The Most Important Fertility Tests for Women: What You Need to Know

Trying to conceive can be exciting, emotional, and overwhelming—especially when you're unsure which fertility tests actually matter. A proper fertility assessment is much more than a single blood test. It’s a full-picture evaluation of hormones, metabolic health, thyroid function, nutrient status, and reproductive anatomy.

This guide is purposely comprehensive, but does not mean you need to test everything on this list all at once. A discussion with your doctor can help pinpoint which tests would be most useful for you.

And... here we go!

1. Day-3 Hormone Profile (Cycle Day 3)

This set of tests provides essential insight into ovarian reserve and how well the ovaries are functioning.

Key markers:

• FSH (Follicle-Stimulating Hormone) – Higher levels may signal reduced ovarian reserve.

• LH (Luteinizing Hormone) – Helps assess cycle regulation and PCOS patterns.

• Estradiol (E2) – Supports follicle development; helps interpret FSH accuracy.

• AMH (Anti-Müllerian Hormone) – Can be measured anytime; indicates ovarian reserve.

These are foundational for understanding how many eggs remain and how the ovaries respond hormonally.

2. Progesterone Test (7 Days After Ovulation)

This test confirms whether ovulation actually occurred.

• Typically measured on day 21 of a 28-day cycle (or exactly 7 days post-ovulation). This test aims to hit the peak of progesterone production post-ovulation, so knowing when you ovulate will help to time this test.

• Helps assess luteal phase adequacy, which supports implantation and early pregnancy.

  
  

3. Thyroid Function Panel

Thyroid health is directly connected to ovulation, menstrual regularity, and pregnancy outcomes.

Key thyroid markers:

• TSH

• Free T4

• Free T3

• Anti-TPO

• Anti-TG

  
  

Thyroid disorders—both hypo and hyper—can interfere with regular ovulation and increase miscarriage risk.

4. Prolactin

Elevated prolactin can suppress ovulation and alter menstrual cycles.This is an essential test for women with irregular or missing cycles.

5. Fasting Insulin + Glucose (HOMA-IR)

These tests evaluate metabolic health and insulin resistance—common in PCOS.

• Insulin resistance can disrupt ovulation, egg quality, and cycle length.

• Calculating HOMA-IR gives a clearer picture of metabolic function.

6. Vitamin & Mineral Status

Nutrient deficiencies can affect ovulation, energy production, hormone balance, and implantation.

Important markers:

• Vitamin D

• Vitamin B12

• Folate

• Ferritin (iron stores)

  
  

7. Inflammation & Metabolic Markers

These are especially helpful for women with unexplained infertility or recurrent pregnancy loss.

• CRP (C-Reactive Protein) – Inflammation marker

• Homocysteine – Elevated levels may impact fertility

8. Autoimmune Testing

Autoimmune conditions can contribute to infertility, early miscarriage, and implantation issues.

Common markers:

• ANA (Antinuclear Antibodies)

• Thyroid antibodies: TPOAb, TgAb

• Adrenal antibodies (21-OH Ab, ACA)

• Antiphospholipid syndrome markers:

  • Anti-cardiolipin

  • Lupus anticoagulant

  • APA panel

• Celiac antibodies

If autoimmune history or symptoms are present, these tests are important for identifying underlying causes.

9. CA-125 (If Endometriosis Is Suspected)

Not a diagnostic test on its own—but may support suspicion of endometriosis when combined with symptoms and imaging.

10. STI Screening

Infections such as chlamydia and gonorrhoea can impact fertility and pregnancy health.

11. Transvaginal Ultrasound

This imaging test provides a real-time look at reproductive health:

• Uterine lining thickness

• Follicle development

• Ovarian appearance (e.g., PCOS patterns)

• Fibroids, cysts, or structural issues

  
  

Why a Comprehensive Fertility Panel Matters

A true fertility assessment looks at hormones, metabolism, nutrients, anatomy, and immune function—not just one area. This holistic approach helps identify:

✔ Ovulation issues

✔ Low ovarian reserve

✔ Thyroid dysfunction

✔ PCOS or metabolic imbalance

✔ Inflammation or autoimmune issues

✔ Nutrient deficiencies

✔ Anatomical or uterine factors

With the right testing, treatment becomes more targeted, effective, and personalized. Reach out to your naturopathic doctor if you have any questions!