Your Fertility Workup
Learn about the basic blood work and diagnostic testing that should be conducted to assess one's fertility health whether you are trying to conceive or freezing your eggs. Some of these can be run by your OB/GYN, who would refer you to a specialist when needed.
Still confused? We also decode fertility acronyms for you.
Basic Blood Work
You will be asked to come in for blood work ranging from Day 2 to 5 of your menstrual cycle, depending on the clinic. If you are already undergoing Assisted Reproductive Technology (ART), you will be asked to repeat several of these tests through ovulation. Otherwise, it is a one-time test to get a baseline.
This section lists what the clinician will test for and describes the purpose for each. Hover to learn more.
Most accurate predictor of a woman’s egg supply. This test can be more accurate than FSH because there is no fluctuation from month to month and the test is not dependent on a woman’s menstrual cycle, which means women can have the test at any point.
The test helps determine the quality and quantity of eggs available for ovulation.
Levels <1.0ng/ml tend to indicate low ovarian reserve while >3.5ng/nl may be a sign PCOS.
Main female reproductive hormone secreted from the ovary
Releases from the brain and stimulates the ovary to mature an egg.
High FSH levels can indicate to your physician that the hypothalamus and pituitary glands are working harder than normal due to a decrease in ovarian reserve (egg supply).
FSH levels can vary from cycle to cycle.
(Follicle Stimulating Hormone)
Integral to the final maturation and release of a mature follicle.
This is the hormone that surges just before ovulation and what at-home "fertile window" predictor kits test for.
A hormone produced after ovulation, which can also document that you're ovulating.
Typically, this test is done 21 days into your menstrual cycle.
The pituitary gland in your brain creates thyroid-stimulating hormone (TSH) triggering the production of T3 and T4.
When T3 & T4 production is high or low, it can cause fertility issues, increased rate of pregnancy loss, ovulatory disorders, irregular periods, & preterm birth.
When should I have tests done?
The definition of infertility is being under 35 and having tried actively to conceive for 12 months or more without success. If you are over 35, this time is 6 months or more.
If you fall in either category, get tested, but you will likely need more than hormone testing.
Additional Diagnostic Tools/Procedures
Ultrasound of the ovaries first done between days 2 through 4 of your cycle. This test determines the antral follicle count (AFC), which represents the number of eggs available for pregnancy that month.
These follicles can be stimulated so that multiple can mature, rather than the typical one women ovulate monthly.
This internal ultrasound is inserted into the vagina.
An x-ray of the uterus and fallopian tubes to see if a patient’s fallopian tubes are open, to assess whether the uterus has normal shape, and to ensure that the cavity is not affected by fibroids, polyps, or scar tissue.
X-ray contrast is injected into the uterus and an X-ray is taken to detect abnormalities in the uterine cavity. The test also determines whether the fluid passes out of the uterus and spills out of your fallopian tubes.
If abnormalities are found, you'll likely need further evaluation. In a few women, the test itself can improve fertility, possibly by flushing out and opening the fallopian tubes.