Before having any fertility tests, it is essential for the doctor to take a comprehensive medical history. Starting from the woman’s age and menstrual cycles, questions are asked about -amongst others – past pregnancies, contraceptive use, tobacco and alcohol use, previous operations, medical conditions and medication use.

A recent smear test together with cultures of vaginal and cervical secretions as well as mammography if above 35 years of age are necessary.

A very important examination is the transvaginal scan which is accompanied by 3D imaging (3D ultrasound).

In cases of uncertainty about the possible presence of an intrauterine polyp or sub-mucosal fibroid, a sonohysterogram may be required or even a hysteroscopy .

Fertility testing is not complete without some blood tests (some of which need to be performed during specific days of the cycle) such as FSH, LH, oestradiol, prolactin and progesterone, thyroid testing including TSH, T3, T4 and anti-thyroid antibodies, while some other tests may be required in special cases (e.g. SHBG, DHEAS, testosterone, androstenedione).

We should not forget the measurement of AMH (Anti-Mullerian Hormone) which is very important in the assessment of the ovarian reserve.

Hysterosalpingography is one of the necessary fertility tests and determines the patency of the tubes. It can be done either by the classical method of taking X-rays in a radiology lab or by the newer, more patient-friendly method of HyCoSy (using ultrasound).

Depending on individual circumstances or findings from preliminary tests, further tests may be advised, like laparoscopy, karyotyping, thrombophilia screening, thyroid ultrasound, immunological screening and genetic testing (e.g. for cystic fibrosis mutations).