Fertility Tests for Men and Women: Types, Cost, Procedure & Results

What Are Fertility Tests and Why Are They Important for Men and Women?

Fertility tests are medical investigations used to understand factors that may affect a person’s ability to conceive. There is no single test that can give a complete picture of fertility. For women, evaluation may look at ovulation, ovarian reserve, the uterus and the fallopian tubes. For men, the initial assessment usually includes a reproductive history and semen analysis, followed by other tests if required. When a couple is being evaluated for infertility, both partners should generally be assessed rather than assuming that the issue is related to only one partner.

The purpose of fertility testing is not simply to label a test result as “normal” or “abnormal”. It helps the fertility specialist understand what may be contributing to difficulty conceiving and decide whether further evaluation or treatment is needed.

What Fertility Tests Are Done for Women?

A fertility test for women may include blood tests, ultrasounds and, when needed, tests for the fallopian tubes or uterus. The tests recommended depend on your age, menstrual cycle and medical history.

Blood Tests for Female Fertility and Hormone Levels

Blood tests can provide information about ovarian function, ovulation and certain hormonal conditions that may affect fertility.

AMH (Anti-Müllerian Hormone):AMH is commonly used as a marker of ovarian reserve or the number of remaining eggs. It can be measured at different points in the menstrual cycle. However, AMH mainly provides information about egg quantity and should not be interpreted as a standalone measure of fertility or egg quality.

FSH (Follicle-Stimulating Hormone): FSH may be measured during the early part of the menstrual cycle, often along with estradiol, when assessing ovarian function.

LH (Luteinising Hormone):LH plays an important role in ovulation. Testing may be recommended when there are concerns about irregular cycles or ovulatory problems.

Estradiol: Estradiol may be measured alongside FSH during the early follicular phase to help assess ovarian function in specific clinical situations.

Progesterone: A progesterone test may be used during the luteal phase to help assess whether ovulation has occurred.

Prolactin: Raised prolactin levels can interfere with menstrual cycles and ovulation. This test is generally recommended when symptoms or menstrual irregularities suggest that it may be relevant, rather than as a routine test for everyone.

Thyroid tests: Thyroid-stimulating hormone (TSH) may be checked because thyroid disorders can affect menstrual function and fertility.

Ultrasound Tests to Evaluate the Ovaries and Uterus

Ultrasound is an important part of female fertility evaluation because it allows the doctor to look at the ovaries, uterus and surrounding reproductive structures.

Transvaginal ultrasound: A small ultrasound probe is inserted into the vagina to obtain detailed images of the uterus and ovaries. It can help identify conditions such as fibroids, ovarian cysts and other structural abnormalities.

Pelvic ultrasound: Depending on the clinical situation, a pelvic ultrasound may be performed to assess the reproductive organs and look for abnormalities.

Antral Follicle Count (AFC): During a transvaginal ultrasound, the small antral follicles in the ovaries can be counted. AFC, along with AMH, is one of the commonly used markers of ovarian reserve and can help doctors anticipate ovarian response during fertility treatment.

Tests to Check the Fallopian Tubes and Uterus

Blocked fallopian tubes or abnormalities within the uterine cavity can affect conception or implantation. Specific tests may therefore be recommended when clinically indicated.

HSG (Hysterosalpingography): HSG is an X-ray-based procedure in which contrast dye is introduced through the cervix to assess the uterine cavity and whether the fallopian tubes are open.

HyCoSy: Hysterosalpingo-contrast sonography uses ultrasound with a contrast medium to assess the uterus and fallopian tubes without using an X-ray.

SIS (Saline Infusion Sonography): Also called sonohysterography, this test involves introducing sterile saline into the uterus during an ultrasound. It can provide a clearer view of the uterine cavity and help identify abnormalities such as polyps or fibroids.

Hysteroscopy: A thin camera is passed through the cervix to directly examine the inside of the uterus. It may be recommended when an abnormality is suspected or when treatment of a uterine cavity problem is required.

Tests to Check Ovulation and Ovarian Function

Ovulation is an important part of natural conception, so doctors may assess whether and when ovulation occurs.

Ovulation tracking: Menstrual history and ovulation predictor kits may help identify the fertile period in appropriate cases.

Follicular monitoring: A series of ultrasound scans can track follicle development and help determine whether and when ovulation is occurring. It may also be used when monitoring treatment with fertility medicines.

Progesterone testing: A blood progesterone test taken at the appropriate point in the menstrual cycle can provide evidence that ovulation has occurred.

Women with regular menstrual cycles may not need extensive ovulation testing unless there are other concerns. The exact approach depends on the individual clinical picture.

What Fertility Tests Are Done for Men?

A fertility test for men usually starts with a semen analysis and medical history. Additional tests may be recommended based on the results, symptoms or other fertility concerns.

Semen Analysis to Check Sperm Health

Semen analysis is usually the first and most important fertility test for men. It examines a semen sample in a laboratory to assess different aspects of sperm health.

