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Understanding Fertility Tests

Fertility Testing

AMH, FSH, LH, progesterone, ultrasound, tubal testing and semen analysis.

  • 3 minread
  • 5sections
  • 2myths checked
  • 5sources

AMHFSHLHestradiolprogesteroneultrasoundblood tests

Illustrated cross-section of an ovary showing follicles at different stages.
Illustrated cross-section of an ovary showing follicles at different stages.

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Preview for Kara’s review. Educational draft · clinical approval pending.

Fertility evaluation isn’t one standard test. It is a set of investigations that look at different parts of the picture: ovulation, ovarian reserve, anatomy, the fallopian tubes, sperm and your medical history. Not every person needs every test.

Kara explains

Every test answers a specific question. Before any test, it helps to ask: what is this measuring, why are we doing it, what can it tell us, and what can’t it?

AMH (anti-Müllerian hormone)

AMH helps estimate how the ovaries may respond to stimulation; it isn’t a fertility verdict.

AMH is produced by cells of developing follicles and is a common marker of ovarian reserve. It is useful for estimating how the ovaries may respond to stimulation medication. It is not a pregnancy test, not a fertility verdict and not a measure of egg quality. Professional guidance cautions against using it as a general screening test for natural fertility.

FSH, LH and estradiol

FSH and LH are usually checked early in the cycle, one reason blood tests are booked for specific days.

These hormones are part of the signalling system between the brain and the ovaries. FSH and LH are usually checked early in the cycle (one reason blood tests are booked for specific cycle days), and some guidelines, such as NICE in the UK, recommend them mainly when cycles are irregular. Not everyone needs a full hormone panel: tests are chosen to answer a question about you.

Progesterone

A progesterone blood test in the second half of the cycle can help show whether ovulation is likely to have happened.

Progesterone rises after ovulation. A blood test timed for the second half of the cycle (usually around a week before an expected period) can help show whether ovulation is likely to have happened.

Ultrasound

An ultrasound can look at the uterus and ovaries, and count the small follicles visible at the start of a cycle.

A pelvic ultrasound can look at the uterus and ovaries. Counting the small follicles visible at the start of a cycle (the antral follicle count) is another way of estimating ovarian reserve. Like AMH, it helps predict how the ovaries may respond to IVF medication. But neither test predicts whether you will get pregnant better than your age does.

Tubal testing and semen analysis

A semen analysis is ideally considered alongside the woman’s tests, not after them.

Some assessments check whether the fallopian tubes are open. For the male partner, a semen analysis is an established part of fertility assessment, ideally considered alongside female testing, not after it.

Myth vs evidence

Myth

“A low AMH means you can’t get pregnant.”

Evidence

AMH reflects ovarian reserve, not your chance of conceiving in a given month. A low reserve does not mean you can’t conceive, and a reassuring result doesn’t guarantee pregnancy.

Myth

“One blood test will tell you whether you are fertile.”

Evidence

Fertility involves several biological steps. A single result is one part of the picture, not your whole story.

Take to your appointment Ask your healthcare professional
  1. What is this test measuring, and why are we doing it now?
  2. What can this result tell us, and what can’t it?
  3. Should my partner be tested at the same time?
  4. Does this test need to be done on a specific cycle day?

Words you may hear

Ovarian reserve
An estimate of the number of eggs remaining in the ovaries.
Antral follicle count (AFC)
The number of small follicles seen on ultrasound early in a cycle.
Estradiol
A form of oestrogen produced mainly by developing follicles.
HSG
Hysterosalpingogram, an X-ray test that checks whether the fallopian tubes are open. Some clinics use an ultrasound version instead (HyCoSy or HyFoSy), which avoids X-rays and tends to be less uncomfortable.
Kara’s key takeaway

Tests provide information. They rarely provide your entire fertility answer on their own.

Watch with Kara

Videos on this topic are coming to the channel:

  • What Is an AMH Test?
  • What Can AMH Tell You, and What Can’t It?
  • Understanding FSH
  • Understanding LH
  • What Does Progesterone Tell Us?
  • Why Are Blood Tests Done on Certain Days?
  • What Happens During a Fertility Assessment?

See the video schedule

It takes two
Concept illustration, not to scale.

Male fertility belongs in the same conversation. These illustrated guides pair with this topic:

Keep learning

Want the foundations in one place? The free Fertility Starter Guide covers ten things everyone should understand about their fertility.

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Sources 5 studies and guidelines Show the research