Updated by the Progyny Editorial Team. Reviewed by Dr. Janet Choi, Chief Medical Officer, Progyny — December 2025.
When starting your family building journey, the first step is to understand your health and fertility profile.
Your reproductive endocrinologist will talk with you about your goals with fertility treatment and ask questions about your medical and reproductive history. You’ll also discuss diagnostic testing (it may take up to a month to complete testing and get results).
Diagnostic tests will help your team create a personalized treatment plan for both you and/or your partner. Choosing the most effective treatments for your unique needs will increase your chances of achieving your goals.
Ovarian reserve
During a fertility evaluation, your doctor may use blood tests and/or an ultrasound to estimate your egg supply, often called ovarian reserve. Everyone born with ovaries has all their eggs at birth, and this supply naturally decreases with age. (This is unlike sperm, which is produced continuously after puberty.)
The estimate for how many eggs remain does NOT measure how fertile you are or guarantee your chances of pregnancy. It’s simply information to help your doctor choose the safest and most effective medicine doses if you go forward with fertility treatment.
Bloodwork to estimate ovarian reserve may include:
- Anti-Müllerian hormone: This can be done on any day of your cycle
- Estradiol or follicle-stimulating hormone: Tested on the 2nd or 3rd day of your natural menstrual cycle (only if you’re not on the pill or hormonal support)
- Thyroid-stimulating hormone: To screen thyroid function
- Prolactin and testosterone: If you have irregular or absent menstrual cycles
Ultrasound
A transvaginal ultrasound is used to perform an antral follicle count, or how many follicles are in the ovaries. This is a rough indicator of ovarian reserve. An ultrasound may also allow your doctor to learn if you have any growths (like non-cancerous cysts) in the ovaries.
Transvaginal ultrasounds may also be used to check the thickness of the uterine lining, as well as the shape of your uterus. Your doctor will be able to see if there are any growths (like polyps or fibroids) that might affect your fertility.
Uterus and fallopian tubes
It’s important to find out if there are any issues in the uterus or fallopian tubes that are making it difficult to become pregnant or maintain a pregnancy.
Depending on your family building goals and medical history, your doctor may recommend tests including:
- Hysterosalpingogram (HSG): An x-ray that uses contrast dye to check for blockages in the fallopian tubes and look for signs of uterine fibroids, polyps, scar tissue, or other problems in the uterus
- Sonohysterogram (SIS): A transvaginal ultrasound that is done while your uterus is filled with saline solution, to better see the inside of the uterus
- Hysteroscopy: A visual exam of the inside of the uterus using a small, lighted tube inserted through the vagina
Sperm quality
Your doctor will also assess the fertility of a partner with sperm.
The first step is a semen analysis, which evaluates the number, movement, and shape of the sperm.
For additional testing, the partner producing sperm may be referred to a reproductive urologist, who specializes in male fertility. Tests may include ultrasounds or hormone tests.
Genetic testing
Fertility testing includes genetic testing to identify if you or your partner carries any genetic disorders or mutations. Finding potential genetic issues early can be helpful in your fertility journey.
Moving forward after fertility testing
Fertility tests will give you and your doctor essential insight into your fertility profile (and your partner’s fertility profile). And this will help you work together on a personalized treatment plan. Be sure to ask any questions along the way!
You can always ask your Progyny Care Advocate for guidance, as well.
Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.