Female fertility tests

If you have tried to conceive naturally for at least one year (regular sex without birth control), carrying out some tests is a good idea.

The female reproductive system tends to be more complex than the male. As a result, there are more first-line tests a woman should do to determine her fertility status. These tests usually involve inspecting key reproductive hormones, and checking the fallopian tubes are intact. 

Diagram of the female reproductive system, drawn with Chinese calligraphy, TCM Healthcare — London fertility clinic

Our tests

We will explain the results to you and explore your options if there are issues. As a reputable laboratory carries out our tests, the results are accepted by doctors and clinics across the world. Most results are available between 1 and 3 working days.

Have a look at our comprehensive set of pathology tests.

Female fertility profile (hormonal imbalance) test

This is a first-line blood test to check fertility status. It tests these major hormones, which are involved in reproduction:

  • FSH (follicle-stimulating hormone)

  • LH (luteinising hormone)

  • Prolactin

  • Oestradiol (17-beta)

These hormones’ levels can be improved, sometimes substantially.

FSH

When a woman goes into menopause, she is running out of eggs in her ovaries. The brain senses the low oestrogen environment, and the pituitary gland releases more FSH to stimulate the ovaries to produce good follicles and oestrogen. Think of it like stepping on the gas pedal in the car to get it going: The FSH is the gas, and the pituitary gland releases FSH to get a follicle “going” at the beginning of every menstrual cycle. If there are fewer or lower quality follicles left, the amount of “gas” has to be increased to develop a follicle.

Prolactin

High prolactin levels can interfere with ovulation, making it intermittent or take longer to occur. Signs can be infrequent or irregular periods.

Another issue can be a deficiency in the amount of progesterone produced after ovulation, which may result in a uterine lining less able to support or sustain an embryo implant. An indicator of this is your period coming shortly after ovulation. 

Oestradiol (17-beta)

Oestradiol (17-beta), a form of oestrogen, is the main hormone involved in female production. If you have low oestrogen levels, it probably means: Your ovaries are not getting the proper signals, or they are not physically capable of releasing your eggs.

Low oestrogen levels can suppress ovulation altogether or cause other fertility-related problems, such as the uterine lining not thickening, which is required for fertilised egg implantation.

Fee

£140

Includes a report, follow-up phone call to explain the result and to talk about potential treatments.

How long do results take?

Next working day

When can I do the test?

  • Monday to Friday 7am–6.30pm

  • Saturday 9am–4.30pm

Test conditions

If you are using contraceptives, it’s best to stop and wait until your first cycle starts.

You should come in on day 2, 3 or 4 of your cycle — day 1 being the first day of menstruation.

AMH (anti-Mullerian hormone) test

This is sometimes used as a test for menopause, early menopause and polycystic ovary syndrome (PCOS). It is a must-do test prior to egg freezing and IVF.

If you’re looking to do IVF, chances are you will have come across the abbreviation AMH. This stands for anti-Mullerian hormone, a hormone found in the blood, produced by granulosa cells in ovarian follicles. It is also referred to as an ovarian reserve test.

AMH is a proxy reading of your egg reserve. It is often combined with a Female fertility profile test which gives an indication of your egg quality.

The ovarian reserve refers to a woman’s supply of eggs and is closely associated with ability to become pregnant. However, it is important to note that good egg reserve is necessary for IVF but it is less important for natural pregnancy. The orthodox medical view is a woman is born with all the eggs she will ever have, unlike men, who continually produce sperm. So, as a woman ages, her egg numbers decline. The greater the number of remaining eggs, the better the chances of conception.

If you are in your twenties or thirties, and are experiencing perimenopause or suspect you may be having early menopause, this test is sometimes used as it is a relatively inexpensive way of giving you an indicative reading to see if further tests are warranted. 

What the test results mean

Exceptionally low AMH: Menopause and early menopause

Exceptionally low AMH means your egg reserve is very low. While it correlates with menopause, it should not be the sole basis for judgement since other hormones such as FSH and oestradiol (17-beta), as well as your menstrual cycle’s patterns, are also important.

An exceptionally low AMH score would mean IVF will be difficult to carry out and lower IVF success rate.

Low AMH: Perimenopause

A low AMH means your egg reserve is low. This is particularly important for assisted reproductive techniques (ART) as a low egg reserve means your ovaries are unlikely to respond well and produce enough eggs for IVF or freezing.

It is worth noting low AMH is increasingly used as a predictor for natural pregnancy success. This can be misleading and seems to stem from ART reasoning, which may not apply in this context.

Good AMH: Satisfactory fertility status

A good AMH score means your egg reserve is satisfactory. This is a pre-requisite for IVF or egg freezing success.

