Medically reviewed by Dr. Shweta Agarwal, MBBS, DGO. Last updated: June 2026.
Information on this page is educational and does not replace a medical consultation. Outcomes depend on individual clinical factors.
A fertility workup is not a cause for alarm — it is simply gathering clear answers. The evaluation is planned and interpreted by Dr. Shweta Agarwal (MBBS, DGO), with on-site pathology and embryology lab support. In Marathi, this evaluation is known as वंध्यत्व तपासणी (infertility testing) — a phrase your doctor may use during consultation.
When should we get a fertility workup?
A fertility evaluation is recommended after a defined period of trying to conceive without success — the threshold depends on age, because egg quantity and quality decline with time.
- If the woman is under 35: after 12 months of regular, unprotected intercourse without conception.
- If the woman is 35 or older: after 6 months, as evaluation should not be delayed.
- Sooner — don't wait — if there are known risk factors: irregular or absent periods, PCOS, endometriosis, previous pelvic surgery or infection, two or more miscarriages, or a known male-fertility concern.
Either partner can be the starting point of an investigation. Testing early does not commit you to treatment — it simply tells you where you stand.
Why do both partners need to be tested?
Both partners are tested because infertility is, statistically, as likely to involve the man as the woman. Roughly a third of cases relate to a female factor, a third to a male factor, and the rest to a combination of factors or remain unexplained. Testing the couple together, from the start, gives the complete picture and avoids losing months investigating only one partner.
The male test — a semen analysis — is simple, non-invasive and quick, so there is no reason to defer it. Evaluating both partners in parallel is the fastest route to an accurate diagnosis and the right plan.
What tests are done for the woman?
The female evaluation checks three things: is she ovulating, how is her egg reserve, and are the uterus and tubes healthy?
Hormone profile & AMH (ovarian reserve)
Blood tests measure key hormones — FSH, LH, prolactin, TSH (thyroid), and AMH (anti-Müllerian hormone). AMH reflects ovarian reserve (the remaining egg supply) and helps predict how the ovaries may respond to fertility medication. Hormone bloods are often timed to specific cycle days (e.g. Day 2–3).
Transvaginal ultrasound & follicular tracking
A transvaginal ultrasound (TVS) examines the uterus and ovaries in detail, counts the antral follicles (another marker of ovarian reserve), and can detect conditions such as PCOS, fibroids or ovarian cysts. Follicular tracking — a short series of scans across the cycle — confirms whether a follicle is growing and ovulation is occurring.
HSG — fallopian tube patency
Hysterosalpingography (HSG) is an X-ray test that checks whether the fallopian tubes are open and the uterine cavity is normal, by passing a contrast dye through them. Blocked tubes are a common, treatable cause of infertility. HSG is quick (5–10 minutes) and usually causes only mild, period-like cramping.
Hysteroscopy — inside the uterus
Hysteroscopy uses a thin camera passed through the cervix to look directly inside the uterine cavity, identifying polyps, fibroids, adhesions or a septum that could interfere with embryo implantation. It is recommended when imaging suggests a uterine abnormality or after implantation failure.
Laparoscopy — the pelvis
Laparoscopy is a minimally invasive procedure that lets the surgeon view the pelvic organs directly. It is the definitive way to diagnose endometriosis and pelvic adhesions, and it can often treat what it finds in the same session. It is reserved for selected cases rather than used routinely.
What test is done for the man?
The cornerstone of male fertility testing is the semen analysis — a simple, non-invasive test that examines a semen sample for the factors that determine fertility:
- Sperm count (concentration): the number of sperm present.
- Motility: how well the sperm move.
- Morphology: the shape and structure of the sperm.
- Volume, pH and liquefaction: supporting measures of semen quality.
The sample is typically given after 2–5 days of abstinence. If the results are abnormal, the test is usually repeated for confirmation, and further evaluation for male infertility — hormone tests, sperm DNA fragmentation, or imaging — may be advised. Specialised sperm-function tests are used in cases of recurrent pregnancy loss or failed IVF.
What does the diagnostic journey look like, step by step?
The workup is designed to give you a clear diagnosis and a plan, usually within one menstrual cycle:
- Initial consultation: You meet Dr. Shweta Agarwal together as a couple. Bring any previous reports, scans or treatment records.
- History & examination: A detailed medical, menstrual, lifestyle and family history for both partners, with a clinical examination.
- Investigations: The relevant tests are scheduled — hormone bloods and ultrasound on specific cycle days, HSG after the period ends, and semen analysis any time after 2–5 days of abstinence.
- Results review: Your test results are interpreted together, correlating the numbers with your history rather than reading them in isolation.
- Personalised plan: You receive a clear explanation of the findings and a recommended path — which may be timed intercourse, lifestyle changes, ovulation induction, IUI, IVF, or further investigation.
If every test returns normal — which happens in a meaningful minority of couples — that "unexplained infertility" result is itself useful information that guides the next step.
What does a fertility workup cost?
The cost of a fertility workup depends on which tests are clinically indicated for you — a basic evaluation (hormone profile, ultrasound, semen analysis) costs less than one that includes HSG, hysteroscopy or laparoscopy. You are told which tests are recommended and why before anything is done, and you receive a transparent estimate up front.
See /costs-emi for current pricing information. Final cost depends on the tests clinically indicated for you.
- 0% EMI options are available for treatment that follows, if needed (3–24 months).
- See the IVF cost & 0% EMI page for treatment pricing and financing details.