Just like in the gut, there is an ecosystem of microbes in the vagina. Called vaginal microbiome, the health of these microbes has been associated with systemic – and reproductive – health in recent years.
Imbalance of vaginal microbiome is extremely common; one in three women experience bacterial vaginosis (bacterial infections) each year, for instance. Given the reproductive health implications of suboptimal vaginal microbiome, understanding yours and taking proactive steps to support its health can be an under-appreciated key to your journey.
This is an emerging field, but there are now several innovative companies that offer vaginal microbiome tests – some done at home, others exclusively through doctors’ offices. After thorough evaluation, Ovaterra’s scientific team recommends the Evvy Vaginal Microbiome Test for women who are trying to conceive.
Why our scientific team thinks Evvy can make a difference on your journey
- What Evvy does: Evvy is an at-home test to get a full picture of your vaginal microbiome, which studies have shown to impact not just vaginal health, but also reproductive health and pregnancy outcomes. With easy-to-understand results and access to their vaginal health experts, Evvy helps you take proactive steps to support your reproductive health via healthy vaginal microbiome.
- Who Evvy is for: Many things in life – like sex, stress and medications – influence the composition of your vaginal microbiome. Everyone, including women on the TTC journey, benefits from having a full baseline. For women who haven’t been able to figure out why they aren’t getting pregnant, Evvy can provide additional clues to act on.
- What differentiates Evvy from others: Evvy uses a specific next-gen sequencing technology to detect all bacteria and fungi, while most other at-home tests focus on finding a select few. With Evvy, you also have access to Evvy’s trained health coaches who will help you interpret your results and draw up an action plan.
- Science behind Evvy: Evvy is built on over 600 peer-reviewed studies on vaginal microbiome and female health. The metagenomic sequencing that Evvy uses is the current cutting-edge technology for identifying a vast array of species through DNA.
- Experience of using Evvy: Evvy is intuitive to use. It takes just 5 minutes to take a vaginal swab to send into their CLIA-certified laboratory for analysis. Users also rave about the empathic, informative support from Evvy’s experts, the simple user experience and the brand.
Our evaluation process: An evaluation you can trust
The fertility journey is hard enough. What feels like an overwhelming amount of generic, frequently conflicting information out there doesn’t help. This is why we evaluate products and services for the journey so you can make an informed decision easily and efficiently.
- Everything we feature has been evaluated for scientific evidence and personally tested for user experience and impact.
- Combined, our scientific team is responsible for the births of over 30,000 babies, with 960+ peer-reviewed studies cited in the scientific literature, over decades of clinical work and research.
- We know the journey, both from the research perspective and on the personal level.
- We pay for all products and services that we evaluate.
- Where relevant, we test them at independent laboratories for verification.
The science behind Evvy
Science on vaginal microbiome and reproductive health
A healthy mix of bacteria in the vagina plays an important role in protecting the health of genital tract. A group of bacteria called lactobacilli is particularly important: They secrete lactic acid, which keeps the vaginal pH low to protect against pathogens. Protective bacteria even secrete antibiotics (called bacteriocins), which makes it even harder for disruptive microbes to settle in. A healthy proportion of lactobacilli also helps keep inflammation down.
More recent research has started to shed light on the more systemic health effects of vaginal microbiome. The health of vaginal microbiome has been associated with multiple aspects of reproductive and prenatal health:
- Keeping pelvic inflammatory disease at bay, which has been found to negatively affect pregnancy chances.
- Contributing to the normal processes of conception, either naturally or with fertility treatments like IVF.
- Potentially protecting pregnancies from complications, such as miscarriages, preeclampsia and preterm labor.
“With Evvy, we are closing the gender health gap,” say Priyanka Jain, Co-founder of Evvy. To that end, Evvy plans to share anonymized data of its users with scientists to further understanding of the link between vaginal microbiome and many aspects of female health.
Science on the testing technique
Evvy uses a specific type of next-generation sequencing technology, called metagenomic sequencing, to identify all microbes in vaginal swab samples.
Other sequencing tests under the “next-gen” umbrella, like 16S or 18S, can only look for a limited number of genetic variables, because these methods require specific primers and probes for the target species. In metagenomic sequencing, “libraries” of DNA and RNA sequences are built from a single sample, which are analyzed bioinformatically. This way, Evvy can identify all of the species present in the vaginal microbiome, as well as the proportion of each, giving you insight that other testing methods cannot provide.
Vaginal swab samples are analyzed at a CLIA-certified laboratory in the US. CLIA stands for Clinical Laboratory Improvement Amendments. A division within the Centers for Medicare and Medicaid Services (CMS) implements the CLIA program to ensure accuracy and validity of your test results.
