Fertility Evaluation: What to Expect

If pregnancy isn’t happening as planned, our structured Infertility Work‑Up helps determine why — and how best to move forward. At NCCRM, both partners are evaluated because fertility is a team effort.

When Should You Begin?

Under 35?

Try for 12 months before evaluation.

Age 35 or older?

Consider starting after 6 months, due to natural fertility decline.

Known Factors

Known factors such as irregular cycles, pelvic surgery, a cancer history or male issues, consider an evaluation as soon as possible.

What We Check: Step-by-Step Breakdown

Getting Started With Tubal Ligation Reversal

1. Comprehensive Review

  • Medical history & physical exam for both partners — covering reproductive history, surgeries, health issues, and lifestyle.
Ovulation assessment

2. Ovulation Assessment (Female)

  • Menstrual tracking and symptoms
  • Bloodwork, including progesterone, TSH, prolactin, and AMH (ovarian reserve indicator)
  • Ovulation kits or ultrasounds may be used when cycles are irregular.
Uterine and Tubal Health

3. Uterine & Tubal Health

  • Ultrasound to check the uterus, ovaries, and basic tube assessment
  • Hysterosalpingography (HSG) or HyCoSy to evaluate tubal patency and the uterine cavity.
  • Hysteroscopy or laparoscopy when indicated by a history of endometriosis, scarring, or prior pelvic surgery
Semen Analysis

4. Semen Analysis (Male)

  • At least one semen analysis using WHO standards
  • Furthe ther testing if results show low volume, count, motility, or shape. May include hormone testing or genetic screening
Additional testing for infertility

5. Additional Testing As Needed

  • Genetic screening (e.g., karyotype, fragile X) if indicated
  • Infectious disease testing (STIs, HIV, etc.)
  • Advanced ovarian reserve tests such as day‑3 FSH or Clomid challenge
  • Pelvic evaluation for chronic pain or unexplained infertility
diagnosis and treatment

6. Diagnosis & Treatment

  • Explain the finding clearly
  • Identify any treatable issues
  • Outline recommednded treatments

Guidance and Support Every Step of the Way

Why choose NCCRM?

  • Couples-first care—both partners are evaluated equally.
  • Streamlined scheduling—we help you get tests done efficiently.
  • Evidence-based decisions—we follow ACOG and AAFP guidelines .
  • Compassionate support—fertility can feel overwhelming; we’re with you every step.
fertility guidance and support by NCCRM
fertility treatment and support

Next Steps

  1. Schedule an appointment at NCCRM
  2. Complete personalized testing plan
  3. Review results and plan treatment