The test generally evaluates:

• Sperm concentration: The number of sperm present per unit volume of semen.
• Sperm motility: How well the sperm moves. Movement is important because sperm needs to travel through the female reproductive tract to reach the egg.
• Sperm morphology: The size and shape of sperm.
• Semen volume: The amount of semen in the sample.

A semen analysis provides useful information about male reproductive potential, but a single result does not necessarily give a complete picture of fertility. Results also need to be interpreted in the context of the individual’s history and other findings.

Sperm DNA Fragmentation Test to Assess Sperm DNA Quality

Sperm DNA fragmentation testing assesses the integrity of genetic material within sperm. It may be considered in selected situations, such as certain cases of recurrent pregnancy loss or repeated unsuccessful fertility treatment, depending on the specialist’s assessment. It is not generally required as a routine first-line fertility test for every man.

Hormone Tests to Evaluate Male Fertility

Hormone testing may help identify hormonal causes of abnormal sperm production or other reproductive concerns.

Depending on the clinical situation, a doctor may recommend:

• Testosterone
• FSH
• LH
• Prolactin

These tests are generally interpreted together with the medical history, physical examination and semen analysis rather than in isolation.

Ultrasound and Imaging Tests for Male Fertility

Imaging is not required for every man undergoing a fertility evaluation. It may be recommended when the doctor suspects a structural problem.

Scrotal ultrasound: This can help examine the testicles and surrounding structures for abnormalities.

Scrotal Doppler: Doppler imaging can assess blood flow and may be useful when conditions such as varicocele are suspected.

Testicular assessment: A physical examination and, where needed, imaging can help evaluate testicular size, structure and other findings that may affect sperm production.

Genetic Tests for Male Infertility

Genetic testing may be recommended when there are specific indications, particularly in men with very low or absent sperm counts or certain clinical findings.

Depending on the situation, testing may include:

• Karyotyping: Examines the number and structure of chromosomes.
• Y-chromosome microdeletion testing: Looks for specific genetic changes associated with impaired sperm production.
• Other clinically indicated genetic tests: These may be recommended based on the individual’s history, examination and test results.

Genetic testing is therefore not a routine fertility test for every man. The decision depends on the underlying clinical concern.

How Much Do Fertility Tests Cost for Men and Women?

The fertility test cost can vary depending on the type of test, the laboratory or diagnostic centre, location and whether multiple investigations are advised together.

What Is the Cost of Fertility Tests for Women?

The following table can be used for the current centre-specific prices:

Female Fertility Test	Estimated Cost in India
AMH Test	₹1,000–₹2,500
FSH/LH	₹800–₹1,500
Progesterone	₹300–₹600
Ultrasound	₹800–₹2,000
AFC	₹1,000–₹2,500
HSG	₹3,000–₹8,000

Note: Fertility test prices may vary depending on the centre, test type and individual requirements. Some patients may need only a few investigations, while others may require a more detailed evaluation.

What Is the Cost of Fertility Tests for Men?

The cost of male fertility testing depends on the investigations advised.

Male Fertility Test	Estimated Cost in India
Semen Analysis	₹300–₹1,000
Sperm DNA Fragmentation Test	₹4,000–₹8,000
Hormonal Profile	₹1,000–₹2,500
Scrotal Ultrasound/Doppler	₹1,000–₹2,500
Genetic Tests	₹3,000–₹10,000+

Not every man needs all of these tests. Semen analysis test is generally part of the initial male fertility evaluation, while advanced testing is recommended when there is a clinical reason to do so.

Who Should Undergo Fertility Testing?

Fertility testing may be worth considering if:

• You have been trying to conceive without success for 12 months if the woman is under 35.
• You have been trying for 6 months if the woman is 35 or older.
• The woman is over 40 and you want to assess fertility without waiting.
• Periods are irregular, absent or unusually short or long.
• There is a known or suspected condition affecting the reproductive system.
• There is a history of recurrent pregnancy loss, previous fertility treatment or a condition that may affect fertility.
• There are concerns about sperm health, sexual function or previous conditions that may affect male fertility.

Understanding Your Test Report and Normal Ranges

A fertility test result is not simply about being normal or abnormal. One result outside the reference range does not necessarily mean you cannot conceive, while a normal result does not guarantee pregnancy.

For example, semen analysis looks at sperm count, motility and morphology together. Similarly, AMH and AFC indicate ovarian reserve but do not directly predict natural fertility. Your fertility specialist will consider these results along with your age, medical history and other findings to understand the bigger picture.

What Happens After the Test?

Once your fertility tests are complete, the next step is usually to review the results with a fertility specialist.

Depending on the findings:

1. Your results may be reassuring: No significant fertility-related concern may be identified, and you may be advised to continue trying naturally or follow up as appropriate.
2. A possible cause may be identified: Your doctor may recommend treatment or additional evaluation based on the findings.
3. More tests may be needed: Some results need to be confirmed or investigated further before a treatment decision is made.
4. Fertility treatment may be discussed: Depending on the diagnosis, age and duration of infertility, options such as ovulation induction, IUI or IVF may be considered.

The aim of fertility testing is not to order every available investigation. It is to identify the relevant factors and use that information to make a sensible treatment plan.