My Journey with Fertility Testing, Part Two
Test: Everlywell’s Women’s Fertility Test
Average Read Time: 10 minutes
CW: Needles, blood, fertility
This blog is part two of a series about at-home fertility testing. Check out part one here!
Before the test begins…
Today, before the start of my next cycle, I’m setting up my account for the next fertility test I’m going to try out. I had a pretty bad experience with Proov (see post here), so I’m excited to try something else out to see if I can recommend it to a wider community. This Everlywell test (sold by Natalist) was given to me by my best friend, who took it and said, “It was a fairly straightforward way to get a baseline assessment, which I then felt confident using in conversations with my doctor.”
As I’m setting up my account, there are a few things I’ve noticed right off the bat. First, the test is a “women’s fertility test”, which makes me automatically skeptical, since people with uteruses can take this test without identifying as a woman. Also, during intake, they ask about your assigned sex at birth. This seems irrelevant, since someone with testes cannot take this test with accurate results.
One positive thing I’m noticing: that it’s not just about achieving pregnancy. There’s a definite focus on health overall, so it feels like it would be a test for a wider swath of people already.
This test is also a blood test. You take the first test on either day 3 or 4 of your cycle, and then, depending on your cycle length , you take it between days 19-21 again. Since my cycle is 31 days, I’ll use that data moving forward. This is different from Proov, which used urine to determine hormone levels. One advantage Proov has over Everlywell right now is that there were more samples being taken. This test only has you take 2 blood samples throughout. It will test estradiol (estrogen), luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone, and thyroid-stimulating hormone (TSH). This test does not test at all for progesterone-related markers, as compared to Proov, which tests for a progesterone marker but not for total testosterone or TSH. The table below gives a comparison of the two fertility tests.
One final observation as I start to set this test up: while the test I completed was sold by the going-out-of-business company Natalist, the actual test is overseen by a company called Everlywell. They do tests for a wide variety of issues, such as Celiac disease, food allergy and sensitivity, heart health, etc. Their fertility-specific tests include:
Men’s health test
Ovarian reserve test
Perimenopause test
Postmenopause test
Sexual health test
Testosterone test
And there are more that can serve to help you better understand your overall health.
And now… onto my testing experience:
Today is day 3 of my cycle, and that means it’s the first blood collection day! Thank the goddess my best friend was visiting because 1) she’s done this test before, and 2) it was actually incredibly nerve wracking to do the test! In the end, I had her prick me instead of doing it myself. Usually I’m not a scaredy-cat when it comes to things like needles and blood, but in that moment I was glad to have someone who I trust around!
In order to do the test, you take a sharp (basically, a needle hidden in a plastic contraption - see picture below: SHARP NOT SHOWN) and prick yourself on the finger. You have to collect quite a bit of blood, so here are a few tips to promote blood flow, from Everlywell as well as my friend and her doctor husband:
Use your middle finger (the test recommends ring finger)
Wash your hands for a minute in warm water before doing the test
Shake out your hands and move your body to get the blood moved down into them
After you prick yourself, massage the tip of the finger and/or massage from knuckle to fingertip/prick point to promote blood flow to the area.
Once you stick yourself, you put a drop of blood into 12 circles on a specific collection sheet that they provide (see picture below; CW: dried blood samples). The test asks that you don’t touch the sheet directly with your finger, and to instead let the blood “drop” from your finger onto the sheet. This can be tricky! You need to fill each circle with blood completely. Once you’re done, you scan the blood collection sheet with the app, which will verify that you’ve filled the circles enough. You let the test dry for 30 minutes, put it in a biohazard bag, and wait until the next test!
Because my last cycle was 36 days (outside of my norm of 31 days), I’m going to test on day 21. This is the middle date for people who have average cycle lengths (21-35 days) and someone who has a long cycle (36-40 days). So now, I just continue to live my life until day 21! This test already feels a lot less stressful than the Proov test: there’s much less to remember and do, and for some reason a blood test feels much more accurate to me than a urine test for testing hormone levels. But we will see what the results say!
