Introduction
Starting IVF is a significant step, and it often arrives after a long road. By the time most people reach this point, they’ve already done a great deal of hoping, waiting, and wondering what might be standing in the way. The desire to simply get on with treatment is completely understandable. But one of the most valuable things you can do before IVF begins is also one of the most overlooked: thorough fertility testing for both partners. Not as a box to tick, and not as a delay, but as the foundation for a treatment plan that is actually built around your situation rather than a general template. This guide explains what fertility testing involves, why both partners need to be assessed, and how the results genuinely shape what happens next.
Why Testing Both Partners Matters
There is a persistent cultural assumption that fertility challenges are primarily a women’s issue. The medical evidence tells a different story. The male partner is solely responsible in approximately 20% of infertility cases and is a contributing factor in another 30 to 40% of all cases, meaning the male factor substantially contributes to around half of all infertility cases overall. As male and female causes often co-exist, it is essential that both partners are investigated for infertility and managed together.
This matters enormously for treatment planning. Without understanding both sides of the picture, a fertility specialist is working with incomplete information. The right approach, the right medications, the right techniques — all of these depend on knowing what is actually going on for each person. Testing isn’t about finding fault. It’s about finding answers that lead somewhere useful.
Fertility Testing for Women
Female fertility testing focuses on three things:
- how many eggs remain
- how hormones are functioning,
- and whether the reproductive anatomy is healthy and clear.
Ovarian reserve: the AMH test
The AMH (Anti-Müllerian Hormone) test has become one of the most important tools in fertility assessment. AMH is a hormone produced by the cells surrounding developing follicles in the ovaries, and its levels, measured through a simple blood test, reflect the estimated number of eggs remaining. An AMH test can also indicate how well a woman may respond to the injectable fertility drugs used to stimulate the ovaries to mature multiple eggs in preparation for IVF. One of its practical advantages is that it can be taken at any point in the menstrual cycle, making it straightforward to arrange. It’s worth understanding what AMH does and doesn’t tell you. Higher levels of AMH mean more eggs are likely available, while lower levels suggest the egg supply is shrinking — however, an AMH test cannot tell you about the health or quality of your eggs, or predict with certainty whether you will be able to get pregnant. It is one important piece of the picture, interpreted alongside other results and your age.
FSH and other hormone tests
Alongside AMH, doctors typically measure FSH (Follicle Stimulating Hormone) and sometimes LH (Luteinising Hormone) and oestradiol. FSH is a hormone that controls the growth of eggs in the ovaries, and providers typically measure it around the third day of the menstrual cycle.
Together, these hormone levels give a fuller view of how the ovaries are functioning and how they are likely to respond to stimulation during IVF.
Antral follicle count
A pelvic ultrasound allows the specialist to count the number of small, resting follicles visible in the ovaries at a given time. AMH and antral follicle count are considered the most sensitive and reliable markers of ovarian reserve in current fertility evaluations. The ultrasound also allows doctors to examine the structure of the uterus and ovaries, identifying anything that might need attention before treatment begins, such as fibroids, cysts, or other changes that could affect implantation.
Fallopian tube assessment
Where clinically appropriate, a test called a hysterosalpingogram (HSG) may be used to check whether the fallopian tubes are open. While IVF bypasses the tubes entirely, understanding the full picture of reproductive health helps doctors plan the most appropriate care.
Fertility Testing for Men
Male fertility testing is less complex in its initial form, but no less important. The cornerstone is the semen analysis, which examines several key parameters: sperm count, motility (how well sperm move), morphology (the size and shape of sperm), and overall semen volume and quality.
What makes this test so significant is what it can reveal about the right path forward. If sperm parameters are outside normal ranges, the treatment approach may change substantially. If abnormalities are found in the initial evaluation, hormonal testing and an optional scrotal ultrasound can then be performed to make a more detailed determination of the nature and severity of the underlying issue. One of the most important clinical decisions that semen analysis can inform is whether ICSI (Intracytoplasmic Sperm Injection) is recommended.
In standard IVF, sperm and eggs are placed together and fertilisation happens naturally in the laboratory. With ICSI, a single sperm is selected and injected directly into an egg, which is particularly helpful when sperm count, movement, or shape is a concern. IVF with ICSI is the preferred treatment for men whose sperm show poor results on key function tests. Without a semen analysis, this decision would simply be a guess.
What Testing Makes Possible
Taken together, the results of fertility testing allow a specialist to build a treatment plan that is genuinely tailored rather than generic.
Hormone levels guide the dosage and protocol for ovarian stimulation. Semen analysis results determine the most appropriate fertilisation method. Ultrasound findings may reveal conditions worth addressing before an embryo transfer is attempted. Pre-existing health conditions, medications, and medical history all add further context that shapes the approach. For many patients, this stage of the process also brings something less clinical but equally valuable: clarity. After months or years of not knowing, a thorough assessment can finally offer answers, or at least a clearer direction. That shift from uncertainty to informed action is something many people describe as a turning point in their journey.
What to Expect
Most fertility tests are straightforward and minimally invasive. Blood tests are a simple draw, usually taking just a few minutes. Ultrasound scans are non-invasive and typically performed during a routine appointment. Semen analysis requires a laboratory sample, provided at the clinic. The process as a whole can usually be completed over a small number of visits. Coming to your initial consultation prepared helps make the most of the time. Bringing any previous fertility test results, being ready to share relevant medical history, and noting any medications or supplements you’re taking all give your specialist more to work with from the outset.
A Conversation, Not Just a Process
At New Leaf Fertility Partners, we believe fertility testing should feel like the beginning of a supported journey, not an impersonal checklist.
Understanding your results, knowing what they mean for your treatment options, and feeling genuinely heard in the consultation — these things matter. The clinical decisions that follow testing are significant ones, and you deserve to understand the reasoning behind them. If you are considering IVF and would like to understand what fertility assessment would involve for you and your partner, we would be glad to talk you through it.