What is the utilization of direct-to-consumer fertility tests (DTCFTs) among infertility
patients? How does the perceived utility of DTCFTs differ between patients and reproductive
Infertility patients visiting the Duke Fertility Center between December 2020-2021
were sent an electronic invitation to participate in our patient survey. Members of
the Society of Reproductive Endocrinology and Infertility (SREI) were sent email invitations
to participate in our REI survey. DTCFTs were defined as tests not ordered by a physician
nor performed at a physician's office, including calendar methods of ovulation prediction,
urinary ovulation prediction kits, basal body (BBT) temperature monitoring, hormone
analysis, ovarian reserve testing, and semen analysis. Patients and REIs were asked
how likely they were to recommend a given DTCFT on a 0-10 Likert scale.
In total, 425 patients (response rate=50%) and 178 REIs (response rate=21%) completed
the surveys. Patients reported utilization of calendar methods of ovulation prediction
(85%), urinary ovulation prediction (79%), BBT monitoring (31%), hormone analysis
(14%), semen analysis (10%), and ovarian reserve testing (9%). REIs rated the utility
of all DTCFTs significantly lower than patients (average discordance -4.2, p<.0001),
except for urinary ovulation prediction, which REIs gave a significantly higher score
(discordance +1.0, p<.0001). Prior pregnancy was significantly associated with home
ovulation prediction utilization among patients (OR 3.21 [95% CI 1.2-9.83]).
Methods of ovulation prediction are commonly used by infertility patients. Significant
discordance exists in the perceived utility of DTCFTs between patients and REIs Patient
education and guidelines are needed to better inform patients considering DTCFTs.