Wondering if a Modern Fertility test is worth it?
As someone with ovaries in their late 20’s - my online algorithm is aggressively invested in my egg freezing and fertility testing options (& we’ll pretend my hefty search history of fertility research has nothing to do with it).
While the prey-like marketing and messaging of these ads is worthy of a whole other discussion…the fertility education advocate in me is pleased this has at least become a mainstream topic. Knowledge is always power, so I’d like to provide you with even more if this question has crossed your mind.
*Disclaimer* I am not affiliated with Modern Fertility, nor have I taken a Modern Fertility test. This is the research I would compile and the advice I would give if my closest friends were to ask me this question (and because I wondered it myself).
What markers are tested?
Modern Fertility’s Hormone Test includes the following markers:
Anti-Mullerian Hormone (AMH)
What is it? AMH is a protein produced by the ovarian follicles (where eggs develop). This means the more eggs there are, the more AMH is produced.
What I want you to know: AMH is a measure of ovarian reserve, but it's not useful in assessing oocyte or embryo quality, nor in predicting pregnancy. This review goes through pros/cons of AMH in fertility assessment, and one con is the following: In normal populations, women with a low serum AMH level achieve similar pregnancy rates compared to those with normal or high AMH levels. Too often a “lower than average” AMH result freaks people out, when in reality it says nothing about the quality of your eggs or the likelihood of conception.
AMH is influenced by vitamin D deficiency, so supplementing with vitamin D if your levels are low could be a great place to start.
AMH levels tend to be elevated in PCOS, so a result like this could precipitate an official diagnosis with your provider.
Does MF test while on hormonal birth control? Yes.
Thyroid-Stimulating Hormone (TSH)
What is it? A hormone released by the pituitary gland into the blood stream, where it finds the thyroid and binds to the thyroid cells, getting the thyroid to produce the right amounts of T3 and T4 (hormones that affect brain, heart, bone, digestive, and metabolic health).
What I want you to know: While TSH is the most sensitive and useful marker to measure thyroid function, there are a few things that can affect your result. Even though Modern Fertility allows you to test this marker while on hormonal birth control, long term use (10 years or more) has been linked to higher TSH levels (indicating hypothyroidism). Certain medications can disrupt TSH levels, so if you take any - testing through your provider might be a safer option.
Biotin supplements can also lead to falsely low levels of TSH.
Does MF test while on hormonal birth control? Yes.
Free Thyroxine (Free T4)
What is it? Free T4 is the active form of the thyroid hormone.
What I want you to know: It’s most useful as a secondary test to confirm an under-active thyroid if TSH is high. Free T4 can also be converted into T3 (another important thyroid hormone), making T4 the more important marker to measure.
Does MF test while on hormonal birth control? No.
Estradiol (E2)
What is it? Estradiol is the primary form of estrogen in the body, and it’s produced by the ovaries. Estrogen’s rise in the follicular phase is what starts off the ovulation process. Estrogen travels from the ovaries to the brain to slow the production of FSH, so that the dominant follicle producing that estrogen gets all the attention for ovulation.
What I want you to know: Since estradiol (estrogen) fluctuates through the menstrual cycle, Modern Fertility is supposed to be tested on cycle day 3 (the third day of bleeding). Day 3 is considered the clinical “baseline” - and testing on another cycle day would likely give a result outside of this day-3 range.
Does MF test while on hormonal birth control? No.
Follicle-Stimulating Hormone (FSH)
What is it? FSH is a hormone made by the pituitary that tells the ovaries to make follicles which make eggs. As we mentioned above, estrogen’s rise causes FSH to go down - because we don’t need to be stimulating any more follicles when we’ve got a great one growing and ready to travel to the uterus!
What I want you to know: FSH also needs to be tested on day 3 of the menstrual cycle due to this clinical baseline, and gives great insight into the brain-ovary connection when analyzed with estradiol.
Does MF test while on hormonal birth control? No.
Luteinizing Hormone (LH)
What is it? LH is the hormone that surges and triggers ovulation. It’s what urine ovulation prediction kits are measuring, because levels of LH are highest right before ovulation.
What I want you to know: Since this test is being done on cycle day 3, LH will still be low at this point. But irregular ovulation patterns could be identified if LH is too high or too low at cycle day 3.
Does MF test while on hormonal birth control? No.
Prolactin
What is it? Prolactin stimulates milk production and pauses ovulation after birth.
What I want you to know: High prolactin can be the cause of irregular periods, no periods, PMS, acne, facial hair, and headaches, among other symptoms. To best test day 3 prolactin levels, make sure you are hydrated, relaxed, and you measure levels in the morning (between 8am-noon).
