A fertility evaluation is designed to identify factors that may be making pregnancy more difficult. It is not one single test, and it does not always lead immediately to advanced fertility treatment.

For many patients, the process begins with a careful conversation and a step-by-step plan.

Your Menstrual and Medical History

Your provider may ask about:

• How long you have been trying to conceive
• How often you have intercourse
• Cycle length and regularity
• Previous pregnancies or miscarriages
• Pelvic infections
• Endometriosis symptoms
• Prior surgeries
• Medications and supplements
• Family history
• Chronic medical conditions

Bring information about recent periods and any ovulation testing you have completed.

Evaluating Ovulation

Regular monthly periods often suggest that ovulation is occurring, but they do not guarantee it. Depending on your history, your provider may recommend:

• Progesterone testing
• Thyroid testing
• Prolactin testing
• Testing for PCOS
• Ovulation predictor kits
• Ultrasound monitoring in selected cases

Antimüllerian hormone, commonly called AMH, may provide information about ovarian reserve, but it cannot determine egg quality or guarantee whether natural conception will occur.

Examining the Uterus and Ovaries

A pelvic ultrasound may be used to evaluate:

• Uterine fibroids
• Endometrial polyps
• Ovarian cysts
• Signs associated with PCOS
• Ovarian reserve
• Uterine structure

Your provider may also recommend a test to evaluate whether the fallopian tubes are open and whether the uterine cavity has a normal shape.

Semen Analysis Is Important

Fertility is a shared health concern. A semen analysis may evaluate sperm concentration, movement, and shape.

Completing this testing early can prevent unnecessary delays or procedures for the female partner.

When Should Testing Begin?

ACOG recommends evaluation after one year of regular intercourse without pregnancy for women younger than 35. For women older than 35, evaluation is generally recommended after six months. Testing may begin sooner when there are irregular cycles, known reproductive conditions, or other risk factors.

What Happens After the Evaluation?

Treatment depends on the findings and your goals. Options may include:

• Timing intercourse around ovulation
• Treating a thyroid or hormonal condition
• Medication to support ovulation
• Treating fibroids or polyps
• Managing endometriosis
• Referral to a reproductive endocrinologist
• Intrauterine insemination or in vitro fertilization

Not every patient needs every test or treatment. Your age, symptoms, preferences, insurance coverage, and reproductive goals should be considered.

Women’s Health and Menopause Center offers comprehensive gynecologic care and can help patients understand when fertility testing may be appropriate.

Contact our West Bloomfield office to begin a personalized conversation about your fertility journey.

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