How Can Women Check Their Fertility? | A Guide to Fertility Tests-image

How Can Women Check Their Fertility? | A Guide to Fertility Tests

Medically Reviewed by Hertility on February 5, 2024

Understanding Fertility in Women

Why and When to Check Your Fertility

Initial Self Assessment and Tracking

Overview of Fertility Tests

Common Fertility Issues Identified Through Testing

Next Steps After Fertility Testing

FAQs

If you’re planning a family, now or in the future, checking your fertility can offer you insights and peace of mind. 

Navigating fertility testing can be both enlightening and empowering, offering valuable insights into your reproductive health.

This comprehensive guide will serve as your go-to resource for female fertility tests, providing detailed information about different types of fertility testing, and everything you need to know to take control of your reproductive health, wherever you are in your fertility journey.

We’ll cover where you can get female fertility tests done and when you would be eligible, including fertility tests on the NHS, fertility tests at home, and fertility tests online.

We’ll also explain how fertility tests are carried out, whether they’re painful, and information about blood tests. We’ll delve into the hormones and individual tests so you know exactly how the tests work, what exactly they’re testing for, and what your fertility test results mean for you.

You can get answers to your fertility testing questions including:

  • How can I check if I’m infertile?
  • How many eggs do I have left?
  • Why am I not getting pregnant?
  • How is a woman’s fertility tested?
  • What are the causes of female infertility?

Understanding Fertility in Women

Let’s start with the foundations of female fertility and the biological processes that govern your reproductive system. Your fertility is influenced by various factors, both physiological and environmental. Understanding what goes on inside, and how your fertility works, helps you gain a deeper understanding of fertility testing.

Menstrual Cycle

The foundation of fertility lies in your menstrual cycle—a recurring roughly 28-day cycle that’s regulated by your hormones.

A normal menstrual cycle can last between 25-31 days. The cycle consists of phases, including menstruation (when you get your period), the follicular phase, ovulation and the luteal phase. Within different phases of your menstrual cycle, different things are happening in your body, all orchestrated by your hormones.

Each phase has its superpowers, but for fertility, the most important phase is ovulation.

Ovulation

Ovulation is when a mature egg is released from the ovary making it available for fertilisation (the first step of conception and pregnancy). Ovulation typically happens around the middle of the menstrual cycle (around day 14 of a 28-day cycle, but it might be later or earlier depending on your cycle length) and is an important moment in the fertility timeline.

The egg travels down the fallopian tube where it awaits potential fertilisation by sperm. If you’re not ovulating, this could impact your fertility potential. Issues with ovulation accounts for 40% of female infertility.

Fertilisation and Implantation

Fertilisation occurs when sperm successfully penetrates the egg. If it does fertilise it, the fertilised egg is called a zygote. The zygote travels down the fallopian tube towards the uterus where its goal is to successfully attach itself to the uterine wall lining (implantation). From there, it grows and develops into a baby.

Hormone Regulation

Hormones play a crucial role in the menstrual cycle and fertility.

Follicle-stimulating hormone (FSH) and luteinising hormone (LH) released from the pituitary gland in your brain, along with oestrogen and progesterone from the ovaries, regulate the various phases of the cycle. Each hormone has a specific role to play.

A big part of female fertility testing is testing your hormones to offer insights into your fertility.

Ovarian Reserve

Your ovarian reserve refers to the quantity of eggs you have remaining. It gradually declines with age, particularly after the age of 35. Assessing ovarian reserve provides insights into a woman’s fertility. Age, and therefore, declining ovarian reserve, is the most common reason for infertility.

Cervical Mucus and Reproductive Environment

The consistency of cervical mucus changes throughout the menstrual cycle. Just before ovulation, and during ovulation, your cervical mucus becomes slippery and water like to help the sperm travel through the fallopian tube to meet the egg, for the egg to become fertilised.

If fertilisation is successful, the next stage towards healthy pregnancy is implantation (when the fertilised egg successfully attaches to the uterus wall lining). For implantation to be successful, the uterine lining has to be thick enough. If implantation doesn’t occur, the uterine (womb) wall lining sheds resulting in a period (and no pregnancy).

External Factors

Lifestyle factors such as nutrition, sleep and overall health can impact fertility. Maintaining a healthy lifestyle is essential for optimising reproductive function.

Why and When to Check Your Fertility

There are various reasons why and optimal times you’d want to check your fertility from age-related concerns to family planning and if you’ve been trying to conceive without success.

Family Planning

If you want to get pregnant or are planning a future pregnancy, checking your fertility from the get-go could be beneficial. Getting a fertility test at the start of your journey can help to start your journey from a place of knowledge and understanding.

