Evvy’s core product, the Vaginal Health Test, screens for over 700 species of bacteria and fungi living in your vaginal microbiome. Unlike standard lab tests that check for a handful of known pathogens, Evvy uses a sequencing technology called shotgun metagenomics to read all the microbial DNA in your sample at once, giving you a full picture of what’s present and in what proportions. The standard test does not screen for STIs, though an add-on panel covers those separately.
What the Standard Vaginal Health Test Covers
The core Evvy test identifies all detectable bacteria and fungi in a vaginal swab sample. That includes protective species like various Lactobacillus strains, disruptive bacteria associated with bacterial vaginosis (such as Gardnerella, Prevotella, and Fannyhessea), yeast species beyond the common Candida albicans, and organisms like Ureaplasma and Mycoplasma hominis that standard tests often miss entirely.
Rather than giving you a simple positive or negative result, the test generates a relative abundance profile. This tells you what percentage of your microbiome each organism makes up. For example, you might see that a beneficial Lactobacillus species accounts for 85% of your microbiome while a BV-associated bacterium sits at 3%. The report also includes a diversity score, which measures how many different species are present and how evenly they’re distributed. In the vaginal microbiome, lower diversity (dominated by protective Lactobacillus) is generally considered healthier, which is the opposite of the gut.
How It Differs From Standard Testing
Most vaginal infections are diagnosed with either a culture or a PCR panel. Cultures grow organisms in a lab dish, which works well for common bacteria but misses species that are difficult to grow. PCR tests are highly sensitive but only detect the specific organisms they’re designed to find. No currently available PCR panel detects all anaerobic bacteria or all Candida species, for instance. If something outside the panel is causing your symptoms, the test comes back negative even though the problem is real.
Shotgun metagenomics takes a different approach. It sequences all the DNA in a sample without targeting specific organisms, so it can pick up bacteria and fungi that wouldn’t show on a standard panel. It also provides strain-level detail, distinguishing between closely related species that behave differently in the body. The trade-off is sensitivity: PCR has a lower limit of detection, meaning it can catch very small amounts of an organism that metagenomic sequencing might miss. Evvy’s test has a measured sensitivity of 93.1% and specificity of 90%, validated across 162 reference strains in a certified lab.
The Expanded PCR Panel Add-On
For an additional cost, Evvy offers an Expanded PCR Panel that uses traditional PCR technology to test for organisms and markers the metagenomics test doesn’t cover. This add-on includes:
- Four STIs: chlamydia, gonorrhea, trichomoniasis, and Mycoplasma genitalium. Mycoplasma genitalium is only available through this panel because it’s classified as a reportable STI.
- Ten antibiotic resistance markers: these tell you whether certain organisms in your sample carry genes that make them resistant to common antibiotic classes, including macrolides, tetracyclines, and quinolones. This information can help a provider choose a more effective treatment if you need one.
- Eleven common microbes: species like Candida albicans, Gardnerella vaginalis, Lactobacillus crispatus, Group B Streptococcus, and Ureaplasma. These overlap with the metagenomics test but come back faster, typically within one to three days compared to the longer turnaround for full sequencing results.
What You Get in the Report
Your results break down into a few key areas. You’ll see every organism detected above a 0.75% relative abundance threshold, grouped by whether they’re generally protective, disruptive, or neutral. The report shows species-level detail for clinically important groups, particularly Lactobacillus and Gardnerella, since different species within these groups have different effects on vaginal health. A Shannon diversity index score gives you a single number representing the overall diversity of your microbiome.
Evvy pairs these results with context about what the organisms do and how they interact. If your sample shows a high proportion of anaerobic bacteria and low Lactobacillus, for example, the report flags this as a pattern consistent with bacterial vaginosis. Results can also be shared with a healthcare provider through the platform.
Lab Certification and Accuracy
The test is processed in a lab certified by three major bodies: CLIA (Clinical Laboratory Improvement Amendments), CAP (College of American Pathologists), and CLEP (Clinical Laboratory Evaluation Program). In validation testing, the lab confirmed accurate identification for 95 out of 102 true positive reference strains, with a positive predictive value of 89.6% and a negative predictive value of 93.4%.
It’s worth understanding the broader context for microbiome testing. A 2024 review in the Journal of Law and the Biosciences noted that the direct-to-consumer microbiome testing field lacks standardization, and different companies using different laboratory techniques can produce variable results from the same sample. The scientific community also hasn’t fully agreed on what defines a “healthy” vaginal microbiome across all populations, which means the clinical significance of some findings remains uncertain. Evvy’s metagenomics pipeline is more rigorously validated than many competitors, but the results are best used as one piece of information alongside symptoms and clinical evaluation rather than as a standalone diagnosis.
What It Does Not Test For
The standard metagenomics test does not detect viruses, parasites, or STIs. It won’t pick up HPV, herpes, HIV, or syphilis. If you need STI screening beyond the four included in the Expanded PCR Panel, you’ll need separate testing. The test also does not detect cancer, precancerous cells, or hormonal levels. It’s strictly a microbial inventory of what’s living in your vaginal microbiome at the time you collect the sample.