If you are thinking about starting a family, a great first step is to have an idea of your fertility. More women are turning to fertility testing both when they’re having trouble conceiving and also to plan ahead and take charge of their reproductive health. Like the others, you don’t have to wait until there’s a problem. Fertility tests can provide helpful insights even if you’re just curious about your chances of getting pregnant in the future.

Initial Assessment

Before undergoing fertility tests, your doctor will start with the basics—your menstrual cycle. This step is important because your cycle can reveal a lot about your reproductive health.

Tracking Your Cycle

You’ll be asked to track your periods, especially the first day of each one, to help your doctor understand how regular your cycles are. A typical menstrual cycle lasts between 21 and 35 days. But what matters more than the number is consistency. Big changes from month to month could be a sign of hormonal issues that affect ovulation and your chances of getting pregnant.

What Your Cycle Can Tell You

Regular cycles usually mean you’re ovulating regularly which is a good sign for fertility. Irregular cycles, on the other hand, might point to conditions like PCOS, thyroid issue, and other hormone-related problems. Doctors also look at how heavy or light your period is, how long it lasts, and whether you have symptoms like severe cramps or unusual bleeding. These clues can help identify conditions like endometriosis or other issues that might make it harder to conceive.

When to See a Doctor

If your cycle is shorter than 21 days, longer than 35 days, or varies a lot each month, it’s a good idea to get it checked. The same goes if you miss periods or notice unusual bleeding between them.

Egg Reserve Testing

A key part of fertility testing is checking your egg reserve, how many good-quality eggs you have left. This is helpful if you are over 35, have had ovarian surgery, or have a family history of early menopause.

Antral Follicle Count (AFC)

This test uses an ultrasound to count the tiny follicles in your ovaries that hold developing eggs. A doctor does a quick and safe transvaginal ultrasound to get a close look at your ovaries. You’ll see small dark circles on the screen. Those are the antral follicles. By counting them, your doctor gets an idea of your egg reserve. Keep in mind that this test shows only the follicles that are visible right now. You have many more eggs at earlier stages that cannot be seen on ultrasound.

Anti-Müllerian Hormone (AMH) Test

This simple blood test measures the level of AMH, a hormone made by the follicles in your ovaries. AMH levels give another reliable clue about how many eggs you have left. AMH testing can be done on any day of your cycle. It just involves a quick blood draw, and the results usually come back in a few days. Your AMH level helps doctors predict how your body might respond to fertility treatments and medications. It can’t tell you exactly if or when you’ll get pregnant but it’s a useful tool for planning and treatment decisions.

Who Should Get Tested?

Egg reserve testing is a smart move for:

• Women over 35
• Those who’ve had ovarian surgery or cysts
• Anyone with a family history of early menopause

Ovulation Testing

Even if your periods are regular, it doesn’t always mean you’re ovulating. Confirm ovulation first to be able to fully understand your fertility.

At-Home LH Ovulation Tests

These test strips detect a spike in luteinizing hormone (LH), which happens 24-36 hours before ovulation. This helps you pinpoint your most fertile days. Tips for Accuracy

• Start testing a few days before expected ovulation (around Day 10 or 11 if you have a 28-day cycle).
• Test around the same time each day, afternoon or evening is best.
• Avoid using your first-morning urine.

Women with irregular cycles might find it tricky to catch the LH surge. Conditions like PCOS can cause high LH levels all the time, leading to false positives.

Ultrasound Follicular Tracking

A doctor uses ultrasound scans to watch your eggs develop and predict exactly when you’ll ovulate. How It Is Done

• Starting around Day 10 of your cycle, you will have a few scans over several days.
• The doctor tracks the dominant follicle (which holds the egg) and watches for signs it’s ready to release the egg.

Ultrasound follicular tracking provides a clear view of ovulation, especially useful for irregular cycles or during fertility treatments. It also checks your uterine lining and for signs of conditions like PCOS.

Progesterone Blood Test

This test confirms that ovulation did happen by checking your progesterone levels about seven days after you think you ovulated. After ovulation, your body makes more progesterone to prepare the uterus for pregnancy. If your level is high, you likely ovulated. If it’s low, you might not have.

Comprehensive Fertility Testing

Fertility is not only about ovulation and egg count. It’s also about the health of your reproductive organs and hormones.

Transvaginal Pelvic Ultrasound

It checks for:

1. Fibroids, polyps, or unusual shapes in your uterus
2. Swelling or fluid (called hydrosalpinx) in your fallopian tubes
3. Cysts or signs of PCOS in your ovaries
4. Antral Follicle Count (for egg reserve info)

A slim ultrasound probe is gently inserted into the vagina for a clear, detailed view. No full bladder required.

Hysterosalpingogram (HSG)

HSG checks if your fallopian tubes are open. Blocked tubes can stop the egg and sperm from meeting. A dye is placed into your uterus through your cervix and X-rays show if it flows through your tubes. What It Tells You

• Open tubes = good!
• Blocked tubes = possible cause of concern
• Uterine shape problems can also be spotted

Hormonal Testing

Hormones control every part of your fertility, from the release of the egg to preparing for pregnancy. Testing reveals imbalances and other underlying concerns. Basic Hormone Panel (done on Days 3-5 of your cycle):

• FSH triggers the growth of eggs to get them ready for ovulation
• LH triggers ovulation
• Estradiol balances FSH and LH

Abnormal levels could mean PCOS, low egg reserve, or other hormonal problems. Additional Hormone Tests (based on symptoms):

• TSH checks thyroid function
• High levels of prolactin can change or stop ovulation
• Testosterone/DHEAS checks for PCOS or adrenal issues
• Insulin identifies insulin resistance which is often linked to PCOS

HealthCare Options in Singapore

Public Healthcare Institutions

Public hospitals such as KK Women’s and Children’s Hospital, Singapore General Hospital (SGH), and National University Hospital (NUH) offer fertility assessments. Singaporean citizens and Permanent Residents (PRs) can access subsidised rates with a referral from a polyclinic. Subsidised consultations start at around SGD 40 to 50 while non-subsidised consultations range between SGD 130 to 170. Comprehensive fertility work-ups can range from SGD 400 to 1,500 before subsidies, depending on the assessment’s comprehesiveness.

Private Clinics and Fertility Centres

Private clinics offer shorter waiting times and more personalised care. For example, Raffles Medical Group provides a Fertility Assessment for Couples at SGD 411.78, which includes consultations, transvaginal ultrasound, AMH testing, and semen analysis.

Preparing for Your Fertility Assessment

Bring a detailed menstrual history, previous medical records related to reproductive health, and a list of current medications or supplements. Plan appointment considering your work and travel schedules especially for tests requiring specific cycle timing or multiple visits. If applicable, coordinate with your partner for assessments like semen analysis to ensure that both parties are available for necessary appointments.

Conclusion

Fertility testing is only the first step. The results will drive decision-making about natural conception, treatment options, and assisted reproductive technologies. If you have been trying for several months without success, have irregular cycles, or are simply concerned about age-related fertility, we suggest visiting a women’s clinic in Singapore like WS Law Women’s Clinic. It’s best that you gain clarity about your fertility with the help of professionals.