Fertility workup: What to expect and how to prepare
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If you've been trying to get pregnant without success, we know firsthand the emotional rollercoaster this journey can bring. The constant hope, the crushing disappointment, the endless Google searches for "best way to get pregnant" —it’s a lot. If you’re here, you might be wondering when to seek help and what a fertility workup entails.
First, let’s get the facts straight:
- Infertility is defined as no successful pregnancy after one year of trying to conceive (if you’re under 35).
- If you’re 35 or older, the timeframe shortens to six months without success.
If this sounds like you, don’t panic! A fertility workup is the next logical step, and while it can feel intimidating, it’s an empowering process that helps uncover potential reasons behind infertility and lays out a plan moving forward.
So, let’s break it down—what exactly happens during a fertility workup, what tests to expect, and how to best prepare for this next step. Plus, we’ll share some helpful products that can make the journey a little easier!
In this article
Step 1: Evaluating the fallopian tubes and uterus Step 2: Checking your ovaries and uterus Step 3: Blood work – A deep dive into your hormones Step 4: Semen analysis – Checking his fertility too Step 5: Next steps – Developing a fertility plan How to prepare for a fertility workup Final thoughts: Taking control of your fertility journey
Step 1: Evaluating the fallopian tubes and uterus
Hysterosalpingogram (HSG) – Checking for blockages
A hysterosalpingogram (HSG) is an X-ray test that evaluates whether your fallopian tubes are open and if your uterus has any abnormalities that could interfere with pregnancy. During the test:
- A contrast dye is inserted through your cervix.
- X-rays are taken to watch the dye flow through your fallopian tubes.
- If everything is clear, the dye will spill out at the ends of the tubes. If not, there may be a blockage.
Helpful tip
Some women report mild cramping during the procedure, so taking an over-the-counter pain reliever beforehand, like Advil Liquid Gels , can help ease discomfort.
Step 2: Checking your ovaries and uterus
Pelvic ultrasound – Monitoring ovarian function
A pelvic ultrasound is performed to:
- Check your ovaries for follicle count (which can indicate ovarian reserve).
- Monitor your uterus for fibroids, polyps, or other irregularities.
This is a transvaginal ultrasound procedure, and a full bladder is often needed, so be prepared to chug some water before your appointment!
Helpful tip
If you’re tracking ovulation, a basal body thermometer like the Easy@Home Smart Basal Thermometer can help you log temperature changes, which indicate when you’re ovulating.
Step 3: Blood work – A deep dive into your hormones
Your hormones play a key role in ovulation and pregnancy. Your doctor will order several blood tests to check for:
- Thyroid function (TSH, T3, T4) – A healthy thyroid is critical for fertility.
- Prolactin levels – High prolactin levels can disrupt ovulation.
- Ovarian reserve (AMH Test) – Measures how many eggs you have left.
- Ovulation hormones (FSH, LH, Progesterone, Estradiol) – Determines if you’re ovulating properly.
- STI panel – Some sexually transmitted infections can impact fertility.
Additional blood work
Depending on your history, your doctor may also check:
- Blood type & Rh factor – Important if blood incompatibility is a concern.
- Rubella & varicella immunity – Ensures you’re protected from these infections during pregnancy.
- HgA1c (Diabetes Test) – Uncontrolled blood sugar can impact fertility.
- Recurrent pregnancy loss panel – If you’ve had three or more miscarriages , your doctor may order extra tests.
Step 4: Semen analysis – Checking his fertility too
Your partner isn’t off the hook! A semen analysis is a crucial part of the fertility workup. The test evaluates:
- Sperm count: How many swimmers are in the pool?
- Sperm shape (Morphology): Are they formed correctly?
- Sperm motility: Can they move efficiently?
If the test shows any concerns, your doctor may recommend lifestyle changes or supplements like Conception Men’s Fertility Supplement, which contain zinc and antioxidants to support healthy sperm.
Step 5: Next steps – Developing a fertility plan
Once all tests are complete, your doctor will help create a personalized fertility treatment plan . This may include:
- Lifestyle changes – Adjusting diet, exercise, and stress management.
- Medications – Clomid, Letrozole, or injectables to induce ovulation.
- Surgery – If structural issues (like fibroids) are found.
- Assisted Reproductive Technology (ART) – IUI or IVF, if needed.
How to prepare for a fertility workup
To get the most out of your appointment, come prepared!
What to bring
- A detailed menstrual cycle history
- A list of any medications or supplements you’re taking
- Your partner’s health history (if applicable)
- Any previous test results
Products to support the process
- Ovulation Predictor Kits (OPKs) – Helps track ovulation at home.
- Pre-Seed Fertility Lubricant – A sperm-friendly lubricant.
- CoQ10 Supplements – Can support egg and sperm health.
Final thoughts: Taking control of your fertility journey
A fertility workup can feel overwhelming, but it’s an empowering step in understanding your body and next steps for conception. Whether your journey leads to natural pregnancy, fertility treatments, or assisted reproductive options, knowledge is power .
Key takeaways
- Don’t wait too long to seek help if you’re struggling to conceive.
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A fertility workup is a roadmap —not a verdict. It helps you move forward.
The content on Awaiting the Stork™ is for informational purposes only and is not intended as medical advice, diagnosis, or treatment. Always consult with a qualified physician or healthcare professional to address your unique health needs and circumstances.
Mindy Motta, FNP-C
Mindy is a seasoned OB-GYN Nurse Practitioner and co-founder of Awaiting the Stork™. After overcoming her own years-long fertility journey, she now blends clinical expertise with heartfelt empathy to offer new mom advice and evidence-based support for every stage of motherhood. Mindy’s mission is to nurture confidence, connection, and clarity for women stepping into motherhood’s many joys and challenges.
