Abstract
Research Question
What is the utilization of direct-to-consumer fertility tests (DTCFT) among fertility
patients? How does the perceived utility of DTCFT differ between patients and reproductive
endocrinologists (REI)?
Design
Infertility patients visiting the Duke Fertility Center between December 2020 and
December 2021 were sent an electronic invitation to participate in a patient survey.
Members of the Society of Reproductive Endocrinology and Infertility were also sent
e-mail invitations to participate in the REI survey. DTCFT were defined as tests not
ordered by a physician or performed at a physician's office, including calendar methods
of ovulation prediction, urinary ovulation prediction kits, basal body temperature
(BBT) monitoring, hormone analysis, ovarian reserve testing and semen analysis. Patients
and REI were asked how likely they were to recommend a given DTCFT, on a 0–10 Likert
scale.
Results
In total, 425 patients (response rate 50.5%) and 178 REI (response rate 21.4%) completed
the surveys. Patients reported the utilization of calendar methods of ovulation prediction
(83.8%), urinary ovulation prediction (78.8%), BBT monitoring (30.8%), hormone analysis
(15.3%), semen analysis (10.1%) and ovarian reserve testing (9.2%). REI rated the
utility of all DTCFT significantly lower than patients did (average discordance –4.2,
P < 0.001), except for urinary ovulation prediction, which REI gave a significantly
higher score (discordance +1.0, P < 0.001). Prior pregnancy was significantly associated with home ovulation prediction
utilization among patients (adjusted odds ratio 3.21, 95% confidence interval 1.2–9.83).
Conclusions
Methods of ovulation prediction are commonly used by fertility patients. Significant
discordance exists in the perceived utility of DTCFT between patients and REI. Patient
education and guidelines are needed to better inform individuals considering DTCFT.
Key words
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Biography
Benjamin J. Peipert, MD, is the Education Chief Resident in Obstetrics and Gynaecology at Duke University, USA. Ben is a passionate provider and advocate, research interests including access to care, medical innovation and health policy. After his residency, he will start his fellowship in Reproductive Endocrinology and Infertility at the University of Pennsylvania, USA.
Key message
Ovulation prediction tests are commonly used among fertility patients. Reproductive endocrinologists gave significantly lower utility scores for all forms of direct-to-consumer fertility testing compared with patients, except for urinary ovulation prediction. Patient education and guidelines are needed to better inform individuals considering direct-to-consumer fertility tests.
Article info
Publication history
Published online: November 17, 2022
Accepted:
November 11,
2022
Received in revised form:
October 24,
2022
Received:
June 23,
2022
Declaration: The authors report no financial or commercial conflicts of interest.Footnotes
Presented at the Virtual Annual Meeting of the American Society for Reproductive Medicine, October 2020.
Identification
Copyright
© 2022 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
