The Fertility Scam Files: How TikTok Wellness Queens Are Selling Fake Medical Tests to Gen Z

Introduction

TikTok has become an unlikely fertility clinic. Between 15- to 60-second videos, charismatic wellness creators—often styled as friendly peers or “wellness queens”—package complex reproductive health topics into digestible, emotionally charged clips. For Gen Z, who regularly turn to social platforms for health answers, those clips can influence decisions ranging from whether to try hormonal birth control to whether to pay for an at-home fertility test. What started as accessible health content has, in many corners, shifted into a market: direct-to-consumer tests, one-click subscriptions, and an ecosystem of supplements and clinics all promoted under the banner of empowerment.

This exposé pulls back the curtain on how fertility anxiety is being monetized on TikTok and Instagram. Two recent, high-quality investigations reveal the scale and structure of the problem. A JAMA Network Open analysis of nearly 1,000 Instagram and TikTok posts about controversial screening tests—including fertility assessments—found that 84% of posts appeared to be promotional rather than evidence-based. Even more striking, 87% of those posts mentioned benefits while neglecting to discuss risks or limitations; collectively the creators involved had nearly 200 million followers. Lead researcher Brooke Nickel described the body of content as “overwhelmingly misleading.” Complementing those findings, research presented at the 2025 ACOG (American College of Obstetricians and Gynecologists) meeting examined the top 100 TikTok videos tagged for hormonal birth control. The results: more than half of educational videos contained misleading or non–evidence-based claims, and only about 25% cited reliable sources. Those studies used validated evaluation tools such as PEMAT and DISCERN to assess understandability, actionability, and quality—standard instruments in health communication research.

This is not merely an academic problem. When young people internalize oversimplified, commercially framed medical advice, the fallout includes unnecessary anxiety, wasteful spending, delays in seeking medical care, and potentially harmful self-guided choices. In the sections that follow I map how these “wellness” narratives are constructed, who profits, how platforms amplify them, and what clinicians, researchers, regulators, and everyday users can do to push back.

Understanding the Fertility-Testing Ecosystem on Social Media

The fertility-testing ecosystem on platforms like TikTok rests on three pillars: emotional storytelling, simplified biomedical claims, and monetization. Each pillar plays to platform strengths—virality, snackable narratives, and seamless commerce—and each contributes to misinformation.

Emotional storytelling: Short-form video prioritizes narrative hooks. Creators tell first-person stories—“I did an AMH test, and now I’m panicking”—that foreground emotion over nuance. Personal testimony feels relatable and authoritative; a peer’s anecdote often beats a dense clinical guideline when viewers are scrolling late at night and worried about their reproductive future.

Simplified biomedical claims: Complex biomarkers such as Anti-Müllerian Hormone (AMH) are translated into clean, actionable-sounding messages: “AMH tells you how many eggs you have” or “low AMH = infertility.” In reality, AMH is a limited marker: it estimates ovarian reserve, not pregnancy chances at a given age, and it must be interpreted in context (age, menstrual history, other labs). Many posts omit these subtleties and omit citations to clinical recommendations. The JAMA Network Open study found that 84% of posts promoted tests rather than neutrally explaining them, and 87% touted benefits without referencing risks or limitations. That gap between claim and context is fertile ground for misleading narratives.

Monetization: Hidden or explicit monetization links posts to direct-to-consumer tests, telehealth appointments, or supplement lines. The same JAMA analysis pointed to substantial financial conflicts of interest: content promoted commercial testing services with minimal scientific backing. Influencers make money through affiliate codes, branded partnerships, and ads; they present testing as empowerment while extracting revenue from fear. The study noted these creators’ enormous reach—nearly 200 million collective followers—amplifying both influence and profit.

The ACOG presentation on TikTok and hormonal contraception reveals another vector: anti-medical messaging. Of the top 100 videos analyzed, 50 were patient narratives and 43 focused on individual cases rather than evidence. Among educational content, only 25% cited reliable sources, and 46 videos encouraged viewers to avoid hormonal birth control. This shows that the problem is not isolated to fertility testing; it’s part of a broader trend of reproductive health content that foregrounds individual experience and skepticism of medical advice.

Mechanisms of spread: algorithms and engagement economy. Short, emotionally charged content sustains watch time, replays, and share rates—metrics platforms promote. When a video frames a single test as a “must-do,” its engagement signals make it visible to tens or hundreds of thousands of users, who then share it within networks of peers. "Wellness queens" leverage platform features: duets, stitches, and comments to amplify reach, and integrate shopping links to convert trust into transactions.

Key Components and Analysis

To unpack how these dynamics play out concretely, let’s examine key components: the AMH test as a focal point, the creator economy’s incentives, platform affordances, and the quality metrics used in recent studies.