Some individuals and couples wait until the 3-month, 6-month, or 12-month mark trying to conceive without success before pursuing a fertility test. To get a fertility test on the NHS, you have to have been trying for a year without success.

You can, however, check your fertility from the comfort of your own home at any point in your fertility journey. The earlier you know, the better, since fertility declines with age.

Age-related Concerns

Concerns about age-related fertility decline might prompt you to check your fertility to assess your ovarian reserve and fertility potential, especially if you’re considering delaying conception until later in life. This might be the case if you’re in your 30s but don’t want a baby yet.

Women are born with all the eggs they’ll ever have (the ovarian reserve), and as you age, you gradually lose eggs every menstrual cycle. Your naturally declining ovarian reserve is the leading cause of infertility.

In your 20s and early 30s, you are considered at your most fertile age. After the age of 35, fertility can decrease significantly. This prompts many to take a fertility test whether it’s out of curiosity or wanting to plan for the future.

Age is one of the most important factors when it comes to your fertility. If you plan on delaying having a baby until later in life, having a fertility test to check your ovarian reserve (AMH test) might help you to be more prepared, especially if you are considering things like freezing your eggs. The earlier you can plan, the better.

Previous Reproductive Challenges

If you’ve previously experienced difficulties with fertility, it’s normal that you’d want to check your fertility to find some answers that might indicate underlying issues such as hormonal imbalances, structural abnormalities or genetic factors.

Knowing early means you can potentially follow a treatment plan or consider your options for the future with the whole picture. Some people think that once you’ve had one successful pregnancy, you won’t have fertility struggles in future, but some individuals and couples experience secondary infertility—fertility struggles when they have one or more children already.

Health Conditions and Medications

Certain health conditions, surgeries, treatments or medications can impact fertility. If you’ve experienced polycystic ovary syndrome (PCOS), endometriosis, thyroid disorders or have recently had cancer and cancer treatments or surgery, you might want to check your fertility to see if they’ve had an impact on your fertility.

Facing fertility struggles can be difficult, and speaking with family, friends and healthcare professionals like a fertility counsellor or fertility advisor can support you.

Consider Fertility Testing Before You Start Trying

Wondering when to check your fertility? While it’s possible to check your fertility at any age and stage of your fertility journey, checking your fertility before you start trying for a baby can provide you with a foundation of fertility knowledge, especially if there are some potential fertility struggles.

Identifying any issues early on will mean you can get treatment or implement lifestyle factors that could enhance your fertility.

After 6-12 Months of Trying Without Success

You might be considering fertility testing if you’ve been trying to conceive without success for 6-12 months. It’s generally recommended by healthcare professionals that after 6-12 months of regular, unprotected sex without success, checking your fertility is necessary to assess whether there are any underlying problems that you’re unaware of.

Generally, when you’ve been trying for six months or more after the age of 35, the NHS will consider you for fertility testing. Before age 30, they may suggest waiting twelve months. This timeframe is often shortened for people who have pre-existing health conditions that could impact fertility.

Early awareness and intervention can increase the likelihood of a healthy pregnancy. By discovering information about your fertility early on, you can get peace of mind and plan for the future.

Initial Self-Assessment and Tracking

Tracking Your Menstrual Cycle For Fertility

If you want to have a baby, or even if you want to get to know your own body better, tracking your menstrual cycle, knowing what’s normal for you, and recognising symptoms can go a long way in understanding your fertility.

Before you seek out fertility tests, you can do some fertility self-assessment. Track your menstrual cycle to understand your body better, and know when you’re in your fertile window.

There are different menstrual cycle tracking methods you can use.

If you’re a traditionalist, track your fertility through a pen-and-paper method. Grab your diary and simply mark down the first day of your period (this is considered day 1 of your menstrual cycle) and then the last day of your menstrual cycle (the day before your next period). This will tell you how long your menstrual cycle is, but it will also offer you insights into your fertile window (the time you’re most likely to get pregnant).

Ovulation typically occurs 14 days after the first day of your period in a 28-day menstrual cycle (but it’ll likely be longer if your cycle is longer, and the same applies for shorter cycles), and your fertile window which is a roughly 6 day window including the 5 days leading up to ovulation and the day of ovulation.

You can also track your menstrual cycle using a digital calendar on your phone or a menstrual cycle-tracking app. The apps are handy because they collect any information you’ve entered previously to offer you tips and guidance on your menstrual cycle, fertility and general health and well-being.

