Fertility Investigations

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What are the fertility tests you may have when trying to conceive?

If you’re a heterosexual couple trying to conceive for one year, it could be time to book an appointment with your GP for some initial investigations. Your GP will perform an assessment and run some tests in order to see if there are any fertility problems you may be experiencing. 

Medical background

Your GP will ask specific questions relating to your reproductive health. They will ask if you’ve taken any type of contraception and when you stopped using it. Other questions will include when your most recent menstrual period was, how long your menstrual cycles are and if you have any known medical conditions that may have an impact on your fertility. Some lifestyle factors may have an impact on your fertility and your GP will want to know if you smoke, how much you weigh and how much alcohol you consume. 

Your GP will also make sure that your cervical smear is in date. The cervical screening is a way of checking if there are any abnormal cells in the cervix, which would sometimes need to be removed. This would need to be done before any potential pregnancy. Your rubella status will also be checked as you may need to have a vaccination before starting any treatment. More details on questions from your GP can be found here.

Fertility Tests

You may have blood tests to assess your hormone levels. A progesterone test can be performed during your cycle to check whether you’re ovulating. The timing of the test is based on the length of your menstrual cycle. If you have irregular cycles, you may have additional tests for FSH (follicle stimulating hormone), TSH (thyroid stimulating hormone), prolactin and testosterone. 

An ultrasound may be performed to check your uterus, fallopian tubes and ovaries. This is used to look for signs that your fallopian tubes could be blocked, preventing the eggs from travelling  down after ovulation or preventing sperm from reaching the egg. It could also determine if you have any conditions affecting your uterus, like fibroids or endometriosis, as they may have an impact on your chances of conceiving. 

A semen analysis is performed to check if there are any issues with the sperm, such as a low count or low motility (movement of the sperm). Laboratories that analyse semen samples use methods and reference values in accordance with the most recent World Health Organisation laboratory manual. The results will include:

  • volume (1.5mL or more)
  • sperm concentration (15 million sperm or more)
  • total sperm number (39 million sperm or more)
  • motility (40% or more moving sperm)
  • morphology (4% or more normal forms)

Further investigations

If you are referred to a fertility clinic, you may have more investigations before you can start any treatment. This would include a blood test for AMH (anti-müllerian hormone) and a transvaginal ultrasound scan to assess your AFC (antral follicle count – the immature follicles in your ovaries) to determine your ovarian reserve and how you will respond to the fertility treatment. In some cases you may need to have a repeat semen analysis before the consultant can confirm what treatment type or fertilisation method would be most suitable. Additional blood tests that would need to be performed prior to any treatment start includes screening for HIV, hepatitis B and hepatitis C. Depending on your ancestry, you could be offered tests for Sickle cell anaemia and thalassaemia, as they are inherited blood disorders and could also impact what treatment type would be suitable for you.

Any general advice given by our care team or posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical advice, diagnosis, or treatment. Béa Fertility, the trading name for StepOne Fertility Ltd. makes no representations or warranties and expressly disclaims any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app.