What is a fertility assessment?
A fertility assessment is a set of tests that looks for common, checkable reasons a pregnancy may be harder to achieve. It is not one test, and no single result says whether you can have a child.
What gets tested depends on who is being assessed and which package you book:
- Egg supply: an AMH blood test, often with an ovarian ultrasound.
- Hormones that affect ovulation: thyroid (TSH) and prolactin.
- Anatomy: a pelvic ultrasound, and in fuller packages a tube X-ray (HSG) and a camera look inside the uterus (hysteroscopy).
- Sperm: a semen analysis for the male partner.
AMH: what it measures and what it cannot
AMH (anti-Müllerian hormone) is made by the small follicles in the ovaries. Its level rises and falls with the number of those follicles. That is why it is used as a marker of ovarian reserve — roughly, how many eggs remain.
The catch is that egg number is not the same as the chance of getting pregnant. Each month usually releases one egg, so a lower count does not by itself stop a natural pregnancy. Age, not AMH, is the stronger guide to the chance of conceiving.
Where AMH is genuinely useful is in planning treatment. ASRM notes it predicts how many eggs are likely to be retrieved after IVF stimulation. ASRM also says the markers should not be used to promote egg freezing; that decision rests on your age and reproductive plans.
- A low AMH does not mean you cannot conceive naturally.
- A normal AMH does not mean you can wait indefinitely; age still matters most.
- One value is a snapshot, best read by a fertility specialist alongside age and history.
Thyroid and prolactin
Both hormones can disturb ovulation, which is why they appear in women's fertility packages. ASRM's 2021 guidance treats them differently:
| Test | What it checks | ASRM position |
|---|---|---|
| TSH | Whether the thyroid is under- or overactive | Listed among potential routine tests; important when periods are irregular or absent |
| Prolactin | A pituitary hormone that can suppress ovulation when high | Not routine; indicated with irregular or absent periods, or nipple discharge |
A raised result is a reason for a doctor to look further, not a diagnosis. The comprehensive blood panel page explains how TSH is read.
Semen analysis and the WHO reference values
A semen analysis measures how much semen there is, how many sperm it holds, how well they swim and what share look normal. Laboratories compare the numbers with the World Health Organization's 2021 manual.
| Measure | Lower reference limit |
|---|---|
| Semen volume | 1.4 mL |
| Sperm concentration | 16 million per mL |
| Total sperm number | 39 million per ejaculate |
| Total motility (any movement) | 42% |
| Progressive motility (swimming forward) | 30% |
| Vitality (live sperm) | 54% |
| Normal forms (shape) | 4% |
These figures come from men whose partners conceived naturally within a year. The fifth centile is the level below which only 5% of those men fell. That is why it is a reference point rather than a pass mark.
The WHO manual says plainly that these percentiles do not draw a line between fertile and subfertile men. Results from fertile and infertile men overlap substantially. The joint guideline of the American Urological Association and ASRM adds two practical points:
- One sample is not enough to judge. Semen varies a lot between ejaculates, so a second analysis, ideally a month or more later, matters if the first is abnormal.
- No single number decides fertility, apart from rare findings such as no sperm at all. Several abnormal values together raise the risk more than one does.
Ultrasound, HSG and hysteroscopy
Blood tests cannot show whether the tubes are open or the uterine lining is clear. Imaging can, and ASRM says tubal disease should be specifically excluded in an infertility work-up:
| Test | How it works | What it shows |
|---|---|---|
| Pelvic ultrasound | Sound waves, usually through a vaginal probe; no radiation | The shape of the uterus, the ovaries, and the small follicles that can be counted |
| HSG (hysterosalpingogram) | Contrast dye passed through the cervix, with X-ray pictures | Whether the fallopian tubes are open, and the outline of the uterine cavity |
| Hysteroscopy | A thin camera passed through the cervix into the uterus | Polyps, fibroids or scar tissue inside the cavity; ASRM calls it the definitive method |
HSG has its own limits. It shows only the inside of the uterus and tubes. ASRM notes it misses about half of polyps and fibroids inside the cavity, which is where hysteroscopy comes in.
When to seek an evaluation
The American Society for Reproductive Medicine (2023) sets the timing for couples with regular, unprotected sex and no known fertility problem:
| Female partner's age | Start an evaluation after |
|---|---|
| Under 35 | 12 months of trying without a pregnancy |
| 35 or older | 6 months of trying without a pregnancy |
ASRM's patient site lists reasons to seek advice sooner, without waiting:
- Irregular periods, or a risk of fallopian tube damage
- A family history of early menopause, or a condition that can cause it
- Past cancer treatment in either partner
- Testicular problems in childhood, or difficulty with sexual function
When both partners are trying together, ASRM advises evaluating both at the same time. Testing only one partner can miss the cause.
What a fertility assessment can't tell you
- An estimate of egg supply (AMH)
- Thyroid or prolactin problems that can disturb ovulation
- Blocked tubes, polyps, fibroids or scar tissue, when HSG and hysteroscopy are included
- Sperm count, movement and shape
- Your chance of conceiving naturally. No test predicts it; age and time trying matter most. A fertility specialist interprets the results together.
- Egg quality. AMH estimates how many eggs remain, not how healthy they are. Age remains the main guide.
- Whether ovulation is happening. That needs cycle-timed hormone tests a fertility doctor orders. The hormone tests page explains the panels.
- Inherited conditions. Carrier screening is a separate test; see genetic testing.
- Cervical health. Pap and HPV testing are part of a gynecology exam.
What to expect on test day
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1Before you bookTell your coordinator your cycle pattern and whether you could be pregnant. HSG is usually scheduled 7–10 days after a period starts, before ovulation. Your coordinator confirms timing when you book.
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2Blood draw and ultrasoundAMH, TSH and prolactin come from one blood sample. The pelvic ultrasound follows; it uses no radiation.
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3HSG and hysteroscopy, if includedBoth pass through the cervix. Brief cramping and a few days of spotting are common. HSG is not done with a possible pregnancy or an active pelvic infection.
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4Semen sample, for menWHO advises collecting after 2 to 7 days without ejaculation. The clinic gives the collection instructions; your coordinator confirms them when you book.
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5ConsultationA fertility doctor goes through the results. Whether that happens the same day, and in which language, is confirmed when you book.
Cost and coverage
The live prices further down this page are the booking prices at New Dawn Health, and each package lists what it includes. Anything billed separately is confirmed when you book.
- Screening in Taiwan is self-funded for visitors. Short-term visitors are not covered by Taiwan's National Health Insurance, so screening is self-funded.
- Reimbursement at home is a question for your insurer. Fertility testing may be covered only after a diagnosis of infertility. Ask them before you book.
Results and follow-up
- A report and a conversation. Your coordinator confirms when results arrive and who explains them.
- An abnormal semen result is repeated before conclusions are drawn, ideally a month or more later.
- A low AMH changes planning, not possibility. It can matter if you are considering IVF or egg freezing.
- A structural finding such as a blocked tube or a polyp goes to a fertility specialist or gynecologist for treatment options.
- Normal results do not end the question. If pregnancy has not happened within the ASRM timeframes above, a full evaluation is still worth having.
