Testing for Infertility

Before coming in to see us, your GP will have already arranged for you to have basic tests to check for any likely fertility problems. During your first consultation with us, one of our doctors will look over your medical and fertility history and will organise any further tests that are needed. We can usually give you a clear evaluation of your treatment options within a couple of clinic visits.

Additional tests we might request are:

Pre-treatment screening blood tests

Both you and your partner will need to be screened before treatment starts for:

  • Hepatitis B
  • Hepatitis C
  • Human Immuno-deficiency Virus (HIV)

A positive result does not exclude you from receiving treatment.

Females will also be screened to confirm whether they are immune to rubella (German measles), have antenatal blood tests, testing for gonorrhoea, chlamydia, and cervical smear as per the NZ screening recommendations. 

If you have questions about testing for infertility, email us on fertplus@adhb.govt.nz.

Testing for male infertility

In around one third (1/3) of the couples we see, male infertility is the main issue.

The most important test for male infertility is semen analysis. A fresh sample is checked for:

  • Volume - the amount of fluid produced
  • Concentration - the number of sperm per millilitre of semen
  • Motility - the percentage of sperm that are moving
  • Morphology - the percentage of normally shaped sperm
  • Anti-sperm antibodies that may impair sperm function

Sperm quality can vary from sample to sample, so we may ask for a second sample.

If treatments such as intrauterine insemination (IUI) or IVF are being considered, we may ask you to provide another sample for the laboratory at Fertility Plus to test. We have a private room in the clinic where men can produce a sample. If  a sample is collected at home, it must to be delivered to the lab within one hour of being produced.

Other tests we may request are a hormone profile and chromosome testing. This is sometimes requested in men with greatly reduced sperm counts or quality.

Testing for female infertility

When testing for possible female problems, we look for:

  1. Problems with ovulation (not releasing an egg each menstrual cycle)
  2. Damage to the fallopian tubes that may prevent sperm reaching the egg
  3. Problems within the pelvis or uterus that reduce fertility, such as endometriosis and fibroids
  4. A lower than expected number of eggs in your ovaries for your age (also called 'low ovarian reserve'). This is tested by a blood test.

Trans-vaginal ultrasound

An ultrasound scan will usually be done at some time during your investigation. An ultrasound probe is placed in the vagina so that the shape, size and position of the uterus and ovaries can be checked. Abnormalities such as fibroids, ovarian cysts, and polyps within the uterus can be seen.

Hysterosalpingogram (x-ray)

This is an X-ray to check whether your fallopian tubes are blocked. A small tube is placed into the opening of the cervix and fluid visible on X-rays is injected through your cervix into the uterus and fallopian tubes. This test can be used to show if the fallopian tubes are open or blocked. However, it can't pick up pelvic scarring or damage outside the fallopian tubes or endometriosis, which is better detected by laparoscopy. The advantage of a Hysterosalpingogram is that there is no recovery time and general anaesthetic is not required.


It is common for women to have laparoscopy as part of their infertility investigations. If endometriosis or tubal problems are present, further laparoscopic surgery may be advised. This operation is performed under a general anaesthetic. A small cut is made at your belly button (navel) and a tube-like instrument with a camera attached is inserted to view your pelvic organs.

Laparoscopy allows your doctor to check for endometriosis or damage to the outside of the fallopian tubes from past infection. There is a small risk of complications such as damage to other organs (e.g. bowel or blood vessels) and requiring further surgery to repair the damage. Sometimes laparoscopy can include a dye test to check the patency (openness) of your fallopian tubes.

Hormone testing

In all women, the number of eggs declines with age and the decline occurs more quickly during your late thirties.

The following hormone blood tests are done to assess whether a women's ovaries have fewer eggs than expected:

  • Anti-mullerian hormone (AMH) is produced by the ovary. AMH suggests how many immature eggs are ready to respond to the effects of FSH hormone. It can be checked at any time in your menstrual cycle. AMH levels decline naturally with age and are often lower in women with fewer eggs. AMH levels give an indication of how a woman is likely to respond to the hormone stimulation of IVF treatment, but it is not necessarily a prediction of the likelihood of pregnancy. Women with reduced egg numbers will have very decreased levels of AMH. This test is not funded and patients are charged a fee. 
  • Follicle stimulating hormone (FSH) and Estradiol (E2) are checked on day two or three of a menstrual cycle. FSH is produced by the pituitary gland and causes follicles in the ovaries to grow and develop a mature egg before ovulation. In women with a reduced number of eggs, higher levels of FSH are needed to promote follicles to grow, so the FSH levels are increased.

You may still conceive naturally with a significantly reduced ovarian reserve. However, conceiving through the IVF process is less likely in women with a reduced ovarian reserve because it is more difficult for their ovaries to produce an optimum numbers of eggs when stimulated with drugs.