Understanding Fertility Evaluation
If you have been trying to conceive for a year without success, or six months if the female partner is over thirty five, it is time for an evaluation. In roughly a third of couples the difficulty lies with the female partner, in a third with the male partner, and in the remainder with both or with no identifiable cause. This is why we assess both partners from the beginning.
The evaluation is quicker than most couples expect, and we are direct about what the findings mean and what the realistic chances are with each option. You will leave with a plan and a timeline, not just a set of reports.
What the Evaluation Covers
Testing is completed within one or two menstrual cycles in most cases.
- Semen analysis - the first and simplest test for the male partner, repeated if abnormal, with hormonal and clinical assessment where needed.
- Ovulation assessment - cycle history, hormonal profile and follicular tracking by ultrasound.
- Ovarian reserve testing - AMH and antral follicle count, which help set realistic expectations.
- Tubal patency testing - HSG or laparoscopic assessment to confirm the fallopian tubes are open.
- Uterine assessment - ultrasound and hysteroscopy for fibroids, polyps, adhesions or structural issues.
- General health screening - thyroid function, prolactin, diabetes, weight and infection screening for both partners.
- Ovulation induction - tablets or injections with ultrasound monitoring and timed intercourse guidance.
- Onward referral - to IUI, IVF or ICSI when indicated, with a clear explanation of why and when.
Please attend the first consultation together as a couple if you can, and bring any previous reports, scans or semen analyses with you. It avoids repeating tests unnecessarily.
