Understanding Fertility Evaluations & Testing
A fertility evaluation helps your care team gather information to understand your unique set of circumstances, enabling our team to provide the most appropriate care to help you achieve your goals – whether you are actively trying to conceive or want to know where your fertility stands currently, testing is the first step.
General Fertility Evaluation Steps:
- 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 - Transvaginal Ultrasound:This imaging test is performed in-office by one of our specialist providers. . This ultrasound lets your provider visualize your ovaries, uterus, and determine your antral follicle count (“AFC,” tiny resting follicles that indicate your ovarian reserve). They can also look for anything like cysts, fibroids, or structural concerns.
- Ovarian Reserve Testing:Your ovarian reserve refers to the quantity of eggs remaining. Tests like AMH and AFC give your doctor a good indication of your overall fertility potential.
- Uterine and Fallopian Tube Evaluation: Evaluating your uterine cavity and whether or not your fallopian tubes are clear or have blockages present is an important step before initiating fertility treatment. These tests determine if there are tubal blockages, uterine fibroids, ovarian cysts, or other potential barriers to pregnancy. Common tests include:
• Hysteroscopy: A procedure, done under anesthesia, where a tiny camera is inserted into the vagina, guided through the cervix and into the uterus, which allows the physician to visualize the uterine cavity.
• HSG (Hysterosalpingogram): A test where dye is injected into your fallopian tubes and an X-ray is performed which indicates whether your fallopian tubes are open and your uterine cavity looks normal.
Your care team will explain which test(s) is/are appropriate 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 seminal fluid
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 provider will have a follow-up consultation to walk you through your test results, what they mean for your fertility and chances of conceiving, and what treatment options might make sense for you. Whatever comes next, you’ll make decisions together with your care team.
Get Started Today
A specialist in reproductive endocrinology and infertility (REI) is a fertility specialist who can guide you through a thorough evaluation and discuss treatment options. Contact our trusted team of experts for a fertility evaluation today.