AMH tests: promise and limits - What AMH measures: Anti-Müllerian Hormone is produced by ovarian follicles and gives a snapshot of ovarian reserve. It’s useful in fertility clinics, particularly for ovarian stimulation planning. But AMH is not a fertility guarantee. It doesn’t reliably predict natural conception potential, nor does it give a precise timeline for reproductive decline. - How it's sold on social media: Creators simplify AMH into a binary good/bad result. “Low AMH = you must freeze eggs” is a common narrative. The JAMA paper included fertility assessments among the controversial tests studied, and the high promotional rate (84%) indicates that AMH is frequently offered as a product rather than a nuanced medical concept. - Why that matters: Misinterpretation can lead to costly, unnecessary procedures, emotional distress, and increased demand for fertility services without clear clinical indications.

Creator incentives and conflicts of interest - Monetization channels: affiliate links, sponsored posts, private clinics, telehealth sign-ups, supplements sold with the promise of “boosting ovarian reserve.” - Visibility vs. accuracy: Higher engagement often correlates with emotional, striking claims. Accurate, nuanced explanations are less likely to go viral, creating an incentive to oversimplify or sensationalize. - The studies’ findings: The JAMA Network Open team found most posts advanced a promotional angle without discussing limitations; the ACOG research found that educational posts rarely linked to credible sources. Both outcomes point to incentive misalignment between public health and platform commerce.

Platform affordances and algorithmic amplification - Short-form virality favors sensational claims. - Features like “shop” and integrated links allow instant conversion from viewing to purchase. - Moderation gaps: medical claims are harder to police than patent falsehoods because they involve nuance and clinical uncertainty. Posts framed as “personal stories” often escape fact-checking.

Quality assessment tools: PEMAT and DISCERN - PEMAT measures understandability and actionability of patient education materials. - DISCERN evaluates reliability of consumer health information. - The ACOG study used these validated tools to benchmark TikTok content quality, underscoring that much of what passes for “education” fails standard criteria for trustworthy consumer health communication.

Collective reach and systemic risk - Nearly 200 million followers linked to the creators in the JAMA analysis means a substantial population is receiving and acting on oversimplified or promotional messages. - This scale converts individual misinformation episodes into public health concerns, especially when the messaging discourages evidence-based interventions or encourages expensive, unnecessary testing.

Practical Applications

For a Digital Behavior audience—researchers, platform designers, public health communicators, and clinicians—understanding how these dynamics operate suggests interventions at multiple levels. Below are practical, evidence-informed steps each stakeholder can take.

For researchers and academics - Use standardized evaluation tools: continue applying PEMAT, DISCERN, and similar validated instruments when assessing social content. These tools were successfully used in the ACOG study and provide replicable metrics. - Conduct longitudinal monitoring: the platform environment changes rapidly; set up regular scans of trending fertility-related hashtags (e.g., #AMH, #fertilitytest, #fertilitytok) to detect surges in promotional content. - Build datasets for platform collaboration: compile annotated datasets that platforms can use to refine moderation models for medical misinformation.

For platform designers and product teams - Introduce friction before purchase: require a brief educational module when users click from a health-related post to a commerce link (e.g., “AMH tests have limitations; consult your clinician”). - Signal source quality: implement badges or indicators for content that cites peer-reviewed evidence or clinician organizations. - Audit algorithmic incentives: test whether engagement-weighted ranking amplifies posts that make extreme claims and consider adjustments for medical topics.

For clinicians and public health communicators - Meet patients where they are: incorporate common social narratives into intake conversations (“Have you seen posts about AMH?”) and use those hooks to provide evidence-based context. - Create shareable, short-format content: produce 30–60 second videos that convey nuance in plain language and cite sources; use storytelling techniques to compete with anecdotal posts. - Offer rapid triage resources: develop clear decision trees for when testing is appropriate and publish them in clinician-friendly formats that can be linked from social content.

For individual users (Gen Z and parents) - Pause before purchase: treat social posts as prompts to consult a clinician, not as diagnostic tools. - Verify with credible sources: look for citations to clinical guidelines (ACOG, ESHRE, ASRM) or peer-reviewed studies. - Consider the cost-benefit: ask whether a test will change clinical management. AMH often informs IVF protocols but rarely changes first-line fertility recommendations for healthy, regularly menstruating young women.

Actionable takeaways (quick list) - If a post promotes an AMH or fertility test as a definitive predictor, view it skeptically—AMH is not a fertility guarantee. - Check for conflicts of interest: does the creator include shopping links, promo codes, or clinic referrals? - Prefer sources that cite clinical guidelines or peer-reviewed studies; look for PEMAT/DISCERN–style signals of quality. - Clinicians: proactively ask patients about what they’ve seen on social platforms and correct misconceptions empathetically.

Challenges and Solutions

Tackling fertility misinformation on TikTok involves technical, social, and regulatory obstacles. Below, I outline the main challenges and recommend layered solutions.

Challenge 1 — Nuance versus virality - Problem: Evidence-based health communication is complex and nuanced; algorithmically favored content rewards simplicity and emotionality. - Solution: Translate nuance into narrative. Train clinicians and health communicators in short-form storytelling techniques. Platforms can prioritize content quality signals (citations, clinician involvement) alongside engagement.

