Fertility testing is usually the first step in understanding why pregnancy may not be happening as expected. For many couples, it brings something invaluable: clarity.

Rather than a single test, fertility assessment is a carefully structured process that looks at how different aspects of your reproductive health are working together. Because conception involves both partners, testing is  recommended for both husband and wife.

At Child Fertility, our Oxford-trained fertility specialists take a thorough and evidence-based  approach, ensuring that each step is clearly explained and tailored to your individual needs.

What is fertility testing?

Fertility testing refers to a series of investigations designed to evaluate reproductive health in both men and women. These tests help identify any underlying conditions that may be affecting female fertility and male fertility, and guide the most appropriate next steps.

In many cases, there isn’t a single cause.  Fertility challenges can be linked to a combination of factors, including ovulation, sperm health, the fallopian tubes, and uterine environment, which is why a comprehensive and structured approach to testing is important.

When should you consider fertility testing?

Many couples conceive naturally within a year of regular, unprotected intercourse. If pregnancy has not occurred within this time, it may be helpful to explore further. 

In line with clinical guidance, you may consider fertility testing if:

• You have been trying to conceive for 12 months or more
  
• You are over the age of 35 and have been trying for 6 months or more
  
• You have irregular or absent menstrual cycles
  
• You have a known reproductive health condition (such as endometriosis or PCOS)
  
• You have experienced recurrent pregnancy loss
  
• The woman has undergone pelvic or abdominal surgery, or the man has experienced groin trauma or surgery. 
• Or it may be that you have concerns about your fertility and would like reassurance or clarity.
  
  

What does fertility testing involve?

Fertility testing for couples typically includes a combination of assessments based on your medical history, symptoms, and individual circumstances. Investigations are usually introduced step by step, beginning with the most informative and least invasive tests.

Fertility testing for women

• Hormone blood tests: Blood tests are used to assess ovulation and hormone balance. This may include measuring progesterone (to confirm ovulation), thyroid hormones, testosterone and prolactin levels.
• Pelvic ultrasound: Provides a clear view of the uterus and ovaries to help identify conditions such as fibroids, ovarian cysts, or features of polycystic ovaries.
• Fallopian tube assessment: Tests such as HyCoSy (ultrasound-based test) may be used to check whether the fallopian tubes are open and functioning.
• Ovarian reserve testing: Tests such as anti-Mullerian hormone (AMH) and antral follicle count (AFC) give an indication of the number of eggs.

Importantly, these ovarian reserve tests were originally developed to predict how the ovaries may respond to IVF treatment, rather than to predict natural fertility. Results are therefore interpreted carefully, alongside age and overall health. 

• Uterine assessment: In selected cases, further tests such as a sonohysterogram or hysteroscopy may be recommended to assess inside the uterus in more detail.
• Genetic testing: Genetic testing is not routine but may be considered in specific situations, such as recurrent pregnancy loss or certain medical histories.

Fertility testing for men

• Semen analysis: A semen analysis is usually the first and most important test. It evaluates sperm count, movement (motility), and shape (morphology).
• Hormone testing: In some cases, blood tests may be used to check the levels of hormones such as testosterone and others involved in sperm production.
• Imaging: A scrotal ultrasound may be used where there is suspicion of structural issues, such as varicocele.
• Genetic testing: Genetic tests may be recommended in selected situations, particularly in cases of very low sperm count or azoospermia.
• Additional tests: More specialised investigations, such as post-ejaculatory urinalysis are considered when clinically indicated.

Individualised Approach

Fertility testing is about identifying the most appropriate investigations for your individual circumstances, guided by clinical evidence and specialist expertise. 

For many couples, the process brings reassurance. For others, it provides clear direction. In both cases, the goal is the same – to help you move forward with understanding and confidence. 

Take the first step

If you are considering fertility testing in Saudi Arabia, or would like to better understand your reproductive health, seeking early guidance can be a positive and empowering step. 

At Child Fertility, we offer comprehensive assessments, clear communication, and personalised care to help you decide your next step with confidence.