Fertility testing explained

NICE recommends that both partners are investigated at the same time — male factor contributes to around half of all fertility cases, yet is often tested last. Looking at both sides from the start saves time, worry and unnecessary repeat appointments.

Tests for women

AMH (anti-Müllerian hormone) — a simple blood test that estimates ovarian reserve, meaning how many eggs you have left. It doesn't measure egg quality, and a low result doesn't mean you can't conceive — but it's one of the most useful pieces of information for planning.

Pelvic ultrasound — a painless scan that looks at the ovaries (counting antral follicles) and the uterus. It can spot common issues such as fibroids, polyps or signs of polycystic ovaries.

Hormone profile — blood tests measuring hormones such as FSH, LH, oestradiol, prolactin and thyroid function. Some of these are timed to a specific day of your cycle.

Tubal patency test — usually a HyCoSy or HSG, which checks the fallopian tubes are open. Recommended where blockages are a possibility.

Tests for men

Semen analysis — the single most useful test of male fertility. It looks at sperm concentration, motility (movement) and morphology (shape) against WHO 6th edition reference values. A single result is rarely the whole picture; a repeat after 4–12 weeks is standard before drawing conclusions.

What results actually mean

Numbers below a reference range don't equal a diagnosis — they prompt a fuller conversation. Results are always interpreted together, alongside age, history and your goals. In many cases sensible changes or targeted treatment make a measurable difference.

What happens next

Once we have a complete picture, we'd talk through your options — from monitoring and lifestyle support through to IVF or other treatments. Investigations are a starting point, not a verdict.