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Patients in the Press: Los Angeles Times
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Let's be honest. Many men have a rah-rah coach-player relationship with their sperm. They want lots of fast-moving ones (my boys can swim!) -- little first-round draft picks -- but spend most of their reproductive lives trying to stifle the tiny guys. (I'm not ready to be a dad!)

Women, in comparison, tend to be a little less boosterish about their eggs. This difference may account for why many men, already squeamish about depositing sperm in a public setting, tend to arrive at fertility clinics with one female foot in their back.

Now, enter Fertell, a new fertility testing kit that enables men and women to determine where they stand on the reproductive ladder of success without having to display all these conflicting emotions in a doctor's office.

Although home ovulation and pregnancy tests have been available for years -- and some home sperm tests are available -- this is the first kit to offer a "his-her" fertility test, essentially a tag-team approach to home testing. The concept of home testing is particularly attractive to men, who traditionally have been the stumbling block to administering fertility tests, says Dr. Richard Paulson, chief of reproductive endocrinology at USC's Keck School of Medicine.

Available for the last year and a half in Britain, the kit was introduced to the United States in late May by Genosis Inc. and appears to be a hit.

"We had expected sales to be 90% to women, but it's running almost 50% men," says Robert Thompson, president of Genosis. Although it's too early to determine sales figures, the $100 product is selling briskly at pharmacies and online, he reports.

Fertell comes with two tests: a motile sperm test for men and a hormone test for women.

The sperm test works this way: Semen is deposited into a collection container, sits for 30 minutes, then is forced through a chamber with a chemical solution that simulates cervical fluid. For the next 30 minutes, the test measures the number of sperm capable of swimming through the solution. Results appear as one or two red lines in a test result window on the chamber.

Typically at a medical lab, the sample would be put through many more tests. The semen would be analyzed for volume, pH and viscosity, all of which can affect fertility. It would also be placed on a slide, where the sperm would be counted and analyzed. Then the sperm would be stained and evaluated in terms of size and shape.

Fertell's female fertility test works like a home pregnancy urine stick. The test strip measures the level of follicle-stimulating hormone (FSH) present in first-morning urine on day three of the menstrual period. The hormone, when measured in serum, has been found to be a key measure of "ovarian reserve," or the ability of the ovary to produce viable eggs. Results are available in 30 minutes.

Fertell's FSH test is not the same as the test performed at a clinic, which typically would measure serum levels, rather than urine, Paulson says. Further, a clinic would measure FSH and estradiol.

"Both are reproductive hormones and you need to interpret them together to get an accurate picture," he says.

But the Fertell test is considerably cheaper than having the tests done in a medical office, where a semen analysis might run $150 and an FSH and estradiol test would be about $120. An initial consultation with a fertility specialist, excluding tests, could reasonably run about $300.

Fertility doctors have mixed feelings about the product.

"It's beneficial if someone has a problem, and the test picks up the problem early," says Dr. Philip Werthman, director of the Center for Male Reproductive Medicine in Century City. "I've seen so many couples who have been trying for years and just never came in to seek treatment."

The problem, he says, is that a normal result doesn't mean that everything's fine. In fact, couples with normal sperm counts and FSH levels could have problems conceiving for a variety of other reasons.

"I see patients who have a completely normal semen analysis," he says, "and they have tried for years, even gotten egg donors, thinking it's the woman's problem. And we look at the DNA damage to sperm and we find out that there's a high amount of fragmented DNA, and that's the reason these men don't conceive."

Paulson is particularly skeptical of the FSH test.

Unlike a home pregnancy or ovulation test, "on an FSH test, the difference between normal and abnormal values is so small that it can easily be missed," he says.

For example, he says, something as simple as drinking a lot of water two to three hours before the test could lower a woman's FSH reading to a level that would suggest that everything is fine, when in fact there's a fertility problem.

"We've been fighting an uphill battle," Paulson says, "of trying to make the public aware that there is a biological clock, and here comes a test that's going to reassure them that they can just chill at home instead of coming in."

Patients in the Press: Los Angeles Times

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