Fertility Assessment
It is the first step to gaining a better understanding of your reproductive health before beginning your IVF journey.
What is a fertility assessment?
A fertility assessment is a series of tests and evaluations designed to determine a person’s ability to conceive and carry a pregnancy to term. It typically includes physical exams, blood tests, and imaging studies to assess reproductive health and identify any potential fertility concerns.
Additionally, lifestyle and overall health factors that may impact fertility are also considered. The results from a fertility assessment help guide personalised treatment plans for those facing infertility.
Both partners should attend the initial consultation to be evaluated because there are male and female factors to be considered to give you an accurate indication of why you are having difficulties conceiving.
Benefits of fertility assessment
Infertility or subfertility is usually defined as the inability to conceive after 12 months of having unprotected sexual intercourse for a man or in a woman under 35 years of age or after six months in a woman over 35 years of age.
Infertility evaluation is used to help diagnose and treat any underlying issues that may prevent a couple from conceiving, such as hormonal imbalances, structural issues, or underlying medical conditions.
Is a fertility assessment right for you?
If you’ve been trying to conceive without success, or if you want to understand your fertility status before starting a family, an assessment can be incredibly helpful. Here are some key benefits and reasons to consider it:
- Identify underlying issues early: Many fertility problems have no obvious symptoms. Testing uncovers silent issues (for example, low egg count or poor sperm motility) so they can be addressed promptly.
- Personalised treatment plan: Knowing the exact cause of infertility (if one is found) allows your doctor to tailor a treatment plan specifically for you. This could improve your chances of success on the first try—be it through IVF or alternatives like ovulation induction, IUI, or surgery for correctable issues.
- Save time and emotional stress: Instead of going through trial-and-error with treatments, an assessment directs you to the most effective solution faster. This can reduce the emotional strain of multiple unsuccessful attempts.
- Inform your family planning: Even if you’re not ready for IVF or any treatment yet, an assessment gives you a snapshot of your fertility. For instance, you might discover a low ovarian reserve and decide to consider options like egg freezing, or you might gain peace of mind that everything looks good.
- Inclusive for all situations: Whether you’re a couple (heterosexual or same-sex) or a single individual wanting to understand your fertility, this assessment is designed for you. Everyone’s situation is unique, and our team at IVF(SG) provides a supportive, non-judgmental environment for all.
Female fertility tests
Blood tests
- Measure Anti-Mullerian Hormone (AMH)
Ovarian reserve shows how many eggs are left in your ovaries, which helps doctors check your fertility. The Anti-Müllerian Hormone (AMH) test is often used to measure this. A higher AMH level usually means more eggs. However, if your AMH level is too high, it could be a sign of polycystic ovarian syndrome (PCOS). That’s why your fertility specialist must review your complete medical history to understand the results better. - Hormone levels
Certain hormonal imbalances can interfere with egg production and maturation. These include thyroid-stimulating hormone (TSH).
Pelvic ultrasound scan
A pelvic ultrasound is a simple, painless test that helps doctors see the organs inside your pelvis. This test creates pictures of the uterus, cervix, fallopian tubes, and ovaries.
What we look for during the ultrasound:
- The shape and condition of the uterus to detect fibroids, polyps, or structural abnormalities that might affect implantation or pregnancy.
- The endometrium (uterine lining) – to see if it appears healthy and of appropriate thickness for the cycle day, as a receptive lining is important for embryo implantation.
- The ovaries – we examine ovarian morphology and perform an antral follicle count (AFC). The AFC is a count of the small follicles in the ovaries visible at the beginning of the cycle, which alongside the AMH blood test gives a measure of ovarian reserve. We also check for ovarian cysts or signs of polycystic ovaries.
- The fallopian tubes – while ultrasound can’t always visualise the tubes unless they are swollen or filled with fluid, it can sometimes hint at blockages (for example, detecting a hydrosalpinx, which is a fluid-filled blocked tube).
Overall, the pelvic ultrasound helps uncover anatomical reasons for infertility (like blocked tubes, ovarian cysts, endometriosis indicators, or uterine issues).
Male fertility tests
Semen analysis
This is the primary test for male fertility. It looks at the number of sperm and their ability to move, size, and shape. Our clinic will arrange for the male partner to provide a semen sample to assess.
This is usually collected via masturbation later, to be delivered to the clinic at an arranged time. Our partner, Virtus Fertility Centre Singapore’s andrology laboratory, performs the analysis.
A Sperm Chromatin Structure Assay (SCSA) to identify damaged DNA within the sperm may be recommended by the fertility specialist at an additional cost. Other than its primary role in fertilising the egg, the sperm plays a significant influence on the quality of embryos, implantation and successful pregnancy.
High DNA fragmentation levels can be a reason for unexplained infertility, recurrent miscarriages, or failed IVF cycles. Sperm whose DNA integrity is damaged can fertilise an egg but produce embryos of poor quality and result in pregnancy loss.
What we measure: In the lab, embryologists or andrologists will examine the sample under a microscope to assess:
- Sperm Count: the concentration of sperm in the semen. (Is the count sufficient for natural conception or do we need to consider techniques like IVF/ICSI if counts are low?)
- Motility: the percentage of sperm that are moving, and how well they move forward. Good forward progression is key for sperm to reach and fertilise an egg.
- Morphology: the shape and structure of the sperm. We check what percentage of sperm have a normal shape. Abnormally shaped sperm (too large, too small, double-headed, etc.) might have difficulty fertilising an egg.
Frequently Asked Questions
What does a fertility assessment include?
An assessment includes blood tests to evaluate reproductive health, such as ovulation monitoring, hormone tests, followed by pelvic ultrasound scan for the female. For male, it involves semen analysis.
How long does a fertility assessment take?
The assessment process typically takes a few hours to a day, depending on the tests required.
What tests are typically performed during the assessment?
For women, the tests include blood tests for hormone levels, a pelvic exam and ultrasound scan of the ovaries and uterus. For men, it is a semen analysis.
How can a fertility assessment improve treatment outcomes?
It identifies underlying issues, enabling specialists to create tailored treatment plans to increase the likelihood of success.
