Fertility testing
Testing finds out what is going on before any treatment is chosen. Both partners are checked, because fertility problems are just as likely to involve the man as the woman.
With Datuk Dr. Navdeep Singh Pannu, FRCOG, at Alpha IVF & Women's Specialists, Kota Damansara
- Who
- Both partners
- Blood tests
- AMH on any day; some hormones early in the cycle
- Semen analysis
- After 2–5 days without ejaculation
- Tube test
- After your period ends and before you ovulate
What it is
A fertility check looks at each step needed for a pregnancy: whether you ovulate, how many eggs are left, whether the tubes are open, whether the womb is healthy, and whether there are enough good sperm.
Most of it is simple: a pelvic ultrasound, a few blood tests and a semen analysis. The results guide everything that follows, from timed intercourse to IVF, and sometimes show a problem that can be fixed first.
Who it can help
- Trying for a year without success, or six months if the woman is 35 or over
- Irregular or absent periods
- Painful periods or pelvic pain
- Two or more miscarriages
- A history of pelvic infection, surgery or endometriosis
- Planning ahead and wanting to know your egg reserve
How it works
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History
How long you have been trying, your cycles, past pregnancies, operations, medicines and lifestyle, for both of you.
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Pelvic ultrasound
A scan of the womb and ovaries for fibroids, polyps, cysts and signs of PCOS, and a count of the small follicles (antral follicle count).
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Hormone blood tests
AMH for the egg reserve, plus FSH, LH, oestradiol, thyroid and prolactin, and progesterone to confirm ovulation.
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Semen analysis
Sperm count, movement and shape, measured in the laboratory.
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Tube test
An HSG, an X-ray with a dye passed through the cervix, shows whether the fallopian tubes are open.
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Results and plan
Dr. Navdeep explains every result and what it means for your chances, then talks you through the options.
Good to know
Side effects and risks
- The HSG can cause period-like cramps for a short time
- Rarely, infection after the HSG; antibiotics may be given
- Some results are borderline and need repeating
Not just for women
In about a third of couples the problem is with the sperm, and in another third both partners contribute. A semen analysis is quick and should be done early.
Sometimes nothing is found
In some couples every test is normal. This is called unexplained infertility, and it can still be treated.
Bring earlier results
If you have had tests elsewhere, bring the reports. They may not need repeating. See your visit.
Questions people ask
Which day of my cycle should I come?
Any day is fine for the first visit. Some tests are then timed: certain hormones early in the cycle, and the HSG after your period ends.
Does the AMH test say whether I can get pregnant?
No. It shows roughly how many eggs are left, not their quality, and not whether you will conceive.
How should my partner prepare for the semen analysis?
No ejaculation for 2–5 days beforehand. If the sample is collected at home, it needs to reach the laboratory within about an hour, kept at body temperature.
Does the HSG hurt?
Most women feel cramps similar to a period for a few minutes. Taking a painkiller beforehand helps.
Further reading
This page is general information and does not take your personal circumstances into account. Please speak to your doctor for advice that is right for you. Disclaimers