Understanding Fertility Tests in the UK: Your Guide to Taking Control

Kuon Healthcare
Jul 18
5 min read

Updated: Jul 29

Facing fertility challenges can be an emotional journey. However, understanding the steps to take is a powerful stride towards clarity and solutions. In the UK, a range of fertility tests is available for both men and women. These tests, offered through the NHS and private clinics, are designed to pinpoint potential issues and guide effective treatments.

Knowing what to expect and where to seek accredited help is crucial. The Human Fertilisation and Embryology Authority (HFEA) is the UK's independent regulator of fertility treatment and research. They license and inspect clinics to ensure high-quality care, making them an excellent resource for finding reputable providers [^1].

Understanding Fertility: The First Steps

When facing fertility challenges, it is essential to understand the available options. Many couples feel overwhelmed at the start. However, knowing where to turn for help can ease some of that anxiety.

When to Seek Help

The NHS generally advises couples to see a GP if they haven't conceived after one year of regular, unprotected sex. For women aged 36 or over, or if there is a known clinical cause or history of predisposing factors for infertility (e.g., previous cancer treatment, STIs), it is recommended to seek medical advice sooner [^2].

Your GP is the first port of call. They will discuss your medical and sexual history and lifestyle factors. They may conduct initial examinations or refer you for tests [^2].

Female Fertility Tests in the UK

Female fertility is complex. It involves ovulation, egg quality, and the health of the reproductive organs. Tests aim to assess these key areas.

1. Hormonal Blood Tests

Hormonal blood tests are often among the first investigations to assess ovulation and ovarian reserve.

Progesterone: A blood test typically taken around day 21 of a regular menstrual cycle (or 7 days before an expected period) to confirm that ovulation has occurred [^2].
Gonadotrophins (FSH & LH): If periods are irregular, these hormones, which stimulate the ovaries to produce eggs, may be measured. High FSH levels can sometimes indicate reduced ovarian reserve [^2].
Anti-Müllerian Hormone (AMH): This blood test is a key indicator of ovarian reserve – the number of eggs remaining in the ovaries. It provides valuable insight into fertility potential and can also be helpful in detecting Polycystic Ovary Syndrome (PCOS) [^3].
Thyroid Function Tests (TSH) and Prolactin: These hormones can also impact fertility and may be checked [^4].

2. Ovarian Reserve Assessment

Beyond AMH, clinics may also assess ovarian reserve through:

Antral Follicle Count (AFC): This is an ultrasound scan that counts the number of small follicles in the ovaries, which contain immature eggs. A higher AFC generally indicates a better ovarian reserve [^3].

3. Imaging Scans

Imaging scans play a crucial role in assessing female fertility.

Transvaginal Ultrasound Scan: An internal ultrasound is used to examine the uterus and ovaries. It can identify structural issues such as fibroids, polyps, ovarian cysts, or signs of endometriosis [^3].
Tubal Patency Tests: These tests check if the fallopian tubes are open, as blocked tubes can prevent sperm from reaching the egg or the fertilised egg from reaching the uterus.

- Hysterosalpingo-contrast-sonography (HyCoSy): A liquid is passed through the cervix into the fallopian tubes, and its movement is tracked with ultrasound.

- Hysterosalpingogram (HSG): An X-ray procedure where dye is injected into the uterus and fallopian tubes.

4. Infection Screening

Infection screening is another vital aspect of female fertility testing.

Chlamydia Test: This sexually transmitted infection (STI) can cause pelvic inflammatory disease and blockages in the fallopian tubes, affecting fertility. A swab or urine test may be used [^2].

Male Fertility Tests in the UK

Male fertility primarily relies on sperm production, quality, and delivery. Understanding these factors is essential for effective testing.

1. Semen Analysis

Semen analysis is the cornerstone of male fertility testing and is often one of the first tests performed. It assesses:

Sperm Count: The number of sperm per millilitre of semen.
Sperm Motility: The percentage of sperm that are moving and how well they move.
Sperm Morphology: The percentage of sperm that have a normal shape.
Semen Volume and pH: Other characteristics of the ejaculate.

It's usually recommended that a man abstains from ejaculation for 2-5 days before providing a sample for semen analysis to ensure accurate results.

2. Hormonal Blood Tests

Similar to women, men may have blood tests to check hormone levels that influence sperm production. These include:

Follicle-Stimulating Hormone (FSH)
Luteinising Hormone (LH)
Testosterone
Prolactin

These tests can help identify hormonal imbalances affecting sperm production [^5].

3. Physical Examination

A doctor may perform a physical examination to check for any abnormalities in the testicles or surrounding structures. For example, varicoceles (enlarged veins in the scrotum) can affect sperm production [^5].

4. Post-Vasectomy Semen Analysis

For men who have undergone a vasectomy, a semen analysis is crucial to confirm the absence of sperm, indicating successful sterilisation [^6].

Where to Get Tested: NHS vs. Private Clinics

When considering fertility testing, understanding the options available is essential.

NHS: Your GP can refer you for initial tests. If further investigations or treatment are needed, you may be referred to an NHS fertility clinic. Eligibility criteria for NHS-funded treatment can vary by Integrated Care Board (ICB).
Private Clinics: Many accredited private clinics offer comprehensive fertility assessments and treatments, often with shorter waiting times. When considering a private clinic, always ensure they are licensed and regulated by the HFEA [^1].

Understanding your fertility is a vital step. With the range of accredited tests and support available in the UK, individuals and couples can gain clarity and move forward on their path to parenthood.

Accredited Sources for Fertility Information

When seeking information or services related to fertility tests and treatment in the UK, it's crucial to rely on reputable and accredited sources. Here are some key organisations:

Human Fertilisation and Embryology Authority (HFEA): The UK's independent regulator of fertility treatment and research. They license and inspect clinics, providing a vital resource for ensuring high-quality care and helping patients choose a clinic. [^1]
NHS: The National Health Service provides comprehensive and trustworthy information on diagnosing infertility, including various tests and treatment pathways for both men and women. [^2]
Royal College of Obstetricians and Gynaecologists (RCOG): This professional body sets standards for training and clinical practice in obstetrics and gynaecology, offering expert guidelines on the assessment and management of subfertility. [^4]
Imperial College Healthcare NHS Trust: A recognised centre for male reproductive endocrinology and an European Academy of Andrology (EAA)-accredited centre, offering expertise in male fertility. [^5]
North West London Pathology (Andrology Department): Part of Imperial, this department is an internationally recognised centre in the diagnosis, treatment, and research of male infertility, licensed by the HFEA. [^6]
University College London Hospitals (UCLH) NHS Foundation Trust: Their fertility and reproductive medicine laboratory provides essential services like semen analysis and sperm storage. [^7]
HCA Healthcare UK: While a private provider, their detailed resources on fertility screening offer clear explanations of tests and assessments. [^3]

Conclusion

Navigating fertility challenges can feel daunting. However, understanding the tests available and where to seek help is crucial. With the right information and support, individuals and couples can take proactive steps towards their fertility journey.