Fertility Testing for Women

Female Fertility Assessment & Testing

Testing is one of the first steps when considering fertility preservation or treatment. Whether you’re encountering fertility problems for the first time, trying to overcome secondary infertility issues, or are interested in egg freezing or donor insemination, a thorough assessment at one of our clinics can lead you down the right path. From there, our expert medical team uses these results to create your custom fertility treatment plan.

We’ve outlined the most common fertility tests for women. Your personal medical team at Ontario Fertility Network will discuss the most appropriate ones for you.

Common Fertility Tests for Women

During your initial consultation appointment, after review of your medical history, our team will outline what tests are appropriate for you. Female fertility testing occurs during specific points in the menstrual cycle; we will walk you through how, when and where to carry out your testing. With lab and ultrasound onsite, many tests and all cycle monitoring can be done in-clinic This includes determining if and when ovulation is happening, as well as evaluating ovarian function and uterine lining.

At this stage, testing typically includes the following:

Ovulation & Hormonal Assessment

Ovulation Testing
Our reproductive specialists may analyze blood tests and ultrasounds to help determine if ovulation is occuring. A progesterone level blood test drawn on day 21 of the menstrual cycle is a common test to see if ovulation has occurred. A low progesterone level on day 21 of the menstrual cycle suggests that an egg was not produced that month.
Ovarian Functional Tests
These tests examine your hormones throughout your cycle, particularly during ovulation. These include Day 3 FSH (which measures the follicle stimulating hormone), Day 3 estradiol (which analyzes estrogen levels), an ultrasound, and blood tests.
Anti-mullerian Hormone (AMH) Testing

AMH is a blood test that evaluates a woman’s ovarian reserve. Essentially it gives us an idea of how many eggs you have in the bank. The reserve can range from high to very low (which you do not want). It also gives us an idea of if you are normal for your age. 

Hormone Testing
Hormones naturally fluctuate throughout your menstrual cycle. However, an imbalance in these hormones, and the timing of their fluctuations, may contribute to fertility challenges. Depending on the results from the above tests, additional blood work may be performed. Hormones that may be evaluated include luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, progesterone, prolactin, thyroid, testosterone, DHEAS, and androstenedione.
Ultrasound Tests

Ultrasound is a non-invasive technique to examine your internal organs in more detail. In the initial examination, an ultrasound test is used to assess the uterus and ovarian structures. Ultrasounds may also be used throughout your fertility journey to help guide your treatment plan. An ultrasound test may be used to observe the thickness of the uterine lining or follicle development.

A sonohysterogram allows your fertility team to perform a thorough check of the uterine cavity and tubal patency. The procedure involves the insertion of a tiny amount of saline (most times with a contrasting agent known as “echovist” for superior imagery), into the uterus, fallopian tubes and cervix. Then a transvaginal ultrasound is performed, examining the uterine structure. Similar to the hysterosonogram, this ultrasound is usually performed between days 5-11 of your menstrual cycle.

Additional Fertility Testing

If the initial phase of testing comes back normal, then your fertility team may investigate further. Some of the following tests may be prescribed, depending on your medical history and previous fertility challenges:
Hysterosalpingogram (HSG)

A hysterosalpingogram involves the insertion of a dye into the cervix, uterus, and fallopian tubes. An X-ray is then performed and examined by a radiologist. HSG’s are sometime done in peripheral hospital.


Intravenous sedation is used to avoid any discomfort or pain. Your fertility specialist will then examine the inside of the uterus, checking for any abnormalities, scarring, or growths. During this time, pictures can be taken to allow for further examination after the procedure is complete.

A hysterosonogram is a type of ultrasound used to check for blocked tubes or any growths in the uterus. This procedure is typically performed before ovulation occurs, during days 5-11 of your menstrual cycle (day 1 being the first day of menstrual bleeding).
Endometrial Biopsy

An endometrial biopsy is sometimes indicated to assess the quality of the endometrium and rule out pathology. In this procedure, a small amount of endometrium tissue is taken and tested. .

Endometrial Receptivity Array (ERA)
Endometrial receptivity can be one of the causes of infertility in women who have had two or more unsuccessful embryo transfers following IVF treatment. Endometrial Receptivity Analysis (ERA), is a genetic test that takes a small sample of a woman’s endometrial lining. This process helps to determine the ideal timing for the embryo transfer.
Matris Ultrasound
Matris is an non-invasive diagnostic tool that assesses endometrial receptivity — before the embryo or blastocyst transfer. It uses proprietary technology to assess a patients’ uterine lining using an ultrasound, and essential information to increase the probability of a successful transfer.

The Right Fertility Treatment for You

Our reproductive team will know what tests to recommend for you, based on your medical history and other variables. This assessment helps our experts determine the right treatment plan for you and your partner.

Begin your fertility journey with the Ontario Fertility Network by filling out our online form.


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