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February 9, 2012

Spitting: A Bad Habit. The Role of Saliva vs. Serum (Blood) Test for Hormone Evaluation

Patients undergoing infertility treatment are faced with numerous appointments, various testing, “needle-pricks” by phlebotomists, and injections of fertility medications.  Quality centers search for ways to minimize the stress and inconvenience that infertility treatment can impose on patients and search for ways to make treatment more “patient-friendly“ without compromising  pregnancy success rates.  We believe that making infertility treatment convenient and stress free are important considerations and that is why our team focuses on care and convenience everyday.

One possible way to reduce the inconvenience of treatment is to minimize daily blood sampling to monitor hormone levels.  There are many ways to evaluate hormone levels including measuring in saliva, serum (blood), and even urine.  The gold standard for testing hormones is by obtaining a serum sample via blood draws.   Although testing for hormone levels in both urine and saliva is possible, they are certainly not new technologies.  In fact, the first study evaluating the use of saliva to monitor hormone levels in an IVF cycle was published in 1985.  Even though this study was published over 25 years ago, using saliva to monitor hormone levels during infertility treatment never became “standard” because serum (blood) testing is the most accurate and reliable method for assessing hormones.   In fact, the accuracy and validity of saliva hormone testing has even been questioned by health insurance plans. (Click here for detailed information.)

At the Fertility Centers of New England, we understand that the elimination of blood draws is attractive for patients.  However, there is no evidence to support the use of saliva hormone testing as a reliable method for monitoring response to infertility treatment.  Importantly, there are no data to support improved pregnancy rates when substituting serum testing with saliva testing for hormone levels.  The team at the Fertility Centers of New England is focused on minimizing the number of blood draws required during infertility treatment, which also minimizes the number of days a patient needs to visit our center during treatment. Typically, patients are required to have their blood drawn 3-4 times during an actual IVF treatment cycle.  While we continually look for ways to minimize stress and improve the patient experience during infertility treatment, our number one priority is to maximize your chances to achieve  a successful pregnancy.

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Brian E. Miller, Ph.D.