Exceptionally high AMH: PCOS

The AMH test is sometimes used as part of a diagnostic tool kit to see if you have polycystic ovary syndrome (PCOS). A proper diagnosis will involve other hormone tests, such as testosterone. Further diagnostic tool may involve an antral follicle scan (we can help arrange these). It should also be interpreted in light of your menstrual and reproductive history. 

Gynaecologists and IVF clinics seem to think AMH cannot be altered. They are therefore unlikely to administer medication to help. However, we at TCM Healthcare have an excellent track record of helping women improve AMH, either to increase it in order to improve egg freezing or IVF success chances or to decrease it in order to help PCOS patient to regain hormonal imbalance. These results have been confirmed by IVF specialists.

Fee

£105

Includes a report, follow-up phone call to explain the result and to talk about potential treatments.

How long do results take?

Next working day

When can I do the test?

  • Monday to Friday 7am–6.30pm

  • Saturday 9am–4.30pm

Testing conceptions

If you are using contraceptives, it’s best to stop and wait until your first cycle starts.

Otherwise, any time during your cycle.

Egg freezing test

If you’re looking to do egg freezing or IVF (which often involves freezing eggs), it is almost certain that your consultant will ask you to do an AMH test. The reason being that what he is most interested in is to see how good your egg reserve is.

AMH test result is a proxy reading of your egg reserve. This in turn gives an egg freezing/IVF specialist a good idea of how many eggs he is likely to collect when you are under hormonal stimulation.

AMH test is therefore a prerequisite for egg freezing.

While AMH test tells you your egg reserve and quantity, the female fertility profile test gives an indication of your egg quality since if your key reproductive hormones are at the right level and are in balance, your egg quality is likely to be good.

Hence, AMH and the Female fertility profile tests are the standard tests you may wish to go for as a first step for egg freezing.

Fee

£105 (AMH) + £140 (female fertility profile test) = £245

Includes a report, follow-up phone call to explain the result and to talk about potential treatments.

How long do results take?

Next working day

When can I do the test?

  • Monday to Friday 7am–6.30pm

  • Saturday 9am–4.30pm

Testing conceptions

If you are using contraceptives, it’s best to stop and wait until your first cycle starts.

Otherwise, any time during your cycle.

PCOS profile test

PCOS is characterised by:

  • A high number of small cysts in the ovaries

  • Irregular, missing or no periods

  • Hair loss or hair growth

Two hormone markers for PCOS are:

  • AMH

  • Testosterone

PCOS patients often have higher-than-normal AMH levels because small cysts in the ovaries generate AMH additional to that generated by the egg reserve. They also may have high testosterone, responsible for hair loss or hair growth.

Taking a female fertility profile test (See first test on this page) where periods are highly irregular or do not occur can be worthwhile.

After starting treatment, hormone retests will show how well you respond to it.

Fee

£180

Includes a report, follow-up phone call to explain the result and to talk about potential treatments.

How long do results take?

Next working day

Test conditions

If you are using contraceptives, it’s best to stop and wait until your first cycle starts. 

You can do this test anytime of your cycle.

Ovulation (progesterone) test

Ovulation is when one or more eggs are released from one of your ovaries. This happens towards the end of the time you are fertile between periods.

Each month, 15–20 eggs mature inside your ovaries. The ripest egg is released and swept into one of your Fallopian tubes, which connect your ovaries to your uterus. Your egg survives for less than 24 hours after you’ve ovulated, but sperm can survive for up to 7 days, so this means you don’t have to time sex to the exact moment you ovulate to get pregnant — you actually have a fertility window of about 6 days.

Progesterone is a female hormone produced by the ovaries during ovulation. It helps prepare the lining of the uterus (endometrium) to receive the egg if it is fertilised. Progesterone levels increase after ovulation and peak at day 21 of the menstrual cycle, so it is tested on that day to see if ovulation has occurred.

This is a good test for women who have irregular periods to check if they are ovulating. It is also a good proxy test for those who suspect they have polycystic ovary syndrome, as having it means ovulation is not happening.

Fee

£75

Includes a report, follow-up phone call to explain the result and to talk about potential treatments.

How long do results take?

Next working day

Test conditions

If you are using contraceptives, it’s best to stop and wait until your first cycle starts.

You should come in on day 7 before your next cycle — day 1 being the first day of your menstruation.

Menopause and early menopause test package

Menopause occurs when a woman’s ovaries stop producing an egg every 4 weeks. In the UK, the average age for a woman to reach menopause is 51, though some women experience it in their 30s or 40s.

Menstruation can sometimes stop suddenly when reaching menopause. However, it is more likely periods will become less frequent with longer intervals between each one, before they stop altogether.

