your body produces after ovulation, so a positive test confirms that you have ovulated and therefore can rule out ovulatory issues, a leading cause of people assigned female at birth's infertility.

Each kit includes five strips and a pee cup. Use one of the strips as a baseline test the day after your period ends. This test should be negative and will help you tell the difference between positive and negative tests later on. Keep in mind that one line on a PdG test is positive, two lines are negative and one line is positive (meaning ovulation did occur) — this is the opposite of most ovulation tests and can be confusing.

Begin testing using the remaining strips seven days after your peak fertility as indicated by an ovulation test. Seven days after ovulation, you should see a positive PdG test. MyLAB Box recommends testing on days seven, eight, nine, and 10 after your peak and ideally, all those tests should be positive.

Results are visible right on the stick, but downloading the Proov app and inputting details about your cycle will yield even more information including when to test for your cycle and lifestyle tweaks that may help balance your hormone levels (plus the Proov app doesn’t sell data). If you’re trying to get pregnant, these FDA-approved ovulation confirmation tests can provide data needed for future months of conception. Most importantly, they can confirm whether you have or have not ovulated, and that information will be crucial to tell your doctor if you’re having trouble getting pregnant.

Whether you’re hoping to get pregnant or hoping to avoid pregnancy while not on birth control, the ability to accurately pinpoint an LH surge is crucial. Natalist ovulation tests do just that. Before ovulation, the hormone LH rises drastically, signaling to the ovaries that it’s time to release an egg, so if you catch your “surge” it means you should have sex if you want to get pregnant. The test can detect LH in the sample at 25 mlU/mL (that’sMilli-International Units per Milliliter and is a measurement of how much of the hormone is present in urine).

To use the ovulation sticks, you’ll either urinate directly onto the tip of the stick or pee into a cup and dip the stick. After waiting a few minutes, two purple lines will appear in the window — the line on the right is the control and the results are on the left. 

Unlike a pregnancy test, two lines do not indicate a positive result. The body makes LH all month long, so you will likely see two lines each time you test, but an LH surge is indicated when the test line is as dark as or darker than the control.

Natalist also makes Ovulation Test Strips which are less bulky and use less plastic than the sticks (though the brand does have a “plastic neutral” claim meaning with each plastic-containing order, they promise the removal of a comparable amount of plastic from the environment). However, one potential advantage of using a stick over a strip is that you can write the day and time you tested and line your tests up to see your LH progression over the month; this can be especially helpful for those who have lower levels of LH and may never get a deep purple result.

Tracking ovulation can be annoying and time-consuming, especially if you’re doing it over several months, so a device that simplifies this process, such as the Ava Wearable Bracelet can make tracking a snooze, literally. What sets the bracelet apart is that it tracks temperature, physiological stress, and resting pulse rate while you sleep — as well as your sleep patterns. These physiological markers change with your fertility and general health, so tracking these patterns can help create a clear picture of your overall health as you try to conceive. Ava Wearable Bracelet looks like a bracelet or watch and you only need to wear it while you sleep so it’s not a big deal if you don’t love how it looks. It tracks physiological signals that are markers for fluctuating hormone levels and it’s able to pinpoint as many as five fertile days (in contrast, LH tests can typically pinpoint two fertile days).

The wearable measures five physiological signs of fertility: temperature, heart rate, heart rate variability, skin perfusion (which can indicate blood flow and vessel health), and respiratory rate. Temperature, heart rate, and skin perfusion all rise slightly as ovulation approaches. Because it does the work for you while you sleep, you don’t need to remember to take your temperature first thing in the morning as with the Basal temperature method or pee on an ovulation stick. Sync to the app and your results will display overnight. 

The bracelet also converts to a pregnancy tracker, providing week-by-week content about the baby and your body. There’s even an option to print off 12 months of data, which may be useful to share with a fertility doctor.

Ava is definitely an investment. While you won’t find it for under $279, if you’re willing to pay a little extra, a refund may be available to you if you’re not pregnant within a certain timeframe. While the $279 option does not come with a refund, the two price upper tiers ($309 and $359) do if you’re not pregnant in 12 or six months respectively. 

Monthly financing is available through Klarna at a rate of $50 per month.