Does MF test while on hormonal birth control? No.
Are the results accurate?
In regular blood testing, results may vary from lab to lab. And even if you go to the same lab, your results can vary from test to test. This is most often due to clinical variation, where each test has an accepted range of variation.
Beyond this, Modern Fertility (commendably) conducted a clinical study that compared the results of the hormones they test via both venipuncture and finger prick. For all the markers, the results from both collection methods were shown to be interchangable, meaning you would get the same result from a regular blood draw with a high degree of both accuracy and precision.
Two parts of decision making:
1. The evidence
First, we want to understand the facts, statistics, and direction of evidence for what we’re deciding on. In this case, it would be what we went through in the above section:
What are the markers, how accurate is the testing, and what’s involved ($179, sample is collected by a finger prick, and wait about 7-10 days to get your results).
2. Your personal filter
Here is where you factor your own risk tolerance, personal preferences, budget, and personality into the equation. In this case, it would be if you are on hormonal birth control, understand that you will only get 2 markers tested instead of the complete set (but still pay the exact same price).
This would also be the time to weigh how you feel about pricking your finger (though you can bring this test to Quest Diagnostics where they will perform it for you).
And then you might also want to consider the following:
If something is going to empower you, advance you, and make you feel energized and behind the wheel of your life - then you should totally do it.
If something is going to haunt, agonize, or intimidate you, and you know you’re likely to spiral and doom-seek based on new information - it may not be for you just yet.
Fear is never the goal. Our nervous system balance is KEY in fertility health, and anything that damages your peace is not worth it. This can be applied to horror stories about birth, medical trauma, black-and-white advice, and testing services that are not actionable. And yes, there is a difference between education/preparation and going down a rabbit hole of doom. If you’re not empowered and provided with healthy and sustainable next steps at the end of a service, I can’t get behind that.
This is not to minimize the importance of truth, advocacy, and visibility in the medical space - but rather to stress the wildly important role our mindset plays in our health, and how we should seek out the information that serves us most.
The key takeaway:
Does Modern Fertility pass the scientific sniff test? On a whole, yes. And if:
Knowing this information will be beneficial to your mental health
You are not on hormonal birth control (or are ok with paying full price for 2 out of 7 markers)
You have a regular period (or want a test to help identify menstrual irregularity cause)
You plan to use this information as a preliminary screening/conversation starter with your provider
Yes, this may be a worthwhile investment for you.
And please remember, this hormone test is NOT an infertility indicator or diagnosis, but rather an assessment of where your body is at the moment.
Your peace of mind and sense of power in your life are incredibly worthy of protection, so please make sure the decisions you make in this space honor them both.
Written by Michelle Cawley, MS. 2/21/23
The information on this website is provided for educational purposes only and should not be treated as medical advice. WTT Nutrition makes no guarantees regarding the information provided or how products may work for any individual. If you suffer from a health condition, you should consult your health care practitioner for medical advice before introducing any new products into your health care regimen. For more information, please read our terms and conditions.
REFERENCES
Dewailly, D., & Laven, J. (2019). AMH as the primary marker for fertility, European Journal of Endocrinology, 181(6), D45-D51. Retrieved Feb 21, 2023, from https://eje.bioscientifica.com/view/journals/eje/181/6/EJE-19-0373.xml
https://www.aacc.org/cln/articles/2012/november/fertility-testing.
Ran Y, Yi Q, Li C. The Relationship of Anti-Mullerian Hormone in Polycystic Ovary Syndrome Patients with Different Subgroups. Diabetes Metab Syndr Obes. 2021 Mar 25;14:1419-1424. doi: 10.2147/DMSO.S299558. PMID: 33790608; PMCID: PMC8006968.
Qiu Y, Hu Y, Xing Z, et al. Birth control pills and risk of hypothyroidism: a cross-sectional study of the National Health and Nutrition Examination Survey, 2007–2012. BMJ Open 2021;11:e046607. doi: 10.1136/bmjopen-2020-046607
Odhaib SA, Mansour AA, Haddad NS. How Biotin Induces Misleading Results in Thyroid Bioassays: Case Series. Cureus. 2019 May 23;11(5):e4727. doi: 10.7759/cureus.4727. PMID: 31363424; PMCID: PMC6663274.
Thapa S, Bhusal K. Hyperprolactinemia. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537331/
Burke, Erin E. PhD; Beqaj, Safedin PhD; Douglas, Nataki C. MD, PhD; Luo, Robert MD, MPH. Concordance of Fingerstick and Venipuncture Sampling for Fertility Hormones. Obstetrics & Gynecology 133(2):p 343-348, February 2019. | DOI: 10.1097/AOG.0000000000003066