Warning on self-test fertility kits
20 October 2009
By Rebecca Robey
Appeared in BioNews 531
Women have been warned against relying on 'over-the-counter' home fertility tests to gauge whether they can afford to delay starting a family. Scientists and doctors cautioned that such tests may provide false hope, encouraging women that they have several years of fertility left without looking at all the important factors.
Women are born with their complete supply of eggs for their lifetime contained within their ovaries. Over time this supply steadily diminishes, eventually leading to the menopause when the supply is exhausted. Home fertility tests, or 'ovarian reserve' tests, cost as little as £25 to £180 and use a blood or urine sample to estimate the number of eggs a woman has left by measuring her levels of a hormone called follicle-stimulating hormone (FSH). As the number of eggs falls, the level of FSH in the woman's blood rises, and so the information can be used to predict how many child-bearing years a woman might have left.
However, fertility experts are concerned as they feel these tests do not offer a complete picture. Such tests do not give any information about the quality of the eggs or other factors that may be crucial for fertility. Stuart Lavery, a consultant gynaecologist at the IVF (in vitro fertilisation) unit at Hammersmith hospital, London, explained: 'The concern with over-the-counter tests is that although they are helpful, because they focus the mind on fertility, they can also give false reassurance. If the fallopian tubes are blocked or the partner doesn't have fabulous sperm, it may be giving you false hope'.
These concerns were raised after research presented at the American Society for Reproductive Medicine's annual meeting in Atlanta, Georgia, US, provided evidence that the same tests may be useful indicators of the likelihood of successful IVF when used in a clinical setting. A study at the Advanced Fertility Centre of Chicago used FSH tests in conjunction with ultrasound examinations that also estimate the size of a woman's egg reserve to predict the fertility of 1,380 women under the age of 35 who were undergoing IVF. IVF was successful in 59 per cent of women with normal results in both tests compared to 35 per cent of women with abnormal FSH levels and just 9 per cent of women who had abnormal results in both tests.
Ovarian reserve tests are routinely used in women over 35 years old considering IVF in the UK, and the new study indicates it may also be useful for younger women to help them decide whether to pursue the often costly procedure. Dr Todd Deutch, managing director of the Advanced Fertility Centre of Chicago, emphasised that this did not mean the tests were good indicators for women trying to conceive naturally. He said: 'I think relying on these tests to gauge fertility generally... is not a good extrapolation of this data. These tests don't tell the whole story'.
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SOURCES & REFERENCES
Doctors warn against over-the-counter fertility tests for family planning
The Guardian | 20 October 2009
High Street fertility tests could give wrong results, experts warn
The Daily Telegraph | 20 October 2009
Home tests on biological clock 'could give women false hope'
The Times | 20 October 2009
Why home fertility tests fail to deliver
The Daily Mail | 20 October 2009
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I believe that even though the article is vehemently against these over the counter tests because they do not produce fully accurate results, I do not believe that the issue is as great as they make it out to be. They over-exaggerate the maleficence that is caused by these methods. I believe that if the public was simply informed that the test may not consider many factors, the product is a very valuable asset to everyone.
ReplyDeleteOne of the reasons that the test is inaccurate is simply because it is over the counter and not as fully valid as going to the doctors and getting a check-up. I believe it is the customer's duty to recognize this, and not fully base their judgment and hope on the results of these tests. They should know or be informed about the drawbacks of these methods and adjust accordingly. I believe that if they do so more good can be done in the world, and these over the counter tests would be highly ethical.
Furthermore, it is not as if these tests are completely inaccurate. They are fairly accurate in giving a diagnosis. They are just not 100% accurate. If people use these tests with this knowledge, beneficence in the world can be increased dramatically. Thus, it would be highly ethical to retain these products rather than remove them.
~Tully Cheng
I don't think it makes sense to condemn a product that does give many people a reasonable idea as to how many years they are likely to still be fertile just because the product does not provide a full picture in all scenarios. Clearly it would be ideal if the over-the-counter test could accommodate external factors such as egg or sperm quality that affect fertility, but working with what we have, the direct to consumer fertility tests do help some people to gauge with some level of accuracy their fertility. Additionally, it seems that as the article points out, these tests can be even more effective in a clinical setting where they are used in conjunction with other methods that collaboratively can provide a whole picture of the woman's fertility. Therefore, it seems that these tests certainly do have a purpose, whether it be used as an at-home test or in a clinical setting. Although the article points out that these tests can give false hope because they do not provide a full picture of all the factors affecting fertility, it is acknowledged that there is a warning to consumers to this extent. Based on the warnings about these self-test fertility kits, a woman has the right and opportunity to learn about and understand the warnings, as well as the possible risks and benefits of using the information provided from the test results. Being given this information (or having the opportunity to acquire this information), a woman can then make a decision about whether or not to take the test and how to use the information provided by the test if she does choose to use it in an informed way. As a consumer, much of the burden of the decision making falls upon the individual to heed the warnings, become informed about the test, and to exercise his or her right to autonomous decision making in choosing whether or not the test is in his or her best interest. Therefore, it can not be expected or deemed ethical for other measures besides warnings and cautions about the test's accuracy to be implemented by third parties to prevent or discourage the use of this product.
ReplyDeleteI strongly encourage the warnings against relying on 'over-the-counter' home fertility tests to gauge whether they can afford to delay starting a family. Scientists and doctors cautioned that such tests may provide false hope, encouraging women that they have several years of fertility left without looking at all the important factors. Fertility experts are concerned as they feel these tests do not offer a complete picture. Such tests do not give any information about the quality of the eggs or other factors that may be crucial for fertility. In addition, this does not provide any information in regards to the quality of sperm necessary to conceive. With that being said, however, I believe this product is an excellent resource to numerous women all around the world and should not be condemned. This product has its uncertainties and perhaps misleading results, but so do numerous other take home tests, such as pregnancy tests. I think as long as there is a warning of unreliable results and the consumer understands that this product provides solely a current overview of their remaining fertility which may change drastically based on numerous situations. I believe the fertility test should be used with extreme caution by women who are planning on using them to plan their family. This could lead to infertility at a much younger age than the test originally indicated. If a woman was indeed planning on using this as a method to plan for a family, the fertility test should be taken on a regular basis to assure that the fertility rate is declining at a consistent rate and to be able to change their plans accordingly if changes are more drastic than the original test may have indicated. In contrast, I believe the fertility test product is a much more useful tool for those considering in-vitro fertilization. This test could provide a reasonable idea of whether or not a women considering IVF has a high or low chance of fertility. This could help a great deal of women decide if they should undergo an expensive and dangerous procedure, based on their current fertility status. So in the end, I believe this fertility test is a great product when used appropriately and with the understanding that it is a test that the results should be taken lightly and not as a definitive measure of any future plans.
ReplyDelete-KEENAN