Challenge 2 — Hidden monetization and disclosure - Problem: Creator endorsements and affiliate links often blur lines between personal advice and advertisement. - Solution: Enforce clear disclosure policies and make monetization transparent in post metadata. Platforms should require standardized labels (e.g., “Sponsored: Direct-to-Consumer Test”) and surface them prominently.

Challenge 3 — Regulatory gray zones - Problem: Direct-to-consumer testing companies operate in a patchwork of regulatory oversight; social posts often skirt explicit medical claims by framing content as storytelling. - Solution: Regulators should update guidance to cover influencer marketing of medical tests—requiring documentation and evidence for clinical claims used in marketing—and coordinate takedowns of demonstrably false claims.

Challenge 4 — Health literacy and trust - Problem: Users may lack the literacy to evaluate biomarkers like AMH; at the same time, distrust of medical institutions fuels turn to peer-voices. - Solution: Invest in community-based health education that partners with trusted creators; leverage those same influencers to disseminate accurate, engaging content in partnership with reputable health bodies.

Challenge 5 — Platform moderation capacity - Problem: Human moderation is expensive and scales poorly; automated systems struggle with nuanced medical claims. - Solution: Develop hybrid approaches: automated triage to flag potentially misleading medical posts and prioritized human review with clinician consultants. Incentivize platforms to allocate moderation resources to medical topics.

Challenge 6 — Research pace vs. platform speed - Problem: Academic publishing timelines lag behind viral trends, creating evidence gaps. - Solution: Create rapid-response research coalitions that publish preprints and policy briefs; use living reviews to update guidance as trends evolve.

Collectively, these solutions require cross-sector collaboration. Platforms alone cannot solve the problem; health institutions, regulators, researchers, and creators must coordinate to rebuild trust and improve the signal-to-noise ratio for reproductive health information.

Future Outlook

Where does this trend go from here? Several trajectories seem likely, influenced by platform evolution, regulatory action, and technological shifts.

Trajectory 1 — Deeper entrenchment with algorithmic amplification If platforms continue prioritizing engagement without health-specific checks, promotional fertility content may become more sophisticated and targeted. Creators will refine messages to optimize conversion: custom-tailored videos, micro-targeted ads based on menstrual-cycle data, and bundled product offerings (test + supplement + telehealth consultation).

Trajectory 2 — Platform intervention and quality signals Pressure from regulators, advertisers, and health organizations could push platforms to implement quality labels for medical content and require disclosure metadata. We may see algorithmic demotion of posts lacking clinical citations and the introduction of quick-fact overlays on health videos.

Trajectory 3 — Regulatory catch-up and legal scrutiny If consumer harm becomes documented—financial loss, delayed care, or unnecessary procedures—regulators may tighten oversight of direct-to-consumer medical test marketing. Requiring evidence for advertised claims and enforcing penalties for misleading influencer marketing would change commercial incentives.

Trajectory 4 — Creator partnerships with clinicians A healthier outcome involves creators partnering with clinicians and health bodies to produce engaging, evidence-aligned content. This hybrid model leverages creators' reach while improving accuracy, and could be incentivized via grants or sponsored public health campaigns.

Trajectory 5 — Technological escalation and AI-driven misinformation AI will complicate the landscape. Synthetic voices, deepfake influencers, or AI-generated “expert” testimonials could amplify deceptive marketing. Conversely, AI could help by flagging misinformation, summarizing clinical guidance into short-form scripts, or personalizing educational content responsibly.

What to watch in the next 12–24 months - Policy signals from regulators (FTC, FDA equivalents outside the U.S.) about influencer marketing of medical tests. - Platform pilot programs that apply health content badges or require source citations. - Research tracking harms: studies documenting economic, psychological, or clinical consequences of following social-media-driven testing recommendations. - The evolution of AMH discourse: whether clinical societies issue more explicit guidance for consumer-facing communications about ovarian reserve testing.

Conclusion

The fertility “wellness economy” on TikTok is not inherently malicious; many creators share sincere experiences and aim to empower. The problem arises when commercial motives, algorithmic attention incentives, and biomedical complexity intersect. Recent investigations—most notably the JAMA Network Open review and the ACOG presentation—paint a worrying picture: the majority of fertility-related social posts are promotional, often omit risk discussion, and routinely fail to cite reliable sources. The collective reach of implicated creators—nearly 200 million followers in one study—elevates this from an online nuisance to a public health concern.

Addressing the crisis requires a multi-pronged approach: better platform design that discourages transactional health claims without context; more agile research that tracks trends and quantifies harm; stricter disclosure and regulatory scrutiny of DTC test marketing; and an expanded public-health toolkit for communicating nuance in 30–60 second formats. For clinicians, the immediate step is pragmatic: ask patients about their social media exposures, correct misconceptions with empathy, and provide clear criteria for when tests like AMH are appropriate.

For Gen Z users reading this: technology gives you unprecedented access to health information, but power without discernment can lead to expensive, stressful dead ends. Before buying a test or shifting care, pause, verify sources, and ask a clinician if the result would change your care. The fertility scam files aren’t a moral panic—they’re a warning. With better design, better science communication, and a little skeptical pause, the promise of accessible health content can still be realized without turning young people’s reproductive futures into commerce.