Fertility Assessment for Women:
What Tests Are Available?
A fertility assessment brings together your history, cycle pattern, relevant tests and, where appropriate, imaging to help identify the next sensible clinical step.
In brief: Fertility assessment is individual. It begins with health, menstrual and conception history, then selects relevant tests and, where appropriate, pelvic imaging. The clinic confirms what can be arranged for your pathway at booking. NICE guidance considers age, duration of trying and relevant risk factors.[6]
Fertility Tests: What Each One Shows
| Test | Timing | Purpose |
|---|---|---|
| AMH (Anti-Müllerian Hormone) | Any time in cycle | An ovarian-reserve marker that can inform specialist planning; it does not measure egg quality or predict natural conception on its own. |
| FSH (Follicle-Stimulating Hormone) | Day 2–5 of cycle | Elevated FSH suggests reduced ovarian reserve or premature ovarian insufficiency. |
| LH (Luteinising Hormone) | When clinically indicated | May help investigate ovulatory disorders alongside history and other findings; an LH:FSH ratio does not diagnose PCOS by itself. |
| Oestradiol (E2) | Day 2–5 of cycle | Baseline oestradiol — elevated levels may indicate reduced ovarian reserve. |
| Progesterone | Timed to the expected next period | May help assess whether ovulation has occurred; the correct timing depends on cycle length, not a fixed ‘day 21’ for everyone. |
| Thyroid function (TSH) | Any time | Thyroid dysfunction is a common and treatable cause of irregular periods and subfertility. |
| Prolactin | Fasting, morning | Elevated prolactin (hyperprolactinaemia) causes anovulation and amenorrhoea. |
| Antral follicle count (AFC) | Day 2–5 of cycle | Pelvic ultrasound count of small follicles — reflects ovarian reserve alongside AMH. |
Evidence-only information
Fertility concerns can feel emotionally demanding. An assessment is a starting point for an individual clinical conversation, not a verdict or a prediction of whether pregnancy will occur.
Frequently Asked Questions
When should I consider a fertility assessment?
NHS advises seeking GP advice after a year of regular unprotected sex without conception, and sooner for women aged 36 or over or where there is another fertility concern. Both partners may need assessment.
What is AMH and what does it tell me?
Anti-Müllerian Hormone (AMH) is produced by small follicles in the ovaries and reflects the remaining egg supply (ovarian reserve). A low AMH suggests reduced ovarian reserve — but it does not predict whether you can conceive naturally. AMH can be measured at any point in the menstrual cycle.
Do I need a GP referral for a private fertility assessment?
The clinic confirms the appropriate appointment route, the clinician involved and any referral requirements at booking. It can also explain what may be suitable to arrange for the selected pathway.
Can a fertility assessment tell me if I can get pregnant?
No single test can predict whether you will conceive. Results contribute to an individual assessment and may indicate whether further investigation or referral is appropriate.
What happens after a fertility assessment?
Next steps depend on the history, examination and any test results. They may include further assessment, treatment of an identified condition, or referral to an appropriate fertility service. The clinician will explain the reporting and follow-up route for your individual pathway.
References
- [1]Broer SL, Mol BW, Hendriks D, Broekmans FJ. The role of antimüllerian hormone in prediction of outcome after IVF: comparison with the antral follicle count. Fertil Steril. 2009;91(3):705–714. https://doi.org/10.1016/j.fertnstert.2007.12.013
- [2]Neven A, Laven J, Teede HJ, Boyle JA. A Summary on Polycystic Ovary Syndrome. Semin Reprod Med. 2018;36(1):5–12. https://doi.org/10.1055/s-0038-1667351
- [3]Chaker L, Cooper DS, Walsh JP, Peeters RP. Hypothyroidism. Lancet. 2022;398(10308):1382–1396. https://doi.org/10.1016/S0140-6736(21)01628-6
- [4]Guerriero S, Condous G, van den Bosch T, et al. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis. Ultrasound Obstet Gynecol. 2016;48(3):318–332. https://doi.org/10.1002/uog.15955
- [5]Fahs D, Abou-Abbas L, Hamdan Z, Salameh P. Polycystic Ovary Syndrome: Pathophysiology and Controversies in Diagnosis. Diagnostics. 2023;13(7):1252. https://doi.org/10.3390/diagnostics13071252
- [6]NICE. Fertility problems: assessment and treatment. NICE guideline CG156. 2013 (updated 2023). https://www.nice.org.uk/guidance/cg156
About this information
This is evidence-only patient information. It does not provide a named clinician review, a diagnosis or a personalised fertility plan.
Book a Fertility Assessment
Discuss a fertility assessment pathway. The clinic confirms appointment options, preparation and any appropriate tests at booking.
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