Fertility Health Check: Why It's Worth Knowing Your Fertility Sooner Rather Than Later

For many people, having a family is something they imagine will happen naturally when the time feels right. While this is true for many couples, fertility is influenced by a range of factors including age, medical history, lifestyle and, sometimes, conditions that have no obvious symptoms.

One of the most common things I hear from patients is, "I wish I'd come sooner." A fertility assessment can provide valuable information about your reproductive health, helping you make informed decisions whether you are planning a pregnancy now, in the near future, or simply want reassurance.

When should you seek fertility advice?

In general, I recommend seeking advice if:

• You are under 35 years old and have been trying to conceive for 12 months without success.

• You are aged 35 or over and have been trying for six months.

• You have irregular or absent periods.

• You have known endometriosis or polycystic ovary syndrome (PCOS), now called PMOS (Polyendocrine Metabolic Ovarian Syndrome).

• You have had previous pelvic infections or surgery.

• You have experienced recurrent miscarriage.

• You have had treatment for cancer or another condition that may affect fertility.

• You are in a same-sex relationship or require donor conception.

• You simply want to understand your fertility before trying for a family.

  
  

You do not need to wait until you have been trying for a long time if you have concerns. Early assessment can often identify simple issues that are straightforward to investigate and treat.

Age remains one of the biggest factors affecting fertility

Although many women conceive naturally in their late thirties and early forties, female fertility gradually declines with age, particularly after 35 years.

This is because both the number and quality of eggs decrease over time. The chance of natural conception each month falls, while the risk of miscarriage and chromosome abnormalities increases.

Male fertility also changes with age, although usually more gradually. Sperm quality, DNA integrity and overall reproductive health can all be affected.

Understanding where you stand allows you to make informed decisions rather than relying on assumptions.

What is included in a fertility health check?

A comprehensive fertility assessment looks at both partners wherever possible. Around one-third of fertility problems are due to female factors, one-third to male factors and one-third involve a combination or remain unexplained.

Depending on your circumstances, your assessment may include:

A detailed consultation

Your medical history provides valuable information. We discuss:

• Your menstrual cycle

• Previous pregnancies

• Medical conditions

• Previous surgery

• Family history

• Medications

• Lifestyle factors

• Sexual and reproductive history

This helps identify any factors that may influence fertility.

Ultrasound scan

A pelvic ultrasound allows us to assess:

• The uterus

• The ovaries

• Antral follicle count (AFC)

• Fibroids

• Ovarian cysts

• Features suggestive of PCOS

• Adenomyosis or endometriosis where visible

This provides important information about your reproductive health.

Hormone testing

Blood tests may include:

• Anti-Müllerian Hormone (AMH)

• FSH and LH

• Oestradiol

• Progesterone

• Thyroid function

• Prolactin

• Vitamin D where appropriate

These tests help assess ovarian reserve and identify hormonal conditions that may affect ovulation.

Fallopian tube assessment

If indicated, a HyCoSy (Hysterosalpingo-Contrast Sonography) can assess whether your fallopian tubes are open.

If you have an abnormal ultrasound scan or have previousy had surgery a small operation called a laparoscopy would be discussed with you to assess whether your fallopian tubes are open and can also provide treatments during the same operation.

Blocked tubes are a recognised cause of infertility but often cause no symptoms.

Semen analysis

Male fertility is an essential part of any fertility assessment.

A semen analysis evaluates:

• Sperm concentration

• Motility

• Morphology

• Overall semen quality

Further specialised tests may be recommended depending on the results.

Can lifestyle make a difference?

In many cases, yes.

Small changes can improve reproductive health for both men and women.

These include:

• Maintaining a healthy weight

• Eating a balanced Mediterranean-style diet

• Regular exercise

• Avoiding smoking and recreational drugs

• Limiting alcohol intake

• Taking folic acid before pregnancy

• Optimising medical conditions such as diabetes or thyroid disease

• Reducing excessive heat exposure to the testes in men

  
  

Lifestyle changes cannot overcome every fertility problem, but they can improve the chances of natural conception and fertility treatment success.

Fertility testing does not mean you need IVF

One of the biggest misconceptions is that attending a fertility clinic automatically means IVF.

This is simply not true.

Many couples conceive naturally after identifying and addressing relatively simple issues such as irregular ovulation, thyroid disorders, low sperm count or blocked fallopian tubes. Others may benefit from ovulation induction, intrauterine insemination (IUI) or minimally invasive surgery before IVF is ever considered.

A fertility assessment is about understanding your individual circumstances and recommending the most appropriate next steps. It’s not rushing into treatment.

The benefits of early assessment

A fertility health check can:

• Identify potential problems early.

• Provide reassurance if everything appears normal.

• Help you understand your reproductive timeline.

• Avoid unnecessary delays in seeking treatment.

• Allow time to consider options such as fertility preservation if appropriate.

• Help you make informed decisions about your future family.

Knowledge is empowering, and understanding your fertility can reduce uncertainty and provide a clear plan moving forward.

Compassionate, personalised fertility care

Every fertility journey is unique.

Whether you have just started thinking about having a family, have been trying to conceive for some time, or have experienced previous disappointment, my aim is to provide evidence-based advice in a supportive and compassionate environment.

Together, we can explore your fertility, answer your questions and develop a personalised plan that is right for you.

Book a Fertility Health Check

If you would like to understand your fertility or are having difficulty conceiving, I would be delighted to help.

A fertility consultation includes a detailed assessment of your medical history, discussion of any concerns, and recommendations for appropriate investigations and treatment tailored to your individual circumstances.

Taking the first step towards understanding your fertility could make all the difference.

Ready to take the next step?

Reading trusted information is often the first step, but it can never replace advice that's tailored to your individual circumstances.

Whether you're looking for reassurance, have questions about your fertility or reproductive health, or are ready to arrange a consultation, we're here to help.

You can visit our website, explore our services, learn more about our team, or book a consultation to discuss your individual situation.

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About Mrs Polly Ford

Mrs Polly Ford is a Consultant Gynaecologist and Subspecialist in Reproductive Medicine and Surgery, and founder of Fertility & Gynae. She is committed to providing compassionate, evidence-based care that helps patients understand their reproductive health and make informed decisions about their future.

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