Fertility tests & 'fertility MOT'

Who it's for

• Anyone curious about their fertility or planning ahead
• People thinking about egg freezing
• Couples who've been trying for a while and want answers
• Single women and same-sex couples before donor treatment

Key facts

• An AMH blood test estimates your egg reserve – it can't tell you your chance of getting pregnant naturally.
• A 'fertility MOT' usually bundles an AMH test with an antral follicle count (AFC) scan.
• NHS GPs can usually arrange first tests once you've been trying for a year, or sooner if you're 36+.
• Semen analysis is just as important – sperm problems are involved in around half of couples' fertility issues.

What happens

1. 1

   Blood tests

   AMH (anti-Müllerian hormone) can be taken on any day of your cycle. FSH and LH are usually taken on days 2–5, and progesterone around 7 days before your period to check you're ovulating. Thyroid and prolactin may be checked too.

2. 2

   Ovarian scan

   A short internal (transvaginal) ultrasound counts the small resting follicles in your ovaries (antral follicle count) and checks your womb and ovaries for things like fibroids, polyps or cysts.

3. 3

   Tube check

   If you're planning IUI, your fallopian tubes need to be open. This is checked with a HyCoSy (ultrasound with a contrast fluid), an HSG (x-ray) or sometimes keyhole surgery.

4. 4

   Semen analysis

   Checks sperm count, movement (motility) and shape (morphology). Usually after 2–5 days without ejaculating.

5. 5

   Results consultation

   A doctor or nurse explains what the results mean for you – and what they don't. Ask for a copy of every result.

How long it takes: Results in days to a couple of weeks. Bundled packages can often be done in one or two visits.

Success rates

• These are tests, not treatment – their value is in helping you plan.
• Ovarian reserve results are most useful for predicting how you might respond to IVF stimulation or egg freezing, which is how NICE recommends they're used.

Each clinic's published rates – compared with the UK average – are on its profile in the clinic finder.

Costs

Single tests are around £85–£200; a bundled first visit is often £150–£650 depending on what's included.

NHS funding

• NICE says people should be offered assessment if they haven't conceived after 1 year of regular unprotected sex, or after 6 cycles of artificial insemination.
• If you're 36 or over, or there's a known cause (e.g. irregular periods, endometriosis), NICE says you should be referred to a specialist straight away.
• Most areas fund NHS fertility testing even where treatment funding is limited. Single women and same-sex couples may be asked to self-fund some insemination cycles first.

Risks and side effects

• Tests are low-risk. The bigger risk is over-reading the results – a low AMH doesn't mean you can't conceive, and a high one isn't a guarantee.