Does the First Response Fertility Test Work?

When the First Response FSH Fertility Test first came out in 2009, it created quite a stir. While some lauded the opportunity for women to take “their fertility into their own hands,” others questioned whether this at-home test gave the user anything of value. Others even wondered if the test could cause more harm than good.

The First Response product has been discontinued as of the spring of 2015. But they weren’t the only source for at-home FSH tests.

There are other tests available for purchase online.

Some of these tests claim to tell you if you’ve reached menopause, while others say they test your ovarian reserves or fertility potential.

Should you try one?

Short answer... no. Don’t waste your money. Here’s why.

How the Tests Work

They work in a similar way as at-home pregnancy tests. Sort of. While an at-home pregnancy test detects whether you have a certain amount of the pregnancy hormone hCG in your urine, these tests look for the hormone FSH.

FSH is always present in your body. The amount of FSH varies throughout the month and throughout your life. 

FSH level tests are always done on day three of your menstrual cycle.

FSH is the follicle-stimulating hormone. It signals the ovaries to develop immature eggs (called oocytes) into mature ones.

If the ovaries are not responding as expected, your body will boost its production of FSH. If your levels on day three of your menstrual cycle are abnormally high, this may indicate a problem with your fertility or your ovarian reserves in particular.

When you take an at-home FSH or menopause test, it will turn up as “positive” if you have a high level of FSH in your urine. (To be clear: positive is bad in this case.)

How much FSH will give you a positive result? It depends on the test.

Some tests being sold online state they will show up as positive if you have 25 mIU/mL or more of FSH detected.

Other tests, including the First Response Fertility test, don’t share how much FSH is required to get a positive result.

Can These Tests Really Indicate Menopause?

Here’s the kicker. These tests say they can tell you if you’ve reached menopause or if your ovarian reserves are low.

But they can do neither.

As far as menopause is concerned, there’s no one test that can say if you’ve reached it or not. Menopause is defined primarily by what’s happening with your menstrual cycles.

If you’ve gone 12 months without a menstrual cycle, and you are in your 40s, 50s, or 60s, you have likely reached menopause. It’s smart to see your doctor to be sure. But there’s no blood test to determine menopause or perimenopause.

A woman can have many symptoms of perimenopause and have normal FSH levels. Or, a woman can have abnormally high FSH levels and not have any menopausal symptoms.

Also, considering that menopause is determined by the number of months you’ve gone without having a menstrual cycle and the FSH tests must be taken on Day 3 of a cycle, it’s hard to imagine when you’re supposed to take the test if you haven’t cycled in months.

These tests are worthless for this purpose.

Testing Fertility Potential or Ovarian Reserves

What about testing your fertility? Or ovarian reserves?

Ovarian reserves refer to the quantity and quality of the eggs possibly contained in the ovaries. Your ovarian reserves naturally diminish with age, as you approach menopause. But they can also be low earlier than normal.

For example, ovarian reserves can decrease earlier than normal in women with Primary Ovarian Insufficiency (also known as Premature Ovarian Failure).

The instructional insert inside one FSH test reads, “This test assesses ovarian reserve only; it does not detect all kinds of fertility issues.”

Except it can’t really even do that.

FSH is not considered to be the best measure of ovarian reserves.

Testing AMH levels (another hormone) and having an antral follicle count that requires an ultrasound of the ovaries are considered more accurate measures of ovarian reserves.

Plus, what is considered normal FSH levels by these tests may be different from your doctor’s.

For example, most doctors consider an FSH level over 10 mIU/mL to be a sign of possibly low ovarian reserves. But most of these at-home tests look for levels much higher than that.

From an anecdotal perspective, online reviews of these FSH tests include stories of women who got a negative result on an at-home FSH test, but their doctors said their FSH levels were higher than recommended (based on blood work).

What Else the FSH Tests Can’t Tell You

If you’re relying on this test to tell you whether you have a fertility problem, you’re in for some disappointment.

These tests can tell you one thing and one thing only: if your FSH is very high.

But low ovarian reserves is just ONE possible cause of infertility. These FSH tests can’t tell you if you have:

• PCOS
• Endometriosis
• Blocked fallopian tubes
• Male infertility
• Unexplained infertility
• A number of other causes of infertility

If you took one of these at-home tests and got a negative result, but you’ve been trying to get pregnant for six months or longer (if you’re over 35), or have been trying for over a year, you should see your doctor.

If you received a positive result on one of these tests, you should see your doctor.

Bottom line: taking the test won’t even save you a trip to the OB/GYN. So why bother?