When and Why to Get Tested
Fertility testing is recommended after 12 months of trying to conceive without success (or 6 months if you are 35 or older). Testing should always include both partners, as roughly one-third of fertility issues are female-related, one-third male-related, and one-third either combined or unexplained. Testing can also be helpful before trying to conceive if you have known risk factors — irregular periods, history of pelvic surgery, prior chemotherapy, family history of early menopause, or known male factor risks. Modern fertility testing is more accessible than ever, with at-home testing options available alongside traditional clinic-based assessment.
Tests for Women
AMH (anti-Müllerian hormone): Blood test that estimates ovarian reserve — how many eggs you have left
FSH and oestradiol: Day 2-5 of your cycle, gives information about ovarian function
LH and progesterone: Confirms ovulation when measured at the right time of cycle
Thyroid function (TSH, free T4): Even mild thyroid issues can affect fertility
Prolactin: High levels can prevent ovulation
Antral follicle count: Ultrasound count of small follicles, complements AMH
HSG (hysterosalpingogram) or HyCoSy: X-ray or ultrasound test to check fallopian tubes are open
Pelvic ultrasound: Looks for fibroids, polyps, ovarian cysts and uterine abnormalities
Tests for Men
Semen analysis: The cornerstone of male fertility testing. Measures volume, count, motility and morphology
Hormonal blood tests: Testosterone, FSH, LH and prolactin if semen analysis is abnormal
Genetic testing: Karyotype and Y-chromosome microdeletion testing for very low counts or azoospermia
Scrotal ultrasound: To identify varicoceles, blockages or testicular abnormalities
DNA fragmentation testing: Assesses sperm DNA quality, can be relevant in unexplained infertility or recurrent miscarriage
Post-ejaculation urinalysis: Checks for retrograde ejaculation if low or no semen volume
Understanding Your Results
Test results should always be interpreted in context — by age, medical history and goals. AMH gives a snapshot of ovarian reserve but does not predict natural fertility well; it is most useful for predicting response to IVF. A normal semen analysis does not guarantee fertility, and abnormal results often improve with lifestyle changes. Many fertility "problems" are actually combinations of mild factors that together reduce chances. Seek a fertility specialist (not just a GP) for thorough interpretation, particularly if you are over 35 or planning treatment. Always ask for actual numbers, not just "normal" or "abnormal".