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What Fertility Tests Are Done? A Complete Guide

Understanding your reproductive health is an important step for anyone planning to start or expand their family. A fertility screening is a series of diagnostic tests designed to evaluate reproductive function in both women and men, helping to identify any factors that may affect the ability to conceive.

SpringHill Clinic is a trusted women’s health clinic in Kuala Lumpur offering comprehensive fertility assessments tailored to every patient, whether actively trying to conceive or simply wishing to understand their fertility potential. 

Understanding Fertility Screening

A fertility screening is a comprehensive evaluation of reproductive health conducted by a doctor who have knowledge and experience in fertility. The process typically involves both partners, as male factors contribute to approximately 30% of infertility cases and play a role in about half of all cases overall.

According to the World Health Organization, approximately one in six people of reproductive age experience infertility during their lifetime. In Malaysia, fertility rates have been declining steadily, with the Department of Statistics Malaysia reporting a total fertility rate of 1.6 children per woman in 2022. 

When to Consider Fertility Testing

Fertility testing is generally recommended for couples who have been trying to conceive for 12 months without success if the woman is under 35, or six months if she is 35 or older. However, testing may be appropriate earlier if there are known risk factors such as irregular menstrual cycles, a history of pelvic inflammatory disease, endometriosis, or previous reproductive surgeries.

Fertility Tests for Women

Female fertility assessment involves several components that evaluate ovarian function, hormone levels, and the structural health of the reproductive organs.

Fertility Blood Tests

What blood test checks fertility? The primary blood tests used to assess female fertility include:

  • Follicle-stimulating hormone (FSH)
  • Luteinising hormone (LH)
  • Anti-Müllerian hormone (AMH)
  • Oestradiol
  • Progesterone
  • Prolactin
  • Thyroid-stimulating hormone (TSH)

FSH and LH are typically measured on days two to three of the menstrual cycle, while progesterone is assessed during the mid-luteal phase — approximately seven days before the expected period.

AMH testing has become particularly valuable because it provides an indication of ovarian reserve, reflecting the quantity of developing eggs in the ovaries.

Key points about AMH testing:

  • Unlike other fertility hormones, AMH levels remain relatively stable throughout the menstrual cycle and can be measured at any time.
  • AMH levels between 1.0 and 3.5 ng/mL typically indicate a favourable response to fertility treatments.
  • Lower AMH levels may suggest a reduced ovarian reserve, while higher levels could indicate conditions such as polycystic ovary syndrome (PCOS).
  • Results should always be interpreted alongside other fertility markers and clinical findings, not in isolation.

Ultrasound Examination

A transvaginal ultrasound at an ultrasound clinic is used to visualise the ovaries and uterus, allowing assessment of the antral follicle count, which provides additional information about ovarian reserve. The scan also helps identify any structural abnormalities, such as fibroids, polyps, or ovarian cysts that may affect fertility. 

Tubal Patency Assessment

A hysterosalpingogram (HSG) is an X-ray procedure that evaluates whether the fallopian tubes are open. During this test, a contrast dye is injected through the cervix into the uterus and fallopian tubes. If the tubes are patent, the dye will flow through and spill into the abdominal cavity, which is visible on the X-ray. Blocked fallopian tubes are a significant cause of infertility, as they prevent the egg and sperm from meeting.

The HSG also provides information about the shape of the uterine cavity, which can be helpful in identifying abnormalities that may contribute to recurrent pregnancy loss. 

Male Fertility Screening

Male fertility assessment is equally important, as sperm-related factors contribute to a substantial proportion of infertility cases. The evaluation typically begins with a semen analysis, which remains the primary test for assessing male reproductive potential.

Semen Analysis

Fertility is not solely a female concern. A semen analysis is one of the first tests recommended for male partners, as male factor infertility contributes to approximately 40–50% of all infertility cases.

The test evaluates several key parameters:

  • Sperm count — at least 15 million sperm per millilitre, or 39 million per ejaculate
  • Progressive motility — at least 32% of sperm should move forward effectively
  • Morphology — at least 4% of sperm should be normally shaped

These reference values are based on World Health Organization guidelines. Results outside these ranges don’t necessarily mean conception is impossible, but they can help identify issues that may benefit from treatment or lifestyle changes.