You can also note down any symptoms, physical and emotional, you experience. When you’ve tracked it for several months, you may start to notice patterns. These patterns can come in handy when it comes to understanding your moods and energy at different times of the month and when speaking to healthcare professionals.

Signs of Ovulation

Knowing when you ovulate is important if you’re trying to get pregnant. Your optimal fertile window falls around five days before ovulation, the day of ovulation itself, and the day after ovulation.

This is because once your egg is released, it can survive in your body for 12-24 hours. Sperm lives for much longer—being able to survive for up to five days in the body. The meeting of sperm and egg is crucial for the first stage of conception, fertilisation, so timing is everything.

You can also track ovulation with ovulation predictor kits (OPKs). They work in the same way that a pregnancy kit does. You urinate on an ovulation test stick and it’ll provide results as to whether you’re ovulating or not. Ovulation predictor kits measure the levels of luteinising hormone (LH), which usually spikes about 24- 48 hours before ovulation. 

Getting to know the signs that you are ovulating can support you in getting pregnant as it indicates your fertile window. 

Overview of Fertility Tests

There are various fertility tests to check your fertility and provide insights into your reproductive health.

Hormones play a pivotal role in fertility and the menstrual cycle. Testing them can provide insights into your fertility. Hormone level assessments will measure follicle-stimulating hormone (FSH), luteinising hormone (LH), oestrogen, testosterone and progesterone. They all play a part in your fertility, and understanding the levels at different stages of your menstrual cycle can provide insights into your reproductive health.
You might also choose to opt for an anti-müllerian hormone (AMH) test, to check your ovarian reserve (how many eggs you have left). With your AMH test results, a healthcare professional can indicate whether your ovarian reserve is where it should be at your age. An AMH test won’t however, offer you insights on the quality of your eggs, just the quantity. It’s important to note that your GP cannot test for this – but you can test your AMH with a Hertility hormone and fertility test.

Some factors can impact fertility beyond hormones, including your reproductive environment (uterus, fallopian tubes and ovaries), overall health and lifestyle choices.

At-Home Fertility Testing

At-home fertility testing is a quick and easy way to check your fertility from the comfort of your own home. There’s no need to wait for several months or years to access at-home fertility testing, you can proactively check your fertility from the comfort of your home. The perks include efficiency, accessibility, and privacy, sparing you the need for doctor’s appointments or leaving your home.

The fertility tests measure crucial hormones—FSH, LH, oestrogen, testosterone and progesterone—offering insights into potential hormonal imbalances that can impact fertility.

Unlike some NHS doctors, at-home fertility tests empower you to explore your fertility without specific symptoms, age restrictions, or prolonged attempts to conceive. Why would you want to wait six months or a year of trying to conceive when you can find out about your hormones and fertility now?

You can order an at-home hormone and fertility test from Hertility at any life stage, with or without symptoms, even if you’re on hormonal contraceptives.

From the results, Hertility creates a custom hormone panel based on your unique needs. Covering medical history, family background, fertility and health goals, lifestyle, and more, this detailed health assessment ensures a personalised approach.

As well as lab-analysed blood test results, Hertility provides a doctor-written report, to help you interpret the results and what they mean for you, including suggestions on how to balance any hormones that are out of whack or lifestyle changes you can make to support your fertility.

Results can reveal insights into reproductive health conditions like PCOS, endometriosis, or thyroid issues.

You can request an at-home fertility test. You follow the instructions and take a finger-prick blood sample. You then send your blood sample off to the lab for analysis.

Results are typically available in as little as ten working days. Ensure reliability by choosing a reputable company with accreditations and positive customer reviews on unbiased review platforms like Trustpilot.

Following specific instructions, particularly regarding the optimal day in your menstrual cycle for testing, will enhance result accuracy. With at-home fertility testing, you gain control over reproductive health without the inconvenience of Doctors appointments and extended waiting times.

Clinical Fertility Assessments

Your reproductive environment (uterus, fallopian tubes and ovaries) could impact your fertility, especially the implantation process, so checking this aspect of fertility is important. Clinical assessments can identify issues with the uterus, fallopian tubes and ovaries.

Ovarian reserve testing in a clinical setting can include an AMH blood test, but another way to measure this in a clinical setting would be an ultrasound scan to look at the Antral Follicle Count, i.e. looking at the number of follicles in the ovary. Usually a combination of both the AMH and AFC is recommended to get the most accurate insight into your ovarian reserve.

Another clinical fertility assessment is hysterosalpingography (HSG)—an x-ray procedure where a contrast dye is injected into the fallopian tubes. The dye allows a healthcare professional to see more on an x-ray. An HSG can identify blockages or  abnormalities in the fallopian tubes  that could impact fertility because it stops the egg and sperm from meeting.

