Evvy vs Fertilysis: Comparison for Vaginal Microbiome Results and Fertility Questions

If you're trying to conceive (TTC) or just curious about your reproductive health, you'll quickly find there's no single test that covers everything. Hormone panels, ovarian reserve testing, imaging, semen analysis, genetic screening, microbiome testing — each looks at a different piece of a complex picture, and the answers you get depend entirely on which piece you're examining.

Vaginal microbiome tests like Evvy and Fertilysis are one of those pieces. They won't tell you whether your tubes are clear or what your ovarian reserve looks like, but research does associate the health of the vaginal microbiome with pregnancy outcomes, including implantation success and response to treatments like in vitro fertilization (IVF) and intrauterine insemination (IUI).

Keep reading to learn more about what each test actually analyzes, how relevant each one is to fertility, what price and out-of-pocket cost typically look like, how shipping and turnaround compare, and what kind of support you get once results land in your inbox.

Choosing between Evvy and Fertilysis: What to consider

Vaginal microbiome analysis

Evvy

Evvy's Vaginal Microbiome Test uses metagenomic sequencing, an approach that reads all the DNA in your sample rather than checking for a fixed list of microbes. That means it can identify bacteria and fungi that narrower tests are built to miss entirely. It's a strong fit if you have ongoing symptoms (vaginal odor, unusual discharge, irritation, recurring infections), have been told your tests are "normal" despite still feeling off, or just want a clear, comprehensive baseline of what's actually living in your vaginal microbiome. And because Evvy’s metagenomic sequencing casts a wider net than targeted panel tests, it’s also better placed to pick up microbiome imbalances and bacteria linked to fertility disruption (including some that traditional testing misses out entirely).

What you can expect from the results:

• A breakdown of 700+ bacteria and fungi detected in your sample. 
• A Microbiome Diversity Score, since a lower-diversity, Lactobacillus-dominant microbiome is generally considered healthier. 
• Microbes flagged against the conditions research has linked them to (BV, yeast infections, fertility, and more). 
• Fertility Insights, a dedicated section of your results that highlights microbiome factors associated with fertility outcomes, including implantation success and IVF/IUI response.
• An option to add a PCR panel for STIs and antibiotic resistance.
• Clinician-reviewed results with a free 1:1 health coaching call, plus the option to access a personalized treatment plan if you're eligible.  

Fertilysis

Rather than a single comprehensive test, Fertilysis offers several separate panels, each focusing on a different aspect of reproductive tract health. Here's what the three core tests relevant to the vaginal microbiome actually cover:

• Vaginal Microbiome: Screens for a defined list of bacteria (including common STIs), fungi, and herpes viruses (HSV-1/2) via vaginal swab. Fertilysis notes that it focuses solely on the vaginal environment and recommends its broader panel for fertility-specific questions.
• Female Microbiome: Combines two vaginal swabs with a menstrual blood sample to assess both the vaginal and uterine microbiomes, screening for 27 pathogens plus an extended virus panel. 
• Inflammation Index: A separate, optional add-on (not included in either panel above) measures cytokine levels and immune markers associated with local inflammation that standard infection testing may miss. Fertilysis recommends pairing it with one of the microbiome panels for a more complete picture.

What you can typically expect from a Fertilysis panel:

• A report on the microorganisms, pathogens, or inflammatory markers included in the particular test.
• Treatment recommendations based on the findings. Fertilysis also offers separate paid clinical consultations for interpretation and, where clinically appropriate, treatment/prescription services.
• The option to add a paid consultation if you want direct interpretation from the Fertilysis team. 

Takeaway

For a comprehensive, unbiased picture of everything living in your vaginal microbiome, Evvy's Vaginal Microbiome Test gives you more breadth in a single swab. On the other hand, if you're interested in getting a complete picture of both the vaginal and endometrial microbiomes in one test, Fertilysis's Female Microbiome takes a broader approach. Each test offers unique insights tailored to different needs.

Fertility assessment

Evvy

Evvy's Fertility Insights look at microbiome features that research has associated with fertility outcomes, including your Microbiome Diversity Score and the relative abundance of five bacteria linked in studies to implantation and IVF/IUI success. While it’s not a fertility diagnosis, it provides useful context on how your vaginal microbiome may be impacting your chances of conceiving. 

When this still helps:

• You're TTC and want to rule out a microbiome-related factor before or alongside other testing.
• You're about to start IUI or IVF and want to optimize your vaginal microbiome going into treatment. 
• Your other fertility workup came back normal, and you want one more avenue to check. 

Fertilysis

Fertilysis is specifically focused on reproductive and fertility-related questions, including infertility and recurrent pregnancy loss. Its Female Microbiome test assesses both the vaginal and endometrial microbiomes in a single test, while the separate Inflammation Index provides additional information about local inflammatory and immune activity.

Where it tends to fit:

• You're already working with a fertility clinic for infertility or recurrent pregnancy loss and want microbiome information alongside conventional fertility testing.
• You want a single test that assesses both the vaginal and endometrial microbiomes.
• Your care team wants to investigate chronic endometritis or silent infections that conventional testing doesn't detect. 
• You want additional information about local inflammatory or immune activity, in which case Fertilysis offers the separate Inflammation Index.

