When you visit the Agora for your first appointment, we will normally offer to carry out some tests to discover why you have been unable to become pregnant. These screening tests are offered to all patients, including women in same-sex relationships and single women, to discover any underlying fertility problems.
This test checks that an egg is being released every month. It can be carried out either at home, using an over-the-counter ovulation predictor kit, or in the clinic using a more accurate blood test that measures levels of the hormone progesterone. This peaks seven days after ovulation has occurred so, for a woman who has a regular 28-day cycle, this would be on day 21.
Ovarian reserve test
We normally advise you to have this test before your initial consultation. It is the best predictor of female fertility as it checks both the quality and quantity of eggs left in the ovary. These normally decline (become less) as a woman ages, although age is not the only factor that affects fertility as some women lose their eggs faster than others.
The ovarian reserve test includes a transvaginal ultrasound scan to find out how many follicles (small sacs of fluid that contain an egg) there are in each ovary (this is known as an antral follicle count) and a blood test to measure the anti-mullerian hormone (AMH). We will also offer you a blood test to measure the levels of various other hormones that affect fertility, including the follicle stimulating hormone (FSH), luteinising hormone (LH) and oestradiol on the second or third day of your cycle. The ultrasound scan also enables the doctor to examine the womb and ovaries carefully to check for abnormalities such as polyps, fibroids and ovarian cysts. The test itself takes around 20 minutes and is usually carried out on the second or third day of your cycle. The results are normally available within a week.
Tubal patency test
This checks that the fallopian tubes are not blocked, either partially or fully, and that they are functioning normally. It is usually carried out between day seven and 12 of your cycle. The test involves examining your fallopian tubes and womb using a transvaginal ultrasound scan. We can also accept the results of a previous hysterosalpingogram. If we think there may be a problem with your fallopian tubes, we can also refer you for a further examination using laparoscopy.
A semen analysis is usually advised before the first consultation so that we can test for any factors affecting fertility. These include whether:
- There are enough normal sperm
- The sperm move normally (this is known as sperm motility)
- There are any antisperm antibodies, which can be present following trauma to the testes either through injury or surgical procedures such as a vasectomy reversal
To find out more, you can download our patient information leaflet about semen analysis.
Causes of infertility can be due to a number of factors affecting the man or woman, and in some cases it can be a combination of factors. When all the tests reveal normal results, this means that the reason for infertility is ‘unexplained’.