A diagnosis of menopause is when there is no period for 12 consecutive months.

Perimenopause, or menopause transition, begins several years before menopause, when the ovaries gradually make less oestrogen. It lasts until menopause, the point at which the ovaries stop releasing eggs. It usually starts in a woman’s 40s, but can begin earlier.

Primary Ovarian Insufficiency (POI)

Primary Ovarian Insufficiency is a condition when the ovaries stop functioning normally in women under the age of 40. Women with POI don’t always stop menstruating and their ovaries do not always completely shut down. Having a POI diagnosis does not always mean pregnancy is impossible.

Having POI does not imply a woman is ageing prematurely. It simply means her ovaries are faltering.

The tests 

We recommend you do two tests if you think you’re in perimenopause or have POI:

  • AMH. Any time in your cycle. Research has shown that low AMH is associated with menopause.

  • Female fertility profile test: FSH, LH, Oestradiol (17-beta) and prolactin. Day 2, 3 or 4 of your cycle or anytime in your cycle if your period has not come for more than 2 months. Menopause or early menopause is often diagnosed if FSH and LH are too high and Oestradiol is too low.

Fee

£105 for AMH, £140 for a Female fertility profile test. Together they form a menopause profile.

Includes a report, follow-up phone call to explain the result and to talk about potential treatments.

How long do results take?

Next working day for each test

Test conditions

If you are using hormones such as HRT, it’s best to stop and wait until your first cycle starts or for two weeks.

Thyroid test

Normal thyroid function is vitally important for fertility. Our thyroid test looks at TSH (thyroid-stimulating hormone), FT3 and FT4 to make sure it is working well.

The menstrual cycle is much more complex than you might imagine. It is a carefully orchestrated process that provides a small window of opportunity for an egg to be fertilised by sperm each month. Thyroid problems can interrupt this process and result in an irregular, or even absent, menstrual cycle.

If thyroid hormone levels are not ideal, they cannot support the luteinising hormone that stimulates the ovaries to release eggs, which makes pregnancy impossible.

Hypothyroidism

Hypothyroidism is when your thyroid is under-active, i.e. not making enough hormones. This is indicated by TSH above the reference range and FT4 below.

It is usually caused by autoimmune thyroid disease, which is when the body’s immune system attacks the thyroid cells as though they were foreign invaders. The most common form is known as ‘Hashimoto’s thyroiditis’. Other causes include pituitary gland malfunction, genetics, radioactive iodine treatment, overdoes of antithyroid drugs and some health foods taken in excess (such as kelp). 

Hypothyroidism is treated by your doctor prescribing a synthetic version of FT4.

Hyperthyroidism

Hyperthyroidism is the opposite; a result of an over-active thyroid. It can affect anyone, but it is ten times more common in women than men. A lower TSH and a higher FT4 are indicators of it. This is usually treated by thionamides to slow the thyroid’s hormone production.

Fee

£85

Includes a report, follow-up phone call to explain the result and to talk about potential treatments.

How long do results take?

Next working day

Test conditions

If you are using contraceptives, it’s best to stop and wait until your first cycle starts.

C-reactive protein (CRP) test for severe period pain and PMS

A study conducted by the Department of Public Health Sciences at the University of California Davis, published in 2016, suggests period pain is measured by acute inflammation. This is measured by the C-reactive protein (CRP), which is produced in the liver and whose levels rise when there is inflammation in the body.

This study looked at whether raised levels of CRP were associated with the oft-reported feelings of dull, painful cramping many women feel before their period — a symptom of what is known as premenstrual syndrome (PMS). PMS is the name given to the pattern of physical, psychological and behavioural symptoms that can occur two weeks before a woman’s monthly period.

Overall, the study found middle-aged women with raised CRP levels had about a 26–41% increase in risk of the various PMS symptoms.

The CRP test is non-specific, but a good test for inflammation and monitoring recovery of inflammation if discovered.

Fee

£75

Includes a report, follow-up phone call to explain the result and to talk about potential treatments.

How long do results take?

Next working day

Other female fertility tests

Other tests offered:

  • Menopause profile

  • Recurring miscarriage profile

Book a test

Call us on: 020 7096 0283
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Disclaimer

While we are happy to explain your test results to you, we always advise consulting your GP and having a proper medical consultation about your result. This is because these tests are Western medical tests and are best explained by Western medical doctors. We do not accept any liability regarding interpretation of test results should you wish us help explaining them.

If you have booked a test and decide to change the time or date, we are more than happy to help you change it to one that is convenient to you at no extra charge. However, cancellation will carry a small administrative fee of £30, before refund.