What it’s really like to use Evvy
Receiving the Evvy test kit & taking a vaginal swab
The test kit arrived quickly at our tester’s home, in a beautiful package. The instructions were clearly outlined, and the vaginal swab was super-easy to do. The entire process took less than 5 minutes to download the app, activate the test kit and take the sample. Then, just drop the sample back in the prepaid envelope and put it in the mail.
Deciphering the Evvy test results and taking action
The results arrived in about 2 weeks. Like all at-home, non-diagnostic tests intended for wellness, Evvy is limited in the recommendations they can provide, as Evvy is a wellness test, rather than a diagnostic test and cannot personalize results. Our tester received a breakdown of each of the types of vaginal bacteria and what the research says about each one. Her personalized plan was more general recommendations based on the scientific literature (which it has to be, per regulatory rules). While not completely specific to her, our tester thought that they still provided some things to think about on her own journey, moving forward.
The profile you create on Evvy’s website is easy to navigate, understand and dig deeper. Our tester loved that each of the recommendations is referenced extensively in research. Even better, Evvy’s scientific team ranks the information as novel, emerging or established, based on how much scientific evidence already exists. The digital platform is set up to show long-term trends, although our tester has taken just one test for now.
Evvy for reproductive health
In the intake questionnaire, our tester mentioned she was trying to get pregnant. Evvy offered her access to an expert. She hasn’t had a chance to meet with the experts yet, but Evvy’s experts are trained health coaches who can work with you on a more personalized plans, based on your goals. Users attest to the accessible, personalized and empathic support Evvy’s vaginal health experts provide to each user.
What it’s like to use Evvy
Our tester thought Evvy fit into her everyday life without much friction. As her vaginal microbiome was healthy, she thinks it’ll be something she’d do once or twice a year after any major health or life changes like a pregnancy. “It’s definitely something to do regularly if struggling with any reproductive issues,” she says, “since studies have shown a connection between the health of vaginal microbiome and fertility.”
Pros of Evvy
- A full picture of your vaginal microbiome: Evvy’s metagenomic testing can detect all bacteria and fungi, as well as measure the proportional composition of your microbiome. Most other at-home vaginal health test can detect a select few. PCR tests, which many doctors’ offices use, can only tell you whether a specific species exists or not.
- Reliable results from CLIA-certified lab: Your vaginal swab is analyzed at a CLIA-certified lab in the US. CLIA is the gold standard for clinical testing labs, ensuring accuracy and validity of the results.
- Guided, data-driven action on reproductive health: With Evvy, you don’t just receive the test results. Your report indicates what the composition of your vaginal microbiome mean, and includes recommendations to keep it healthy. You also get access to their trained health coach for further guidance.
Drawbacks – but not dealbreakers – of Evvy
- Not a medical device: Evvy cannot diagnose you with a condition, or provide medical advice. This limits the level of personalization Evvy can offer you, based on the test results. However, this is a drawback of all wellness tests that you can order without seeing a healthcare provider – and you can always bring the Evvy results to your doctor to discuss your next steps.
- Turnaround: It can take 2-3 weeks to receive your Evvy results, because the in-lab testing method is intensive.
- Cost: Evvy is not the cheapest vaginal microbe test out there. However, most of the similar-sounding tests on the market detect only a few, most common species, need a doctor’s order or don’t offer reproductive health insights. Further, if you haven’t been able to figure out the causes of your struggles, Evvy can provide additional clues. It can be far more cost-effective than trying fertility medications and treatments without addressing your vaginal microbiome.
Other vaginal microbiome tests
- Juno: Juno uses another next-gen sequencing technology, called 16S. With 16S, Juno can only detect a limited number of bacteria and fungi, although it also comes with a vaginal pH test to help detect disruptions in the vaginal microbiome.
- Vaginal EcologiX: This UK-based test uses quantitative PCR to detect a relatively large number of bacteria and fungi, but doesn’t detect all. It’s only available through healthcare providers.
- Stix Yeast Infection Test & Treat Combo: Stix only tests for vaginal pH as a way to detect yeast infections, as the name suggests. It comes with treatment, which is a nice touch, but Stix is not able to spur reproductive health action.
- V-Box: This one only tests for a few most common causes of abnormal vaginal discharge. Like Stix, V-Box is not able to spur reproductive health action.
Evvy test for reproductive health
Reach out if you have any questions for our scientific team on the connection between vaginal microbiome and reproductive health, if Evvy is the right choice for your journey, and more. We are with you.
