What each fertility test can — and cannot — tell you

Female Diagnostic

AMH Test (Anti-Müllerian Hormone)

Quantitative blood evaluation of functional ovarian follicular reserve.

Anti-Müllerian Hormone (AMH) is produced by the granulosa cells of small pre-antral and antral follicles in the ovaries. It serves as the most stable and reliable biochemical marker of a woman’s ovarian egg reserve, indicating how many growing follicles remain and forecasting how the ovaries will respond to medication protocols.

Method

Standard venous blood draw

Timing

Can be drawn on any day of the menstrual cycle (independent of menses)

Results

Same-day or next-day results

When it is recommended

• Assessing baseline ovarian egg reserve prior to fertility planning
• Selecting optimal, individualized gonadotropin medication dosages for IVF stimulation
• Investigating suspected polycystic ovary syndrome (PCOS), where AMH is characteristically high
• Proactively monitoring ovarian reserve over time or prior to fertility preservation

What it measures

• Relative pool of active pre-antral and antral ovarian follicles
• Likelihood of follicular recruitment during controlled ovarian stimulation
• Risk profiling for poor response (low AMH) or hyperstimulation/OHSS (high AMH)

How the result guides your care

• Helps specialists select the safest and most effective stimulation protocol (Antagonist vs Mild vs DuoStim)
• Provides clarity on realistic egg retrieval numbers per IVF stimulation cycle
• Assists in establishing proactive conception timelines

How to prepare

• No fasting required; standard hydration is recommended
• Inform the clinic if taking oral contraceptives or hormonal therapies, as these can temporarily suppress AMH readings

Questions to ask about your result

• What does my specific AMH value mean in the context of my age and antral follicle count?
• Does my AMH indicate an individualized mild or antagonist protocol for IVF?
• How stable is this marker over the next 6 to 12 months?

Female Diagnostic

Antral Follicle Count (AFC) Ultrasound

High-resolution transvaginal sonography visualizing resting ovarian follicles.

Antral Follicle Count (AFC) is an observational ultrasound evaluation where a fertility specialist counts small (2–10mm) fluid-filled follicles visible in both ovaries during the early follicular phase. Paired with serum AMH, AFC represents the international clinical gold standard for assessing ovarian functional reserve.

Method

Transvaginal pelvic ultrasound (TVS)

Timing

Day 2 to Day 4 of the menstrual cycle

Results

Immediate clinical review during appointment

When it is recommended

• Direct visual confirmation of functional ovarian reserve and ovarian size
• Cross-validating AMH laboratory findings to prevent laboratory test discrepancies
• Screening for ovarian cysts, endometriomas, polycystic ovarian appearance, or uterine fibroids

What it measures

• Exact number of resting antral follicles in each ovary (left and right)
• Ovarian stromal volume and blood flow impedance
• Concomitant uterine lining baseline thickness and contour

How the result guides your care

• Confirms the anticipated number of follicles eligible for stimulation in an upcoming cycle
• Identifies anatomical barriers such as ovarian endometriomas before treatment starts

How to prepare

• Performed with an empty bladder for optimal acoustic resolution
• Conducted comfortably in our private ultrasound suite by a trained consultant

Questions to ask about your result

• How does my antral follicle count correlate with my AMH blood test?
• Are both ovaries contributing equally, or is one ovary less accessible?
• Were any cysts or structural findings identified during the scan?

Male Diagnostic

CASA Semen Analysis & Sperm DNA Fragmentation (DFI)

WHO 6th Edition automated semen evaluation and paternal genetic integrity testing.

Computer-Assisted Semen Analysis (CASA) utilizes high-magnification automated optics to evaluate sperm concentration, progressive motility, and strict morphology under WHO 6th Edition (2021) parameters. Our andrology laboratory also provides advanced Sperm DNA Fragmentation Index (DFI) testing to examine the physical integrity of paternal DNA strands.

Method

Ejaculated semen sample in private clinical collection suite

Timing

Requires 2 to 5 days of ejaculatory abstinence for standardized accuracy

Results

Same-day report with embryologist consultation

When it is recommended

• Essential first-line evaluation for all couples attempting to conceive
• Diagnosing oligospermia (low count), asthenospermia (poor motility), and teratospermia (atypical shape)
• Evaluating unexplained IVF failure, recurrent chemical pregnancy, or repeated miscarriage

What it measures

• Sperm count (concentration per mL and total ejaculate)
• Progressive motility (percentage of sperm moving forward vigorously)
• Strict Kruger morphology (cellular head, midpiece, and tail architecture)
• DFI: Percentage of sperm harboring fragmented or broken DNA strands

