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 a vaginal swab 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 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.

The critical thing to understand is that these tests are sold separately. If you want the kind of coverage that Fertilysis recommends for a thorough fertility investigation, you're looking at ordering multiple panels. By contrast, Evvy's single-swab test includes microbiome data across 700+ bacteria and fungi, plus Fertility Insights, all in one test at a single price point.

What you can typically expect from a Fertilysis panel:

• A targeted report on the specific pathogens or inflammatory markers that the panel is designed to detect. 
• Treatment suggestions (antibiotics, antivirals, antifungals, probiotics) are meant to be reviewed with your own doctor or fertility specialist. 
• 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 — without ordering multiple separate tests — Evvy's Vaginal Microbiome Test gives you more breadth in a single swab.

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's entire brand is built around answering fertility questions that standard testing hasn't resolved, specifically unexplained infertility and recurrent miscarriage. Their Female Microbiome panel is their primary recommendation for this, with the Inflammation Index layered on for anyone who needs a closer look at local immune activity. The suite is genuinely designed for people who are already mid-workup and suspect they are missing something.

Where it tends to fit:

• You're already working with a fertility clinic and have had standard testing come back without answers. 
• You've experienced recurrent pregnancy loss or repeated implantation failure and want microbiome data covering both the vaginal and uterine environments. 
• Your care team wants to investigate chronic endometritis or silent infections that conventional testing doesn't detect. 
• You're willing to order multiple separate tests to build a more complete reproductive picture. 

Takeaway

For people already in a structured fertility workup who want microbiome data that includes the uterine environment, Fertilysis is built closer to that use case. For general microbiome insight that you can bring into a broader fertility conversation, an Evvy Vaginal Microbiome Test covers more ground on the vaginal side.

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?

For most people, Evvy is the easier, more affordable, and more convenient choice. One swab covers 700+ bacteria and fungi, includes Fertility Insights, comes with a clinician-reviewed plan, and gives you access to 1:1 coaching and prescription treatment (if eligible), all in one place. The test is HSA/FSA-reimbursable, ships within the US, and results are typically available within 7-10 business days.

To get comparable coverage with Fertilysis, you'd likely need to order two or three separate tests, each at its own cost, which would add up to well over $1,000 before any consultation fees. 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'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.