Fertility Evaluation Before IVF — A Comprehensive Workup

Our approach to evaluation

Every couple undergoing fertility evaluation at Balaji Horizon receives a structured workup: ovarian reserve assessment, tubal and uterine cavity evaluation, partner semen analysis, hormonal panel, and where indicated, more focused testing. The workup is sequenced to balance diagnostic completeness against time-to-treatment — we don’t order tests for completeness if they won’t change the plan.

Ovarian reserve assessment

AMH and antral follicle count together provide a far more reliable picture than either alone. Day-3 FSH still has a role in specific contexts. The numbers are interpreted alongside age, prior cycle response, and clinical history — a low AMH at 32 means something different from a low AMH at 42.

Uterine and tubal evaluation

Hysterosalpingography or saline-infusion sonography evaluates tubal patency and uterine cavity. Hysteroscopy is added selectively. Endometrial thickness and pattern are assessed during the natural cycle to confirm receptivity baseline.

Partner evaluation

A complete semen analysis (WHO 2021 criteria) is standard. DNA fragmentation testing is added where indicated by recurrent loss, advanced paternal age, or prior unexplained failure. Male factor evaluation is not an add-on; it is parallel and equal to female evaluation.

Evaluation topics

Guidelines we follow

• ESHRE Guideline on the Investigation and Diagnosis of Infertility
• ASRM Practice Committee — Diagnostic evaluation of the infertile female
• WHO Laboratory Manual for the Examination of Human Semen (6th edition, 2021)

Where this fits

Evaluation feeds directly into the cycle plan. Findings may direct patients toward special cases or male-factor pathways. For early-stage planning, see cost and planning.