How the result guides your care

• Determines whether natural conception, IUI, IVF, or ICSI represents the most suitable pathway
• Uncovers occult paternal factors that standard macroscopic lab tests overlook
• Guides targeted antioxidant, varicocele, or lifestyle interventions

How to prepare

• Strict 2 to 5 days of abstinence (no ejaculation)
• Private, sound-insulated en-suite collection room provided on-site in Mysuru

Questions to ask about your result

• What percentage of sperm exhibit progressive forward motility?
• Is my Sperm DNA Fragmentation Index (DFI) within the optimal threshold (<15%)?
• Does our result favor IUI or ICSI micromanipulation?

Female Diagnostic

Day 2/3 Hormonal Panel (FSH, LH, Estradiol)

Endocrine assessment of pituitary-ovarian signaling axis and baseline ovarian suppression.

Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) are pituitary hormones that orchestrate egg recruitment and ovulation. Checking these levels alongside Estradiol (E2) on Day 2 or 3 of menstruation evaluates how hard the pituitary gland must work to stimulate the ovaries at cycle baseline.

Method

Venous blood draw

Timing

Day 2 or Day 3 of the menstrual cycle

Results

Same-day results

When it is recommended

• Investigating ovarian reserve responsiveness and pituitary signaling harmony
• Evaluating unexplained cycle irregularities, anovulation, or hypothalamic factors
• Ensuring baseline hormonal suppression before initiating IVF stimulation injections

What it measures

• Day 2/3 FSH level (elevated levels indicate ovarian resistance/decline)
• LH to FSH ratio (a high LH:FSH ratio of 2:1 or 3:1 is a hallmark of PCOS)
• Basal Estradiol (verifies true baseline state; elevated early estrogen can falsely mask high FSH)

How the result guides your care

• Helps distinguish between hypothalamic amenorrhea, diminished reserve, and PCOS
• Guides dosing thresholds for recombinant gonadotropins in IVF cycles

How to prepare

• Schedule blood draw on Day 2 or 3 of active menstrual bleeding
• Fasting is not required

Questions to ask about your result

• Is my FSH level within the expected baseline range (<10 mIU/mL)?
• Does my LH to FSH ratio indicate an ovulatory pattern associated with PCOS?
• Is my baseline Estradiol low enough to begin treatment safely?

Female Diagnostic

Luteal Phase Progesterone & Estradiol Tracking

Confirming ovulatory competency and endometrial secretory preparation.

Following ovulation, the collapsed follicle transforms into the corpus luteum, which secretes progesterone to convert the uterine lining into a receptive environment for embryo implantation. Measuring mid-luteal progesterone confirms whether true ovulation occurred and whether adequate secretory support is present.

Method

Venous blood draw

Timing

Day 21 of a standard 28-day cycle (or 7 days post-confirmed ovulation)

Results

Same-day results

When it is recommended

• Objectively confirming that an egg was successfully released during the cycle
• Diagnosing luteal phase defect (insufficient progesterone to maintain early implantation)
• Optimizing progesterone supplementation in Frozen Embryo Transfer (FET) cycles

What it measures

• Mid-luteal serum progesterone concentration (>10 ng/mL in natural cycles confirms robust ovulation)
• Serum estradiol levels supporting endometrial vascularity

How the result guides your care

• Confirms whether natural ovulatory timing or mild medication (letrozole) produced an effective luteal phase
• Informs personalized progesterone support protocols for IVF embryo transfer

How to prepare

• Timing must be adjusted if your cycles are longer than 28 days (calculated as 7 days after peak LH surge)

Questions to ask about your result

• Did my Day 21 progesterone confirm strong, complete ovulation?
• Would supplemental luteal progesterone be beneficial for my cycle?
• How will progesterone be monitored during an embryo transfer cycle?

Female Diagnostic

Tubal Patency Assessment (HSG & HyCoSy)

Radiological and ultrasound mapping of fallopian tube permeability and uterine contour.

Fallopian tubes cannot be visualized on a standard routine pelvic ultrasound because they are soft, collapsed tubes. Hysterosalpingography (HSG) and Hystero-Contrast-Salpingography (HyCoSy) introduce a safe radiographic or ultrasound-visible dye into the uterine cavity, tracking its passage through both tubes and spill into the pelvis to verify clear patency.

