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What’s the difference between ovulation predictor kits and the fancy fertility hormone trackers (like Inito) that measure estrogen, progesterone, LH, and FSH? It seems like there’s more data I could get from these, but I don’t know how useful that is compared to the cheaper stuff at the drugstore. What’s really important to know?
—Cristina
I like this question because it points to a great example of “less is more.”
Ultimately, when trying for a pregnancy, what is important to know is when you are ovulating. That can be done with something as simple as a generic LH testing strip from your local drugstore or even without testing altogether, like cervical mucus tracking. Everything else you don’t really need.
At-home tests, especially for hormones like estrogen, may not be accurate. Many at-home tests do not have the ability to perform the purification steps necessary to ensure these measurements are accurate, as would be done in a laboratory. This can lead to falsely elevated levels. Similarly, at-home tests are not sensitive enough to detect and quantify lower levels.
Also, most of the testing included in these types of fertility trackers is not actionable. Estrogen levels are typically only tracked during fertility treatments that involve IVF medications as a way to gauge response and titrate doses. At home, there is very little to be gained or done with this information, especially without an ultrasound to correlate. FSH levels, while in combination with estrogen levels, can give a sense of ovarian reserve, and they cannot be interpreted without an accurate estrogen level. Similarly, progesterone levels are not typically actionable at home, even if you suspect you may have luteal phase deficiency.
Lastly, it is important to take a step back and recognize that these types of tests have largely been developed and marketed alongside a growing trend of women waiting to have children until they have reached their education, career, and financial goals. In the wake of this, there is sometimes a tendency to turn fertility into a sort of homework assignment that you can optimize, “ace,” and ultimately control. The reality is there is only so much you can do about your fertility, and this may be an opportunity to recognize that.
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To clarify: it sounds like these trackers like Inito give (a) data that is not necessarily clear how to make actionable and (b) the data itself is not 100% reliable?
If I have that right, a few follow up questions:
1: it sounds like these apps are using the data in an algorithm to predict fertile days. Isn’t that how the apps make the information actionable? Even if we don’t know the exact cause-and-effect of everything yet, could these algorithms be giving better predictions than ones that just rely on, e.g., LH or BBT?
2: why is it that at-home LH tracking is more reliable than tracking for other hormones?
3: on point (b), I did find this study, but I don’t know how to interpret: https://pubmed.ncbi.nlm.nih.gov/37286704/
4: even if the information isn’t useful for predicting ovulation, could it be useful to have tracked all this data so that if we are still having trouble conceiving in 1 year, we can show our doctor the data?
Sorry for all these questions. It would be GREAT to have a longer blogpost on these trackers…they are absolutely everywhere on my instagram feed and I have found solace in this post