Fertility assessments are a vital step for individuals or couples experiencing difficulty conceiving. A comprehensive evaluation can help identify underlying causes and guide the best course of action to improve the chances of conception. Whether you’re trying to conceive naturally or considering assisted reproductive technologies, understanding the tests involved in a fertility assessment is essential.

Here’s an overview of the most common tests performed during a fertility evaluation for both men and women.

For women: Fertility tests

A woman’s fertility assessment focuses on evaluating the health of the ovaries, fallopian tubes, and uterus, as well as overall hormone levels.

Ovulation testing

To determine if ovulation is occurring regularly, your doctor may recommend:

• Blood tests: Measure hormone levels such as luteinising hormone (LH) and progesterone.
• Home ovulation predictor kits: These detect LH surges associated with ovulation.

Hormonal testing

Blood tests assess key reproductive hormones, including:

• Follicle-stimulating hormone (FSH): Indicates ovarian reserve.
• Anti-müllerian hormone (AMH): Reflects the number of eggs remaining in the ovaries.
• Thyroid hormones (TSH): Imbalances can affect ovulation.
• Prolactin: High levels can interfere with ovulation.

Pelvic ultrasound

A transvaginal ultrasound provides detailed images of the ovaries and uterus. It can detect:

• Ovarian cysts or abnormalities.
• Uterine fibroids or polyps.
• Antral follicle count, which helps estimate ovarian reserve.

Hysterosalpingography (HSG)

This specialised X-ray evaluates the fallopian tubes and uterine cavity. A contrast dye is injected into the uterus to check for blockages or abnormalities.

Sonohysterography

Similar to an HSG, this test uses saline instead of dye to examine the uterus for abnormalities like fibroids or scar tissue.

Laparoscopy

In some cases, a laparoscopy may be recommended. This minimally invasive surgical procedure allows direct visualization of the reproductive organs and can help diagnose endometriosis or pelvic adhesions.

For men: Fertility tests

A male fertility assessment focuses on the health of sperm and the potential presence of any underlying issues affecting sperm production or function.

Semen analysis

This is the cornerstone of male fertility testing. A semen sample is analyzed to assess:

• Sperm count: The number of sperm present in the ejaculate.
• Motility: How well the sperm move.
• Morphology: The shape and structure of the sperm.

Hormonal testing

Blood tests check testosterone and other hormones, such as FSH and LH, that regulate sperm production.

Genetic testing

If a low sperm count or other significant issues are detected, genetic testing may identify chromosomal abnormalities or other genetic factors affecting fertility.

Scrotal ultrasound

This imaging test evaluates the testes and surrounding structures to identify conditions like varicoceles, which can impact sperm production.

Post-ejaculation urinalysis

This test checks for sperm in the urine, which may indicate retrograde ejaculation.

For both partners: Additional tests

In some cases, both partners may need additional evaluations:

• Infectious disease screening: Checks for sexually transmitted infections (STIs) that may impact fertility.
• Karyotyping: A genetic test to detect chromosomal abnormalities in both partners.

Why comprehensive testing matters

Fertility is a complex issue influenced by various factors. Comprehensive testing helps pinpoint the exact cause of infertility, whether it’s related to hormonal imbalances, structural issues, or sperm health. This information allows your healthcare provider to tailor a treatment plan suited to your needs, which may include lifestyle changes, medications, or assisted reproductive technologies like IVF or ICSI.

Conclusion

If you’ve been trying to conceive without success, a complete fertility assessment is the first step in your journey to parenthood. These tests provide valuable insights into your reproductive health and help guide you toward effective solutions.

Consult with a fertility specialist to discuss your concerns and begin your evaluation. With the right diagnosis and treatment, many individuals and couples can achieve their dream of starting a family.

Book your consultation today with our male fertility experts.