Method

Fluoroscopic radiopaque contrast dye (HSG) or specialized echogenic foam (HyCoSy)

Timing

Day 7 to Day 10 of the menstrual cycle (after bleeding ceases, before ovulation)

Results

Immediate imaging review with specialist

When it is recommended

• Essential prerequisite before planning Intrauterine Insemination (IUI) or timed natural conception
• Detecting unilateral or bilateral tubal blockages, adhesions, or hydrosalpinx (fluid accumulation)
• Assessing internal uterine contour for septa, polyps, or submucosal fibroids

What it measures

• Bilateral tubal permeability (free contrast spill into the peritoneal cavity)
• Tubal caliber, dilation, or mucosal damage
• Uterine cavity symmetry and endometrial filling defects

How the result guides your care

• Validates whether IUI is a medically viable option (requires at least one fully open tube)
• Identifies toxic hydrosalpinx that requires clinical management prior to IVF embryo transfer

How to prepare

• Scheduled strictly after menstruation ends and before ovulation (Day 7–10)
• A mild prophylactic antispasmodic/analgesic is recommended 45 minutes prior for complete comfort

Questions to ask about your result

• Did both fallopian tubes demonstrate free, unrestricted dye spillage?
• Were any signs of hydrosalpinx or pelvic adhesions noted?
• Was my uterine cavity shape completely normal without septa or filling defects?

Female Diagnostic

Serial Folliculometry & Ovulation Tracking

Sequential transvaginal ultrasound monitoring of dominant follicle growth and rupture.

Serial folliculometry tracks the physiological recruitment, daily growth (1.5–2mm per day), and eventual rupture of the dominant ovarian follicle. It precisely identifies the optimal 36-hour fertile window, correlates follicle size with endometrial thickness, and documents successful egg release.

Method

Series of 3–4 quick transvaginal ultrasound scans over 6 to 8 days

Timing

Starting around Day 9 or 10 of the menstrual cycle through confirmed ovulation

Results

Immediate same-day guidance on follicle dimensions and timing

When it is recommended

• Eliminating guesswork in intercourse timing for couples attempting natural conception
• Accurately scheduling Intrauterine Insemination (IUI) procedures
• Monitoring response to oral ovulatory medications (such as Letrozole) to prevent multi-follicular risks

What it measures

• Diameter of the lead follicle (typically reaches 18–22mm before spontaneous rupture)
• Endometrial thickness and characteristic triple-line trilaminar pattern
• Post-ovulatory physical signs: follicle collapse, internal echoes, and free fluid in the Pouch of Douglas

How the result guides your care

• Confirms whether follicles reach adequate maturity before releasing the egg
• Verifies that the uterine lining synchronizes properly with follicular development

How to prepare

• Short 10-minute appointments scheduled across alternate days during mid-cycle
• Conducted with an empty bladder

Questions to ask about your result

• What size is my lead follicle, and what is my optimal conception window this cycle?
• Has my endometrial lining reached the ideal thickness (>7.5mm) and trilaminar pattern?
• Did follow-up ultrasound confirm complete follicular rupture and release?

Couples Evaluation

Coordinated Couples Fertility Evaluation

Simultaneous dual-partner reproductive evaluation providing complete diagnostic clarity.

Fertility is a shared biological journey. In 30%–40% of cases, subfertility involves combined subtle contributions from both partners. Our Coordinated Couples Fertility Evaluation reviews female and male factors simultaneously in a compassionate, coordinated setting, preventing months of one-sided investigation and delay.

Method

Joint clinical history, female ultrasound/hormone panel, and male CASA semen analysis

Timing

Single coordinated half-day appointment at our Mysuru centre

Results

Comprehensive joint review and roadmap within 24 to 48 hours

When it is recommended

• Couples trying to conceive for 6 to 12+ months seeking a complete, synchronized diagnostic overview
• Preventing the common pitfall of investigating only one partner while missing contributing factors in the other
• Establishing a clear, evidence-based roadmap aligned with medical parameters and personal timelines

What it measures

• Female ovarian reserve (AMH), pelvic anatomy, and ovulatory regularity
• Male sperm concentration, progressive motility, morphology, and DNA integrity
• Joint reproductive timeline, lifestyle factors, and coital timing accuracy

How the result guides your care

• Delivers an integrated clinical diagnosis rather than isolated lab reports
• Empowers couples with clear, stepwise treatment choices: natural optimization vs IUI vs IVF

How to prepare

• Male partner should observe 2 to 5 days of ejaculatory abstinence
• Bring all previous medical reports, ultrasounds, and surgery summaries

Questions to ask about your result

• Based on both our parameters combined, what is our most realistic next step?
• Are there gentle, conservative options we should try before considering advanced procedures?
• What lifestyle or nutritional modifications are scientifically substantiated for our specific profiles?