Fertility Testing: What to Check and Why
If pregnancy is not happening as expected, the fastest way forward is a structured fertility evaluation for both partners. Most investigations start simple, based on history and a baseline exam, and only move to advanced testing when the first results point to a specific issue. Below is a clear guide to the most commonly used tests for women and men.
Woman
Fertility evaluation in women focuses on four things: ovulation, egg reserve, tubes, and the uterus.
Core evaluation
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Medical history and cycle review: cycle length, symptoms, past pregnancies, contraception, prior surgeries or infections
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Pelvic ultrasound: uterus and ovaries, cysts, fibroids, AFC when relevant
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Ovulation assessment: cycle tracking and, when helpful, ultrasound monitoring
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Ovarian reserve testing: AMH and antral follicle count (AFC)
Tests used in selected cases
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Hormone blood tests: such as FSH, LH, estradiol, progesterone when clinically indicated
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Tubal patency testing to check if tubes are open
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HSG (X ray dye test): can assess tubes and uterine shape, but can be uncomfortable and involves radiation
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Sono HSG / HyCoSy (ultrasound based dye or saline test): often better tolerated, no radiation, also helps assess the uterine cavity
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Thyroid function tests when symptoms or history suggest it
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Blood glucose or HbA1c when PCOS or metabolic risk is suspected
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Infection screening for relevant STIs when indicated
Men
Male fertility evaluation typically starts with one key test and expands only if needed.
Core evaluation
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Medical history and physical exam: sexual function, prior infections, surgeries, medications, lifestyle factors
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Semen analysis: the most important first test, assessing count, motility, morphology, and volume
Tests used in selected cases
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Hormone blood tests if sperm concentration is low or a hormonal issue is suspected
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typically testosterone, FSH, LH, prolactin
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thyroid and glucose testing may be added when relevant
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Infection screening for STIs when indicated
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Genetic testing for specific scenarios, especially severe sperm abnormalities
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may include karyotype, Y chromosome microdeletions, and CFTR testing
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Additional investigations if results warrant
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Scrotal ultrasound for varicocele or structural concerns
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Post ejaculatory urine test if retrograde ejaculation is suspected
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Testicular biopsy in selected cases to assess sperm production
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Specialised sperm function testing in limited scenarios
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Imaging such as MRI or CT only when clinically necessary
If you want, I can also convert this into an Elementor friendly layout with short accordion sections: Basic testing, Advanced testing, and When to consider each.
