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When to ask for fertility tests
If you have been trying to conceive for 12 months without success, it is sensible to speak to your GP about fertility testing. If you are over 36, have irregular periods, or have a known medical condition, you may be offered help sooner.
It is also important for both partners to be assessed. Fertility concerns are not only about female fertility, and tests for men can often identify issues quickly.
Common fertility tests for women
Your GP may start with a review of your medical history, menstrual cycle, weight, and any symptoms such as pain or irregular bleeding. This helps decide which tests are most appropriate.
Blood tests are often used to check hormone levels, including thyroid function and ovarian hormones. Some tests, such as AMH, may help estimate ovarian reserve, while others can look for problems with ovulation.
You may also be offered a pelvic ultrasound scan. This can check the uterus and ovaries for conditions such as fibroids, polycystic ovaries, or ovarian cysts.
If needed, your doctor may suggest a test to see whether your fallopian tubes are open. This is often called a hysterosalpingogram, or HSG, and may be arranged through a fertility clinic or hospital.
Common fertility tests for men
The main test for men is a semen analysis. This looks at sperm count, movement, shape, and volume, and it can highlight issues that may affect conception.
If the semen analysis is abnormal, more tests may be offered. These can include hormone blood tests, a physical examination, or checks for infections or blockages.
Men should not wait to ask for testing. It is usually quicker and simpler to investigate male fertility early, especially if pregnancy has not happened after several months of trying.
Other checks your doctor may suggest
Depending on your symptoms, your GP may also test for conditions that affect fertility. These can include diabetes, thyroid problems, sexually transmitted infections, and hormonal conditions such as polycystic ovary syndrome.
If you have had repeated miscarriages, your doctor may recommend additional tests. These may look at hormone levels, the shape of the womb, or, in some cases, genetic factors.
What happens next
Fertility tests are usually arranged step by step, starting with the simplest and most informative checks. Your GP may refer you to a fertility clinic if results suggest a problem or if no clear cause is found.
If you are struggling to conceive, ask your doctor what tests are available on the NHS and whether any can be done sooner based on your age or symptoms. Knowing what to ask for can make the process feel much more manageable.
Frequently Asked Questions
A typical first step is a fertility workup that includes a history and physical exam, ovulation testing, semen analysis, and basic bloodwork for hormones and ovarian reserve.
Common hormone tests include FSH, LH, estradiol, progesterone, prolactin, AMH, and thyroid-stimulating hormone, depending on your situation.
A semen analysis checks sperm count, movement, shape, and volume, which helps identify male-factor infertility that is common and often treatable.
Ovulation testing may include mid-luteal progesterone bloodwork, ovulation predictor kits, cycle tracking, or ultrasound monitoring to confirm whether ovulation is occurring.
Ovarian reserve testing often includes AMH, day-3 FSH and estradiol, and sometimes an antral follicle count by ultrasound to estimate egg supply.
A transvaginal ultrasound can evaluate the uterus and ovaries for fibroids, polyps, cysts, and the number of resting follicles, which may affect fertility.
Uterine cavity tests may include a saline sonogram, hysteroscopy, or hysterosalpingogram to look for polyps, fibroids, scar tissue, or structural problems inside the uterus.
Tubal patency testing usually involves a hysterosalpingogram or similar imaging study to see whether the fallopian tubes are open.
A hysterosalpingogram uses contrast dye and X-ray imaging to check whether the uterus is normal in shape and whether the fallopian tubes are open.
Thyroid testing usually includes TSH and sometimes free T4, because both underactive and overactive thyroid function can interfere with ovulation and pregnancy.
Yes, prolactin is often checked because elevated levels can disrupt ovulation and menstrual cycles and may point to an underlying medical issue.
PCOS evaluation may include hormone testing, ultrasound, cycle history, and metabolic screening to assess irregular ovulation and related fertility barriers.
Genetic testing may include carrier screening for inherited conditions or karyotype testing in selected cases, especially with recurrent pregnancy loss or severe sperm abnormalities.
Infectious disease screening may be ordered as part of a fertility or preconception evaluation, especially before procedures or if there is concern for past pelvic infection.
Recurrent miscarriage evaluation may include uterine imaging, hormone tests, thyroid and prolactin testing, antiphospholipid antibody testing, and sometimes genetic testing.
Age can influence which tests are prioritized, because ovarian reserve testing and more prompt evaluation are often recommended as fertility declines with age.
Yes, both partners should usually be evaluated because infertility can involve female factors, male factors, or both, and testing both sides avoids delays.
Metabolic tests can include glucose or insulin-related screening, lipid testing, and body-weight-related assessment when PCOS, obesity, or diabetes may be affecting fertility.
If periods are irregular, ovulation testing, hormone bloodwork, thyroid and prolactin tests, and pelvic ultrasound are often prioritized because irregular cycles often signal ovulation problems.
People under 35 often seek evaluation after 12 months of trying, while those 35 or older typically seek it after 6 months, or sooner if cycles are irregular or there is a known risk factor.
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