Not conceiving can leave you with more questions than answers. A structured fertility assessment looks at both partners, finds what can be found, and gives you a clear, honest plan for what to do next.
A fertility assessment is a set of consultations and tests that check whether ovulation, sperm quality, the fallopian tubes and the uterus are working as they should. It is the first step before any treatment, and it usually takes one or two menstrual cycles to complete.
What it is not: it is not a treatment and cannot predict with certainty whether you will conceive. It identifies likely causes and helps your doctor recommend the simplest effective option, which may be as straightforward as timing intercourse, a lifestyle change or a short course of medicine.
Many people have no symptoms, so waiting for one only costs time.
| Test | Type | What It Shows | Limitation |
|---|---|---|---|
| Consultation and examination | Clinical | Cycle pattern, history, weight, thyroid, signs of PCOS or endometriosis | Needs tests to confirm |
| Transvaginal ultrasound with antral follicle count | Imaging | Uterus, ovaries, cysts, fibroids, polyps and ovarian reserve | Best done early in the cycle |
| AMH | Blood test | Estimate of remaining egg supply | Reflects quantity, not egg quality or pregnancy chance |
| FSH, LH, estradiol, prolactin, TSH | Blood test | Ovulation, pituitary and thyroid function | Timed to the cycle day |
| HSG or saline sonography | Imaging | Whether tubes are open and the uterine cavity is normal | Mild discomfort; not done during infection or pregnancy |
| Hysteroscopy or laparoscopy | Procedure | Direct view of the uterus or pelvis | Advised only when earlier tests suggest a problem |
| Test | Type | What It Shows | Limitation |
|---|---|---|---|
| Semen analysis | Laboratory | Volume, sperm count, movement, shape | Varies between samples; repeat if abnormal; needs 2 to 7 days abstinence |
| Physical examination | Clinical | Testicular size, varicocele, ducts, hormonal signs | Findings need confirmation |
| Hormone profile (FSH, LH, testosterone, prolactin) | Blood test | Whether a problem lies in the testicle or in brain signals | Best drawn in the morning |
| Scrotal Doppler ultrasound | Imaging | Varicocele, blockages, testicular lesions | Does not measure sperm production |
| Sperm DNA fragmentation, karyotype, Y-microdeletion | Special tests | Sperm DNA integrity and genetic causes | Only for selected men, such as very low counts or repeated failures |
Your specialist reviews your history, cycles, previous reports, medicines and goals, and explains which tests you actually need. You do not have to repeat tests that are recent and reliable.
Blood tests and ultrasound are timed to specific days of the cycle. The male partner gives a semen sample, usually at the clinic for best accuracy.
If your history or ultrasound suggests it, an HSG, saline sonography or hysteroscopy checks the tubes and uterine cavity.
Your doctor explains every result in plain language, what is normal, what is borderline and what it means for you as a couple.
You leave with a written plan. Depending on results this may be lifestyle changes, ovulation tracking, medicines, treating a varicocele or fibroid, IUI, IVF-ICSI, or simply continuing to try naturally for a defined period.
The WHO 6th edition (2021) lists lower reference limits that are often used as a guide. A result below these values does not mean you cannot father a child, and a result above them does not guarantee you will.
| Parameter | Lower Reference Limit |
|---|---|
| Semen volume | 1.4 mL |
| Sperm concentration | 16 million per mL |
| Total sperm number | 39 million per ejaculate |
| Total motility | 42% |
| Progressive motility | 30% |
| Normal shape (morphology) | 4% |
It can identify treatable causes, show whether tubes are open, estimate egg supply, describe sperm quality and help you choose between waiting, simple treatment and assisted reproduction.
It cannot measure egg quality directly, predict the exact chance of pregnancy or find a cause in every couple. About one in several couples is told that all results are normal, and even then there are effective ways forward.
Both Partners, One Plan: female and male evaluation is coordinated by one team.
Only Tests You Need: no routine over-testing.
Honest Counselling: clear explanation of what is proven and what to realistically expect.
Respect and Privacy: sensitive issues are handled with discretion and without judgement.
Transparent Costs: an estimate is shared upfront, in line with applicable Indian regulations and ethical guidelines.
Most couples finish within one to two menstrual cycles, because some tests must be done on specific cycle days.
Yes. Male factors contribute in a large share of couples, and a simple semen test is much easier than female investigations, so it is usually done first.
Most are painless. An HSG can cause cramping for a short time, and your doctor will advise on pain relief.
This is called unexplained infertility. It is common, and options such as timed intercourse, IUI or IVF can still help. Your doctor will guide you based on age and duration of trying.
No. AMH estimates egg quantity, not quality, and it does not by itself rule out natural pregnancy. It helps your doctor decide how urgently to plan.
Not necessarily. Many couples are advised lifestyle changes, medicines or a minor procedure first. IVF is recommended only when it is likely to help.
Yes. Your reports and consultations are handled privately, and you can choose whether your partner attends.
World Health Organization. WHO laboratory manual for the examination and processing of human semen, 6th edition (2021).
American Society for Reproductive Medicine. Evaluation of the infertile couple: Practice Committee guidance on female and male evaluation.
Speak with the StemRx fertility team for a confidential assessment and an honest discussion of your options.
This page is for general information only and is not a substitute for professional medical advice, diagnosis or treatment. Recommended tests vary from person to person. Please consult a qualified doctor about your individual condition.