Takeaway

For people seeking microbiome information as part of a fertility evaluation, Fertilysis's Female Microbiome test provides both vaginal and endometrial assessment in a single test. Evvy's Vaginal Microbiome Test takes a different approach, using a single vaginal swab and metagenomic sequencing to provide broad characterization of the vaginal microbiome, alongside Fertility Insights. 

Results and how actionable they are

Evvy

Test results are reviewed by a licensed healthcare provider and include a plan that connects what was found to your symptoms and outlines a concrete next step, whether that's a treatment option, a lifestyle adjustment, or a recommendation to retest after a set period. The goal is for you not to be left holding a report and guessing what it means.

Fertilysis

Results come by email and typically include treatment suggestions you're expected to bring to your own doctor or fertility specialist, since prescribing isn't built into the same flow. Retesting after treatment is encouraged, and a paid follow-up consultation is available if you want help interpreting results directly with the Fertilysis team.

Takeaway

Evvy's clinician-reviewed plan is built to answer "what do I do next?" on its own, while Fertilysis results generally need a separate conversation with a provider to become actionable.

Clinical support and follow-up

Evvy

Every test includes a free 1:1 call with a certified health coach to walk through your results, plus the option to connect with an Evvy-affiliated provider for prescription treatment if you're eligible. Retesting is built into the platform so you can track whether treatment worked.

Fertilysis

Support is available by email, and a paid consultation can be added if you want a deeper discussion of your results. The team can also liaise with your fertility specialist if requested, but the default path is to take your results to your own provider rather than receive treatment directly through Fertilysis in most cases.

Takeaway

Evvy has more built-in clinical support as standard. Fertilysis's support is available, but mostly opt-in and email-based (and often at an added cost).

Evvy vs Fertilysis: Which one should you choose?

The right choice depends on what you want to learn from microbiome testing, but for people primarily looking for broad vaginal microbiome insights, Evvy offers a simpler, lower-cost starting point. 

Evvy's Vaginal Microbiome Test uses a single vaginal swab and metagenomic sequencing to analyze 700+ bacteria and fungi, including those associated with fertility outcomes. Evvy also offers clinician-reviewed results, 1:1 coaching, and prescription treatment where eligible. The test is HSA/FSA-reimbursable in the US, and results are typically available within 7-10 business days.

Cost is another factor. Evvy’s Vaginal Microbiome Test is $159 for a one-time test ($129 per test with membership), while Fertilysis's Vaginal Microbiome Test costs ~$390. Fertilysis also offers its ~$780 Female Microbiome test, but that is a broader offering that combines vaginal and endometrial microbiome assessment and therefore isn't a direct like-for-like comparison with Evvy's vaginal-only test. The overall testing experience also differs. Evvy's test requires one vaginal swab, while Fertilysis's Female Microbiome requires menstrual blood plus two vaginal swabs. 

And since Fertilysis ships from Greece, the kit delivery and sample return journey adds meaningful time to the overall turnaround before you even factor in processing. Fertilysis also offers a FastTrack option for 5 working days from sample receipt, at an additional cost. 

Fertilysis's panels are built for a specific clinical context (unexplained infertility, chronic endometritis, recurrent pregnancy complications), but if you're already working with a fertility clinic at that stage, your care team will likely order those investigations directly. For most people wanting to understand their vaginal microbiome, get actionable results quickly, and have real support built in from the start, Evvy covers more ground with less friction.

Just remember that whichever you choose, vaginal microbiome testing is one piece of a bigger picture. Pair it with the hormone testing, imaging, and clinical guidance your provider recommends.

FAQs about Evvy and Fertilysis

Evvy vs Fertilysis: Which is the better at-home women's health test?

It depends on what you need. Evvy's metagenomic sequencing gives a broader, more comprehensive read on your vaginal microbiome — covering everything from recurring symptoms to dedicated Fertility Insights — making it the stronger all-round option for most people. Fertilysis is more narrowly focused on targeted infection detection in specific clinical scenarios, so it works best as part of a structured fertility investigation rather than as a standalone starting point.

Evvy vs Fertilysis: Which is better for fertility assessment and vaginal microbiome analysis?

For vaginal microbiome analysis, Evvy's metagenomic sequencing gives you a more comprehensive picture. It reads all the DNA in your sample rather than screening for a fixed list of targets, which means it can detect microbiome imbalances that more narrowly focused tests are built to miss. That broader detection matters for fertility too. Evvy's Fertility Insights flag the specific microbiome factors research has linked to implantation success and IVF/IUI response, all from a single swab. Fertilysis's panels are designed for a specific clinical context (unexplained infertility, recurrent pregnancy loss), but if you're at that stage, your fertility clinic will typically run those investigations directly. Neither test replaces hormone testing, imaging, or a clinician's diagnosis.

Evvy vs Fertilysis: Which test is better if I have recurring vaginal symptoms?

Evvy tends to be the better fit here. Its comprehensive detection, plus a provider-reviewed plan and retesting strategy, is designed to track recurring issues like BV or yeast infections over time, with support included rather than arranged separately.

Evvy vs Fertilysis: Which test is better if I'm already working with a fertility clinic?

If you're already working with a fertility clinic, both tests could potentially complement your workup. Evvy's Fertility Insights and comprehensive microbiome data are a useful addition to any clinical conversation, and Fertilysis's panels are designed to slot into that same context. That said, your clinic will often order similar investigations directly, so it's worth checking what's already included in your care plan before spending on either independently.