Alright! It’s now day 21. I just completed the next part of this test, and I have lots of thoughts to share about the process. First off, I do not recommend trying to do your blood collection when you’re distracted! I needed help pricking myself again, so I decided to do the test when two friends were over for dinner. While mentally this was super helpful (pricks are just no ful!), it meant that I wasn’t being as careful about reading the directions as I should have been.
The process for blood collection was the same as before - drink a big glass of water, wait 30 minutes, prick yourself, and then collect 12 drops of blood onto the collection paper. However, maybe because I had just eaten, maybe because I’d been sitting and chatting for a few hours, maybe time of day, or maybe something else, but my blood did not want to flow! It required 3 different sticks over the course of an hour to get enough blood onto the collection paper.
This is where I messed up - I didn’t carefully read the direction that stated to only put one drop of blood on each circle, regardless of how much it actually fills the circle. I was worried when my blood wasn’t flowing, so about half of my circles have more than one drop of blood in them. I talked with my friend who did this test, and she told me that she also made this mistake. However, it didn’t seem to be much of a problem for her: her results from a Everlywell test were very similar to later in-clinic blood tests with her doctor. But I’m still nervous that I’ve messed up my results and am going to have to do the test again. I guess we now wait and see.
The next part of this process is to mail the box back to Everlywell. They provide a package and return slip, making the process quite easy. I'll bring this to the post office later today, and then it’s just a waiting game!
After I mailed my package, I waited a few days before Everlywell sent me a confirmation that my test was received and I should receive my results in 3-5 business days! Today is a Friday, so I’ll expect them sometime next week. I’m feeling excited to see what this test comes up with!
The final stage of this blog - The Results! I got an email and app notification that my results were ready to read 35 days after day one of the period I used for this analysis. I’ll break down my results below:
*All text in the right-hand column comes directly from the Everlywell app.
For each of these hormones, there is a “Tell Me More” drop down menu, which leads you to a generic overview of the hormone, meaning: what it does both in terms of fertility and in terms of overall health. I appreciated reading information about the connection of these hormones to well-being beyond ovarian/reproductive health. For example, the Everlywell app mentioned the connection between bone health and estrogen levels, as well as TSH levels being linked to metabolism and digestion. In the results section, there are also links to specific websites for people to learn more. While some feel more credible (such as the Mayo Clinic), others gave me pause: they were connected not to medical professional organizations or healthcare facilities, but to media conglomerates. I always encourage people to use their best critical media literacy as they engage with information on the internet, as there’s just so much to navigate. There are already so many credible sources on fertility and hormone management (check out my resource page for some recommendations!). If a client of mine was doing this fertility test, I’d point them to verified resources before I told them to click on these links. For my own health, I have decided that I’ll bring these results to my own doctor, instead of bothering with the information posted in this app.
My results: everything was incredibly reassuring! Every test came back within “normal” range, and so it felt like this test was telling me that I’m healthy and my hormones are balanced. This feels like a bit of weight off my shoulders after the Proov test, which instead made me feel like my body was in rapid decline. I’m currently 35 and I know that age is a factor in reproductive health. Seeing these results made me feel like I can wait a few more years before retesting for health-related purposes. My only lingering frustration is on my own shoulders: I still believe that I have low progesterone due to consistent brown blood at the end of my cycle. This Everlywell test doesn’t measure progesterone, so it actually didn’t address the most important factor on my quest to find out what’s happening within my own body.
Overall, I think I would recommend this test to people who want to test their fertility hormones, as it felt like it gave me results that I trust are accurate without much lift (minus the blood collection, but that was temporary!). Because the language is so gendered in the website, app, and within my results, I would definitely mention that to interested clients who are not cis so that they could make a decision about what feels safe to engage with for themselves.
Finally, I still believe that cycle tracking is one of the best ways to get to know yourself and your body. While these tests feel more “scientific,” fertility awareness is a proven method of tracking overall health and fertility in order to notice your normal and consider how that compares with the general range of “normal.” Tracking is the number-one step for figuring out things that feel right, things that feel wrong, and figuring out your body’s basic patterns. Are you interested in starting to track? Have you been tracking for a while and want a second set of eyes on your patterns? Reach out to me here to book a free 30 minute consultation!
