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The 5 W’s About Fertility Testing

Why: Get Answers with Fertility Testing

Women and men questioning their fertility potential can find answers through a series of fertility tests also known as pre-screening or the diagnostic work-up. Seeing a specialist for fertility testing allows for answers in as little as a month.

Who: Anyone Trying to Conceive or Women Considering Egg Freezing

Fertility testing should be considered when:

  • The female partner is under 35 years old and the couple has been trying to conceive for over one year
  • The female partner is 35-40 years old and the couple has been trying to conceive for six months or more
  • The female partner is older than 40 and the couple has been trying to conceive for three months or more
  • There is a known fertility issue for either partner
  • A couple previously had a child without the aid of fertility treatment but are having trouble with baby number two
  • Male Infertility Single women who will need donor sperm to conceive
  • LGBT couples who will need donor sperm, donor eggs, and/or a gestational carrier to conceive
  • A women who wants to preserve her fertility for pregnancy at a later date

People are often surprised to learn male factor infertility makes up about 40% of infertility cases. When we think about a fertility work-up, it is important to consider and test both partners.

What: Fertility Testing Evaluates Fertility Potential

Fertility testing is made up of a series of evaluations aimed at identifying fertility potential or the various causes of infertility. The tests are designed to answer four basic questions.

For the Ladies:

  • Do I produce quality eggs?
    Blood work – Drawn on the third day of the menstrual cycle, blood work is designed to gain insight into a woman’s egg quality, quantity, and hormonal levels. The tests will evaluate: Follicle Stimulating Hormone (FSH), estradiol (E2), lutenizing hormone (LH), and Anti-Müllerian Hormone (AMH) level. Ultrasound – Also completed on the third day of the cycle is a transvaginal ultrasound to obtain the antral follicle count (AFC). The AFC count measures the number of follicles (potential eggs that are disposed of during menstruation) available at the beginning of a woman’s cycle, which indicates the number of potential eggs a woman has in her ovarian reserve.
  • Is my uterus normal?
    Ultrasound – In addition to identifying the AFC, an ultrasound will also help a physician evaluate the uterine muscle. This scan of the uterus can reveal fibroids or other factors that may keep a woman from conceiving or carrying a pregnancy to term.
  • Are your fallopian tubes open?
    HSG – The fallopian tubes are responsible for transporting an ovulated egg to meet the sperm for fertilization. Blockages in the tubes can keep the two from coming together, making fertilization and later conception impossible. The hysterosalpingogram (HSG) is an X-ray dye test that fills the uterus and fallopian tubes to identify blockages or abnormalities in the uterus.

For the Guys:

  • Do I produce quality sperm?
    Semen Analysis – This can be completed at any point prior to treatment. During the semen analysis, a specially-trained andrologist analyzes the sperm to identify the male’s fertility potential. The analysis has four main components:

    • Volume – the quality of seminal fluid
    • Concentration – the number of sperm
    • Motility – the movement of sperm
    • Morphology – the size and shape of the sperm


Where: Three Points of Entry

Like all medical tests, fertility testing must be ordered by a physician. Men and women interested in getting a work-up can start in one of two places:

  • Primary Care Physician
  • Ob/Gyn’s office
  • Fertility Center

Testing at Shady Grove Fertility, depending on the timing of the menstrual cycle, can be completed quickly, frequently in as little as a month. In addition to a faster turnaround time, patients often find that completing all of their testing at a fertility center is easier. In the majority of cases, all testing from blood work and ultrasounds to HSGs and the semen analysis can be completed in one of our 25 locations.

When: Sooner Than Your Might Think!

Heterosexual couples trying to conceive: 
The natural chances of conception are roughly 20% per month. It is completely normal for pregnancy to take several months to occur. If you meet one or more of the below factors, it may be time to speak with a fertility specialist:

  • A woman’s age (it matters a lot):
    • Women under 35: 12 months of trying to conceive.
    • Women 35-40: 6 months of trying to conceive.
    • Women over 40: After 3 months of trying to conceive.
  • Incidence of family or personal medical history which would indicate seeing a fertility specialist immediately:
    • Repeated pregnancy loss (2 or more losses)
    • Premature ovarian failure
    • Early menopause
    • Endometriosis
    • PCOS
    • Irregular periods or no period at all
    • Male partners with a prior sterilization procedure such as a vasectomy

Single women or LGBT couples:
Women or men who know they need donor sperm, donor egg or a gestational carrier should contact a fertility specialist once they are ready to build their family.

Women who want to preserve their fertility:
After 35, fertility potential in women begins to decline significantly, and therefore, age has a large role in measuring ovarian function and fertility potential.

  • Contact a fertility specialist of there is a family or personal medical history of:
    • Premature ovarian failure
    • Early menopause
    • Women with significant ovarian or medical diagnosis, such as cancer, which are expected to impair fertility
  • To Stop the Clock:
    The best time to freeze is when the eggs are the healthiest. The ideal age range recommended to have fertility testing done for potential egg freezing is 30-37.

If you want to learn more about your fertility, schedule an appointment for fertility testing at Shady Grove Fertility. Please speak with one of our New Patient Liaisons at 877-971-7755 or click to complete the online form


  1. Rachael

    June 13, 2018 - 5:39 am

    This article was really informative and thanks a bunch. My friend got diagnosed with low fertility because of her eating habits.

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