When a couple is unable to conceive after a period of regular unprotected sexual intercourse, starting a fertility study early on allows possible causes to be identified and avoids unnecessary delays, especially when time is an important factor.
An initial well-structured basic study provides key information for making decisions with greater certainty from the beginning.
When is it recommended to start a fertility study?
In general, it is recommended to consult a fertility specialist if pregnancy has not been achieved after 12 months of trying unsuccessfully. In the case of women over 38 years of age, or when there is a medical history that may affect fertility, this period is usually reduced to 6 months.
In each case, the right time to start testing should be assessed on an individual basis.
The medical interview
The fertility study begins with a detailed conversation with the specialist to review the medical and reproductive history of both partners.
In women, aspects such as the regularity of the menstrual cycle, gynaecological history, previous pregnancies, surgeries, possible hormonal alterations and lifestyle habits are analysed. As for men, there is an assessment of factors that may influence semen quality.
This information is essential for deciding which tests are necessary in each case.
Initial tests for women
Basic tests for women aim to evaluate both the functioning of the ovaries and the condition of the reproductive system.
Hormone analysis provides information on how the hormonal system is functioning and estimates the ovarian reserve . It usually includes the determination of anti-Müllerian hormone (AMH), a key marker of the number of available oocytes, as well as other hormones such as FSH and estradiol, which provide information on the ovarian response. Some cases require an analysis on LH, prolactin and thyroid hormones, as alterations in these values can influence ovulation and the ability to achieve pregnancy.
Transvaginal ultrasound is a simple and usually performed test that examines the uterus and ovaries. It can detect abnormalities such as fibroids or polyps and count antral follicles, a key information for estimating the ovarian reserve.
Some cases, depending on the initial findings or the patient's history, may require additional tests to study the uterus and fallopian tubes in more detail. These include hysteroscopy, which allows the inside of the uterus to be visualised and detect any abnormalities that may affect the implantation, and HyFoSy, an ultrasound test used to check whether the fallopian tubes are permeable.
These examinations are not always necessary from the start, but they can provide relevant information to complete the study and guide patients to the most appropriate treatment.
Initial tests for men
Seminogram is a basic test for assessing male fertility. It analyses characteristics of the semen such as quantity, mobility and shape of the sperm.
As male factor is part of a significant percentage of infertility cases, early testing becomes key to make decisions and avoid unnecessary delays.
Why is it important to perform these tests from the start?
A complete initial study allows to identify hormonal, structural or semen quality-related alterations that may be hindering pregnancy. It helps to define the next steps more clearly, whether that means further testing, starting a specific treatment or evaluating assisted reproduction techniques.
At Barcelona IVF , the initial study is key to support the couple from the start, providing clear information, individualised decisions and a tailored plan for each situation.
Dr Cristina Guix
Gynaecologist specialist in fertility at Barcelona IVF
