An Overview of a Fertility Work-Up


When one hears the term “Fertility Work-Up,” it may sound intimidating. However, it can provide incredible insight and direction in how you can best build your family.

Although clinics can vary in what they include in a consultation (some are just conversations, others will consist of the exam), you will generally review your fertility history, any previous treatment you’ve had that’s relevant, and your family-building goals. In general, though, your journey should start with the help of a Reproductive Endocrinologist.

What is a Reproductive Endocrinologist?

While both your OB/GYN and urologist can provide a high-level overview of your reproductive health, you should see a reproductive endocrinologist when it comes to fertility and family building. A reproductive endocrinologist (RE) is a fertility specialist who has received board certification by the American Board of Obstetrics and Gynecology. This certification goes beyond Obstetrics and Gynecology as it also entails specializing in Reproductive Endocrinology and Infertility. RE’s specialize in reproductive organs, diagnosing fertility issues, designing a fertility protocol to best expand your family, and they can educate you on the latest fertility technology such as in vitro fertilization (IVF), genetic testing, and more.

When Should I See a Reproductive Endocrinologist?

Below are some guidelines and suggestions on when to consider seeing a reproductive endocrinologist. They are:

  • Women under 35 years old who have a known medical issue that may impact their fertility. This may include if they have irregular periods, have been diagnosed with PCOS, Endometriosis, blocked fallopian tubes, diminished ovarian reserve, etc.
  • Women over 35 years old who have been actively trying to conceive for more than six months.
  • LGBTIA+ couples or individuals.
  • Men who have a known issue to their health or fertility (low sperm count, etc.)
  • Women who are over the age of 40 as egg quantity and quality diminish as a woman ages.
  • Women with a history of pregnancy loss (whether the pregnancy was conceived naturally or through fertility treatment).

Fertility Work-Up for Women

Depending on where you are in your cycle, blood work will be taken to review your hormones. This includes your Follicle Stimulating Hormone (FSH), which must be checked early in the cycle, day 2 or 3 of your menstrual cycle. Your FSH gives some insight into how many eggs you have. They will also test your Anti-Mullerian Hormone (AMH), which can be tested at any point in your cycle. In addition, it will provide an idea of the quality of eggs you have.

In addition, an ultrasound will be performed. This is to examine the number of follicles on your ovaries, which correlates with the number of eggs you have in your ovarian reserve. They will also look at your uterus and fallopian tubes to see if there are any polyps, fibroids, cysts, or blockages. These tests along with a review of any health concerns and family history will give the doctor an overview of your fertility health.

Fertility Work-Up for Men

In the case of male fertility, they will also take a sperm analysis. The analysis looks at three primary factors:

  • Sperm Count
  • Morphology (the shape of the sperm)
  • Motility (how well it swims)

The most common reasons for male factor infertility are factors that affect the testicles. Other problems include hormone imbalances or blockages in the male reproductive organs. In about 50% of cases, the cause of male infertility cannot be determined and 10% to 15% of male infertility cases have a complete lack of sperm.


In general, 1 in 8 couples has trouble getting pregnant. Whether you are male or female, knowing your fertility health now can either help address any potential problems or help you plan options ahead of time.

Also, if you are building your family with the help of a surrogate, Fairfax Surrogacy offers a full fertility pre-pregnancy work-up on gestational carriers before they are accepted into our program.

No matter your path to parenthood, you should feel you’ve found a protocol that fits you and offers options and hope!