Women under 35 are generally advised to consult a doctor after 12 months of regular, well-timed intercourse without pregnancy, while women 35 or older should seek help after six months. However, earlier evaluation is recommended if:
Periods are absent for three months or more
Menstrual cycles are irregular
There is a history of multiple miscarriages
Either partner has undergone chemotherapy
Family history of infertility or early menopause exists
Suspected endometriosis
Male partner has had groin injury or chemical exposure
Prior surgeries on reproductive organs
Early evaluation can identify issues faster, helping prevent delays, especially for women over 35, where fertility naturally declines with age.
Fertility diagnostics aim to determine which part of the reproductive system may be affecting conception. Key areas include:
Egg quantity and quality
Sperm health
Fallopian tube function
Uterine health
Hormonal balance
Testing is rarely definitive on its own—most diagnostics are pieces of the larger puzzle.
Three primary tests assess ovarian reserve:
AMH (Anti-Müllerian Hormone): Indicates the number of remaining eggs. High levels suggest many eggs, low levels fewer. AMH does not measure egg quality or natural conception potential. Birth control can temporarily affect results.
FSH (Follicle Stimulating Hormone): Measured on day 3 of the menstrual cycle. High FSH can indicate reduced response to fertility medications but does not predict natural fertility.
Antral Follicle Count (AFC): Uses transvaginal ultrasound to count small developing follicles. Low counts may predict lower response to stimulation but not natural conception.
At least one functional fallopian tube is necessary for natural conception. Common assessments include:
HSG (Hysterosalpingogram) : X-ray with dye to check tube openness; also gives limited uterine information.
HyCoSy & FemVue : Ultrasound-based alternatives with 3-D imaging, generally less painful.
Chromotubation : Surgical evaluation during laparoscopy; highly accurate but invasive.
Assessing the uterus ensures it can support a pregnancy. Methods include:
Hysteroscopy: Direct visualization of the uterine cavity; allows treatment of small abnormalities.
Saline Sonogram: Ultrasound with saline to reveal the uterine shape and detect fibroids or polyps.
HSG: Can detect some uterine abnormalities, often done alongside fallopian tube evaluation.
Male factor infertility contributes to 30–50% of cases. Key assessments:
Semen Analysis: Measures sperm count, motility, and morphology to calculate total motile count (TMC).
Medical & Lifestyle History: Evaluates toxins, medications, surgeries, and exposures that may affect fertility.
Sperm DNA Fragmentation (Selective): Used when IVF fails or fertilization rates are low; its utility is debated.
Time intercourse during your fertile window.
Seek medical evaluation after 12 months (under 35) or six months (35+) of trying.
Consider a reproductive endocrinologist for comprehensive testing.
Test both partners.
Inform your doctor if using hormonal birth control before AMH testing.
Repeat abnormal semen analyses at a specialized lab.
Consider additional tests if standard diagnostics show no cause.
At your initial consult:
Which fertility tests do you recommend and why?
Should I stop birth control before testing?
After testing:
Can we review all results together?
What treatment path do you recommend?
What are the expected success rates and costs?
What are the next steps if the first treatment doesn’t work?
Next lessons cover:
How fertility treatments address underlying issues
Differences between reproductive endocrinologists and urologists
Understanding male factor infertility and sperm analysis
Our job is to listen, to connect the dots between your needs, and to determine how we can best help you have your baby. If you’re asking how much does it cost for a surrogate, we’ll walk you through every step of the process to ensure there are no surprises.
To make an appointment with one of our counselors or physicians, please call (212) 661-7673 or email info@surrogacy4all.com. We look forward to hearing from you.
Surrogacy4All is a unique international surrogacy service targeted at providing state of the art IVF and surrogacy services to Intended Parents irrespective of age, sex or color, at the lowest possible cost in the world.
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