Direct-to-consumer fertility testing: Utilization and perceived utility among infertility patients and reproductive endocrinologists

Published:November 17, 2022DOI:

      Structured Abstract

      Research Question

      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 endocrinologists (REIs)?


      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.



      BBT (basal body temperature), DTC (Direct-to-Consumer), DTCFT (Direct-to-Consumer Fertility Test), SREI (Society for Reproductive Endocrinology and Infertility)
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      Benjamin J. Peipert, MD is the current Education Chief Resident in Obstetrics & Gynecology at Duke University. Ben is a passionate provider and advocate, and his research interests include access to care, medical innovation, and health policy. After completing residency, he will be starting his fellowship in Reproductive Endocrinology and Infertility at the University