Understanding Fertility Evaluations & Testing
A fertility evaluation helps your care team gather clues to understand your unique biology to best help you achieve your goals – whether you are actively trying to get pregnant or want to know where you stand currently, testing is the first step.
General Fertility Evaluation Steps:
1. Initial Bloodwork: Your cycle holds a lot of information. Hormone tests — typically drawn on specific days of your cycle — help your doctor understand how your ovaries are functioning. Key hormones checked often include:
• FSH (Follicle-Stimulating Hormone) — helps gauge ovarian reserve
• LH (Luteinizing Hormone) — signals ovulation
• Estradiol — an estrogen that supports follicle development
• AMH (Anti-Müllerian Hormone) — one of the most useful markers for ovarian reserve; this one can be drawn any day of your cycle
2. Transvaginal Ultrasound: This imaging test is performed in-office by a Fertility Institute of NJ & NY provider. This ultrasound lets your doctor see your ovaries, uterus, and antral follicle count (tiny resting follicles that indicate your ovarian reserve). They can also look for anything like cysts, fibroids, or structural concerns.
3. Ovarian Reserve Testing: Your ovarian reserve refers to the quantity and quality of your eggs. Tests like AMH and antral follicle count (AFC) give your doctor a picture of where things stand.
4. Uterine Evaluation: Evaluating your uterine cavity is important before any fertility treatment can begin. This determines if there are blockages, fibroids, cysts, or other potential barriers to pregnancy. Common tests include:
• Hysteroscopy: A tiny camera that looks inside the uterine cavity
• HSG (Hysterosalpingogram): An X-ray procedure that checks whether your fallopian tubes are open and your uterine cavity looks normal
Your care team will explain which test is best for you and what to expect prior.
Fertility isn’t just one partner’s story. A semen analysis is usually one of the first tests recommended. In roughly one-third of cases, fertility challenges relate primarily to the male partner; in another third, primarily to the female partner; and in the rest, it’s a combination or unexplained. A thorough evaluation looks at the whole picture.
• Count: How many sperm are present
• Motility: How well they move
• Morphology: The shape and structure of the sperm
• Volume and pH: Characteristics of the semen itself
This test is non-invasive and straightforward. If the initial analysis shows concerns, a urologist or reproductive specialist can investigate further, looking at hormones, genetics, or structural factors. In many cases, there are effective treatments or solutions.
What Happens After Your Results?
Your doctor will have a consultation to walk you through what the findings mean and what options might make sense for you. Whatever comes next, you’ll make decisions together with your care team.
Get Started Today
A reproductive endocrinologist (RE) is a specialist in fertility medicine who can guide a thorough evaluation and discuss treatment options. Contact our trusted team of experts for a fertility evaluation today.