What Tests Are Performed to Evaluate Fertility?

When to Begin a Fertility Evaluation

Leading medical societies in both the United States and Europe recommend starting fertility testing after 12 months of unprotected intercourse without achieving pregnancy—or after 6 months if the woman is 35 or older.

It’s also advisable to begin earlier if any of the following are present:

• Irregular menstrual cycles

• Gynecological surgeries

• Endometriosis

• Autoimmune diseases

• Previously diagnosed hormonal issues

What Is the First Appointment Like at Baja Fertility Services?

At Baja Fertility Services, the evaluation begins right from the first consultation with:

• A detailed medical history

• Physical examination

• Transvaginal pelvic ultrasound

This first step helps detect visible anatomical issues, estimate ovarian reserve through antral follicle count, and assess the condition of the uterine cavity.

Initial Hormonal Testing

In the first days of the menstrual cycle, key hormonal tests are ordered:

• Anti-Müllerian Hormone (AMH): Estimates ovarian reserve

• FSH, LH, and Estradiol: Assess ovarian function during the follicular phase

• Prolactin and TSH: Identify hormonal imbalances that may affect ovulation

Assessment of the Fallopian Tubes and Uterus

To evaluate the female reproductive anatomy, additional tests may include:

• Hysterosalpingography (HSG): An X-ray using contrast dye to examine the tubes and shape of the uterus

• Sonohysterography: A saline-infused ultrasound used to detect polyps, fibroids, or uterine adhesions

Male Fertility Evaluation

The initial test for men is a semen analysis (also called direct spermatobioscopy), which evaluates:

• Volume

• Sperm concentration

• Motility

• Morphology

If abnormalities are found, additional tests may be recommended, such as:

• Sperm DNA fragmentation

• Male hormonal studies

Additional Complementary Studies

In specific cases, additional evaluations may be required, such as:

• Genetic testing

• Chronic infection screening

• Endometrial biopsies

• Immunological exams

• Karyotyping (especially in cases of recurrent pregnancy loss or family history)

Personalized Evaluation, Not Standardized Protocols

It’s important to note that these studies are not routinely applied to all patients. Each test is recommended based on individual clinical analysis. The goal is not to run more tests, but to run the right ones — with precision and scientific backing.

At Baja Fertility Services, we strongly believe in personalized medical care. We do not follow generic protocols; instead, we adapt each step of the process to the clinical profile of each patient or couple, aiming for:

• Diagnostic efficiency

• Clarity in results interpretation

• Compassionate and professional support

Take the First Step Toward Motherhood

Understanding the root cause of the issue is the first step toward solving it. If you’ve been trying to conceive without success — or if you simply want to understand your reproductive health before planning a pregnancy — our team is here to support you in a professional, ethical, and compassionate environment.

REFERENCES

1. American Society for Reproductive Medicine (ASRM). Evaluation and treatment of infertility: a committee opinion. Fertil Steril. 2021;116(6):1396–1406.
2. European Society of Human Reproduction and Embryology (ESHRE). Female infertility guideline. 2023.
3. Asociación Mexicana de Medicina de la Reproducción (AMMR). Guía para el estudio de la pareja infértil.
4. American College of Obstetricians and Gynecologists (ACOG). Infertility Workup: Clinical Practice Bulletin No. 194. Obstet Gynecol. 2018;131(6):e237–e250.