A laparoscopy is a type of keyhole surgery—a minimally invasive surgical procedure involving a tiny camera (laparoscope) that’s inserted into the abdomen. It helps to diagnose and treat reproductive conditions like endometriosis, adhesions or ovarian cysts.

Genetic tests in a clinical setting can identify hereditary conditions or genetic factors impacting fertility. Screening and preconception genetic testing help to assess the risk of certain disorders before conceiving.

An endometrial biopsy involves analysing a small sample of the uterine lining. This test helps assess the receptivity of the uterus for implantation (when the fertilised egg attaches to the uterine wall lining).

Clinical fertility assessments offer a more detailed evaluation of your fertility, especially when it comes to testing your uterus, fallopian tubes and ovaries. It can help to identify structural reproductive environment abnormalities more precisely.

Interpreting Fertility Test Results

So, you’ve taken the fertility test and you’ve just received the results, but what on earth do your fertility test results mean? Once you’ve received your test results, either from an at-home fertility test or a clinical fertility test, understanding the results and what they mean for you and your goals is crucial. 

When you don’t have a science degree, understanding fertility test results isn’t necessarily easy.

Hertility offers a lab analysis of your blood test, along with a doctor-written report on how to interpret your results with suggestions and guidance on treatments or lifestyle changes to improve your fertility.

Abnormal hormone levels in a blood test, like FSH, LH, oestrogen, and progesterone, may signal hormonal imbalances, indicating conditions like PCOS,, or thyroid issues. If your hormone levels are off, it could affect fertility. Consult a healthcare professional for guidance on balancing them, which may involve adjusting lifestyle choices or medication.

Ovarian reserve testing through an AMH test or antral follicle count ultrasound will indicate how many eggs you have left. A healthcare professional can interpret the results to tell you whether your ovarian reserve is normal for your age. A normal ovarian reserve indicates a good supply of eggs positively influencing fertility.

When it comes to your reproductive environment, knowing if there are any blockages in your fallopian tubes is vital. An HSG can determine this.

An endometrial biopsy can tell you whether your uterus lining is receptive to implantation, therefore increasing the likelihood of implantation and fertility.

Understanding fertility test results is best done with a healthcare professional or fertility specialist. Their expert knowledge can offer specific and personalised guidance, including potential interventions or lifestyle adjustments, for optimising your fertility.

Common Fertility Issues Identified Through Testing

Sadly, for 1 in 4 couples, causes of infertility can’t be identified. If a cause for your fertility problems hasn’t been found, talk to your doctor or trusted healthcare professional about your next steps.

Common fertility issues identified through at-home and clinical fertility testing are:

  • PCOS
  • Thyroid issues
  • Fibroids or polyps 
  • Endometriosis
  • Blockages in the fallopian tubes
  • Uterus wall lining that is not receptive to implantation
  • Scarring of the fallopian tubes
  • Pelvic inflammatory disease
  • Premature ovarian insufficiency (POI)

Next Steps After Fertility Testing

Following fertility testing, you might want to seek medical interventions, lifestyle changes or fertility treatments.

If your tests have identified a hormonal imbalance, lifestyle changes can support you to bring your hormones back into balance.

Lifestyle changes that could help out your hormones include balanced nutrition (including healthy fats, protein with every meal, and plenty of fibre), managing stress, losing weight, regular exercise, getting enough sleep, and avoiding alcohol and smoking. 

You might also want to consider medication to bring your hormones back into balance. You should consult with your healthcare professional on the most suitable medication for your symptoms and test results.

If you prefer to use more natural and holistic methods, you could improve your nutrition by adding some specific supplements to your routine too. Always speak to a doctor or nutritionist before doing this.

If you continue to experience fertility struggles, fertility treatments like ovulation inducation where you are given medication to trigger ovulation, IUI and IVF (in-vitro fertilisation) might be recommended.

If you are not looking to have children immediately, you can explore egg freezing. This entails preserving your eggs for future use in pregnancy, while IVF involves fertilising the previously frozen eggs outside the body and then implanting the embryos into the uterus to support a healthy pregnancy.

Fertility Testing for Special Circumstances

Unfortunately, cancer treatments like chemotherapy and radiation, and certain genetic conditions, can affect fertility. If you’ve had cancer treatment, you may want to check your fertility and opt for fertility preservation methods, such as egg freezing. These are recommended before cancer treatment. This will give you the best chance of having a baby at a later stage in life if any treatment you have may reduce your fertility.