For accurate results, the sample should be collected after two to seven days of abstinence. If the initial analysis shows abnormalities, a repeat test is usually recommended after approximately three months — the time it takes for new sperm to fully develop.

Male Hormone Testing

If semen analysis reveals abnormalities, blood tests may be ordered to assess hormone levels. These include testosterone, FSH, LH, and prolactin. Low testosterone combined with elevated FSH and LH may indicate a problem with testicular function, while abnormal levels can sometimes be corrected with appropriate treatment.

What is Embryo Screening?

Embryo Screening

For couples undergoing in vitro fertilisation (IVF), preimplantation genetic testing (PGT) allows embryos to be evaluated before transfer to the uterus. This can help identify embryos with the strongest potential for a healthy pregnancy, reducing the risk of failed implantation, miscarriage, or inherited genetic conditions.

PGT is not routine for all IVF cycles. Your fertility specialist will discuss whether it may be appropriate based on your medical history, age, and family background.

Types of Preimplantation Genetic Testing

There are three main types of PGT, each designed to detect different genetic concerns:

  • PGT-A (aneuploidy screening) — checks for chromosomal abnormalities such as extra or missing chromosomes. Embryos with the correct chromosome count are more likely to implant successfully and develop into a healthy pregnancy. This test is often recommended for women over 35 or those with a history of recurrent miscarriage.
  • PGT-M (monogenic disorders) — used when there is a known genetic condition in the family, such as cystic fibrosis, sickle cell anaemia, or Fragile X syndrome. It identifies embryos unaffected by the specific mutation.
  • PGT-SR (structural rearrangements) — performed when a parent carries a chromosomal translocation or inversion. These rearrangements can increase the risk of embryos with abnormalities that may lead to miscarriage or birth defects.

Fertility Check-Up Cost in Malaysia

The cost of fertility testing in Malaysia varies depending on the specific tests required. Basic fertility assessments, including blood tests and ultrasound, typically range from RM250 to RM800 per partner. 

A comprehensive fertility screening package that includes multiple tests for both partners are available at various clinics across the country, with package prices generally starting from RM500 to RM1,400.

More advanced testing, such as HSG or genetic screening, incurs additional costs. It is advisable to discuss the full scope of testing with your fertility specialist to understand what is included and any potential additional expenses. 

SpringHill Clinic offers structured health screening packages in Malaysia that include fertility assessments, providing transparent pricing and comprehensive care.

What to Expect During Your Fertility Check-Up

Your first consultation will involve a detailed medical history review, including information about your menstrual cycle, previous pregnancies, medical conditions, medications, and lifestyle factors. Both partners will be asked about their general health and any previous reproductive concerns.

Physical examinations may be conducted, followed by the appropriate diagnostic tests. Most initial investigations, such as blood tests and ultrasound, are completed relatively quickly. Results are typically available within a few days to a week, depending on the specific tests performed.

Following the assessment, your fertility specialist will discuss the findings with you and recommend appropriate next steps. These may include lifestyle modifications, medication, surgical intervention, or assisted reproductive technologies, depending on the identified factors.

Preparing for Your Fertility Check-Up

Proper preparation can help ensure accurate test results. Women should note the dates of their menstrual cycles, as certain blood tests need to be performed on specific days. For semen analysis, men are typically advised to abstain from ejaculation for two to three days before the test, but not longer than five days.

It is helpful to compile information about your medical history, including any previous surgeries, current medications, and family history of genetic conditions or fertility issues. Bringing a list of questions to your appointment can also help you make the most of your consultation with your fertility specialist.

Key Takeaways

  • Fertility screening evaluates reproductive health in both partners through blood tests, imaging, and semen analysis
  • Female hormone tests, including AMH, FSH, and LH help assess ovarian reserve and function
  • Semen analysis measures sperm count, motility, and morphology to evaluate male fertility
  • Embryo screening can identify genetic or chromosomal abnormalities before embryo transfer during IVF
  • Basic fertility check-ups in Malaysia typically cost between RM250 and RM800 per partner
  • Early evaluation and consultation with a fertility specialist can help identify issues and guide treatment options

Take the Next Step

Starting your fertility journey can feel overwhelming, but you don’t have to navigate it alone. Our experienced team at SpringHill Clinic provides compassionate, confidential fertility assessments tailored to your unique needs. We’re here to support you every step of the way. Book an appointment today.