Fertility Evaluation – IVFandICSI.com

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

Medical history and cycle review: cycle length, symptoms, past pregnancies, contraception, prior surgeries or infections
Pelvic ultrasound: uterus and ovaries, cysts, fibroids, AFC when relevant
Ovulation assessment: cycle tracking and, when helpful, ultrasound monitoring
Ovarian reserve testing: AMH and antral follicle count (AFC)

Tests used in selected cases

Hormone blood tests: such as FSH, LH, estradiol, progesterone when clinically indicated
Tubal patency testing to check if tubes are open
- HSG (X ray dye test): can assess tubes and uterine shape, but can be uncomfortable and involves radiation
- Sono HSG / HyCoSy (ultrasound based dye or saline test): often better tolerated, no radiation, also helps assess the uterine cavity
Thyroid function tests when symptoms or history suggest it
Blood glucose or HbA1c when PCOS or metabolic risk is suspected
Infection screening for relevant STIs when indicated

Men

Male fertility evaluation typically starts with one key test and expands only if needed.

Core evaluation

Medical history and physical exam: sexual function, prior infections, surgeries, medications, lifestyle factors
Semen analysis: the most important first test, assessing count, motility, morphology, and volume

Tests used in selected cases

Hormone blood tests if sperm concentration is low or a hormonal issue is suspected
- typically testosterone, FSH, LH, prolactin
- thyroid and glucose testing may be added when relevant
Infection screening for STIs when indicated
Genetic testing for specific scenarios, especially severe sperm abnormalities
- may include karyotype, Y chromosome microdeletions, and CFTR testing

Additional investigations if results warrant

Scrotal ultrasound for varicocele or structural concerns
Post ejaculatory urine test if retrograde ejaculation is suspected
Testicular biopsy in selected cases to assess sperm production
Specialised sperm function testing in limited scenarios
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.