Post-treatment fertility tests help to assess the impact of the cancer treatments on your fertility. It can be emotionally challenging to take these tests, but it’s better to know of any fertility struggles sooner so you can start planning for the future and consider the best options for your fertility goals.

Depending on the fertility test results post-cancer treatment, you might be recommended  to consider fertility treatments like IVF.

If you have a known genetic condition that could affect your fertility, having a fertility test can offer you insights into your reproductive health. Preconception fertility counselling can provide you with information and guidance on available testing options.

To check fertility for known genetic conditions, you might be recommended to undergo carrier screening—a type of genetic test that can check whether you carry a gene for certain genetic disorders.

While knowing the information can be emotionally stressful, it will help you in making informed decisions about your fertility. Prenatal testing during pregnancy can assess foetal health for those at risk of passing on genetic conditions.

For those over 35, it’s usually recommended to wait six months of trying before seeking fertility testing; for those under 35, waiting a year is advised, unless you have a health condition that might impact your fertility .

However, if you have symptoms, a history of cancer or treatment, or a known genetic condition affecting fertility, see a healthcare professional promptly, especially if you’re planning for a baby soon. Remember, timing matters and age significantly influences fertility.

Early planning, open communication and knowing your options when it comes to fertility testing are crucial to helping you make informed decisions for your reproductive health.

Recognising the critical impact of age and timing is vital, yet it’s empowering to take proactive control of reproductive health. By combining accessible at-home fertiliy tests with clinical insights, individuals can make informed decisions, navigate potential challenges, and pursue their family-planning goals with confidence.

FAQs in Fertility Testing

How do I check my fertility at home?

You can check your fertility at home by ordering an at-home Hormone and Fertility Test, completing the blood test using the finger-prick method, and sending your blood sample off to the lab for testing. A few days later, your results will be available in your Health Hub.

Where can I get a fertility test done?

You can get a fertility test done from the comfort of your own home. All you have to do is order a Hormone and Fertility Test.

If you’re over 35 and have tried for six months or younger and tried for twelve months to conceive, your GP might offer a fertility test if you express concerns about fertility issues.

How do I know if I’m infertile?

Infertility is defined as the inability to get pregnant. The reasons for fertility struggles are often unclear and that can be frustrating

To check your fertility, you can take a fertility test. However, it is important to know that these tests can’t tell you if you are going to have a baby for sure or not. It’s now easier than ever and you can get results within three days. To check your fertility, order an at-home fertility test from Hertility or speak with your GP.

You don’t have to have been trying to conceive to order a fertility test. You can access an at-home fertility test at any age and any life stage. Early detection is important when it comes to fertility. Finding out any fertility issues sooner rather than later will give you the best chance of having a baby now or in the future. Age is the biggest factor for infertility.

How is a woman’s fertility tested?

A woman’s and those AFAB’s fertility is tested in various ways. One of the most common fertility tests is hormone level assessments. A hormonal imbalance can affect your fertility and indicate PCOS, and thyroid issues.

You will be asked to do a blood test to look at your hormones. From there, you may be invited to a consultation, GP’s surgery or hospital to discuss your test results if you have questions or need treatment.

Other fertility tests include pelvic ultrasound scans and x-rays (like a hysterosalpingogram or HSG) where you’d need to attend a clinic or hospital in person.

An ultrasound scan is used to check your ovaries, uterus and fallopian tubes. An ultrasound scan can be carried out by moving a probe over your tummy with some gel (like a pregnancy ultrasound). An ultrasound can also be carried out transvaginally— where a probe is inserted into your vagina.

If the ultrasound suggests a possible blockage, you might be referred for a further test like a laparoscopy, where a tiny camera offers better visualisation of what’s going on inside.

An HSG involves a specialist dye being injected into your uterus and fallopian tubes. The dye can help to identify blockages and offer clearer visualisation.

Is it painful to check my fertility?

It’s not painful to check your fertility. Fertility tests usually involve taking a finger-prick sample of blood. This is a sharp prick in your fingertip for less than a second.

In a clinical setting like a GP surgery or clinic, you might get your blood test taken with a needle through a vein (the veinous method). If you don’t like needles, this might be stressful, but apart from an initial sharp prick when the needle is inserted into your arm, there is no significant pain to worry about.

Zoya Ali BSc, MSc

Zoya Ali BSc, MSc

Zoya is a scientific researcher with a Bachelor's degree in Biotechnology and a Masters in Prenatal Genetics & Foetal Medicine from University College London. Her research interests are reproductive genetics, fertility preservation, gynaecological health conditions and sexual health.

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