Fertility assessment

With regular unprotected intercourse and no pregnancy, assessment is commonly advised after 12 months if under 35 and after six months from age 35. Over 40, earlier discussion is appropriate. Irregular periods, pelvic disease, known tubal or semen problems, or upcoming treatment affecting fertility are reasons not to wait.

The clinician reviews cycles, pregnancies and surgery and may examine the uterus, ovaries and lining with ultrasound. AMH and antral follicle count provide clues to ovarian reserve and stimulation response, not a stand-alone measure of egg quality or natural pregnancy chances. Ovulation or tubal testing is added when appropriate.

Semen analysis looks at volume, sperm concentration, movement and shape. Complete collection, the abstinence period and recent fever may influence interpretation. Abnormal findings can lead to repeat testing or referral to a male fertility specialist.

AMH usually does not require a particular cycle day, while baseline FSH and estradiol may be requested early in the cycle. For tubal testing, mention your period date, possible pregnancy, infection and allergy history. Follow the instructions for your specific tests, including whether fasting is needed.

Immune, clotting, sperm DNA fragmentation and chromosome tests are not routine requirements for every first visit. Ask what the test investigates, whether the result changes a decision and what alternatives exist. Sometimes assessment does not identify a clear cause; an abnormal number also does not automatically mean IVF is needed.