Women’s fertility test / assessment

A cycle that varies from one month to the next, a desire to better understand your body before trying to conceive (ttc), preconception, trying for a baby, or simply curiosity. There are many reasons why you may be interested in your fertility, and none is more valid than another.

It is important to say this from the outset: an irregular cycle, a few months of unsuccessful trying, or the desire to “take stock” absolutely do not mean that there is a problem. Female fertility naturally changes with age, gradually and not like a guillotine falling on a specific date. To better understand this change, discover our article on  age and fertility which explores the topic in depth.

Having a fertility assessment, whether it is a simple pharmacy test or a comprehensive medical assessment, is above all a way to gain some reference points. The key point to bear in mind before going any further is that these two approaches do not really have the same scope. A test bought from a pharmacy provides a one-off piece of information about a single parameter. A medical assessment, on the other hand, combines several examinations to provide more comprehensive information. We will look at both approaches in detail.

A fertility medical assessment always begins with a discussion with the doctor or gynaecologist: the duration and regularity of your cycles, your medical history and your lifestyle. This consultation then guides the choice of further tests, which may include a blood test and an ultrasound scan.

AMH measurement (anti-Müllerian hormone)

AMH is now one of the most widely used markers for estimating ovarian reserve, meaning the number of remaining eggs. Its advantage is that it can be measured on any day of the cycle. However, one point that is often misunderstood deserves clarification: AMH indicates the quantity of eggs, not their quality. An AMH level alone therefore cannot predict the chances of pregnancy [1]. We have also dedicated a full article to anti-Müllerian hormone (AMH), which we invite you to read to find out more.

FSH measurement (follicle-stimulating hormone)

FSH is another hormonal marker, generally measured at the very beginning of the cycle. This hormone provides additional information, but it is less reliable when interpreted on its own: an elevated level often reflects an already established reduction in ovarian reserve, whereas AMH allows earlier detection [2]. This is why these two measurements are most often combined.

Ultrasound and antral follicle count

A pelvic ultrasound can count the antral follicles visible on the ovaries at the beginning of the cycle. This is known as an antral follicle count, or AFC. Combined with AMH, this count helps refine the estimate of ovarian reserve.

Depending on the context, the doctor may supplement this foundation with other tests (a broader hormonal assessment, investigation of a specific cause). The choice and order of tests are always tailored to each situation by the healthcare professional looking after you. Consequently, there is no single standard pathway for all women.

Fertility tests sold in pharmacies, para-pharmacies or online have become much more widespread in recent years. They are accessible, easy to use at home, and can provide an initial indication. However, it is important to clearly distinguish between two categories of products, which are often grouped together under the generic term “fertility test”.

Ovulation tests

These tests detect the surge in luteinising hormone (LH) in urine, which occurs around 24 to 36 hours before ovulation [3]. They help identify the most fertile window of the cycle, which can be useful when trying to conceive. However, they do not measure any parameters related to ovarian reserve or egg quality. Their role is limited to identifying the time of ovulation.

Pharmacy ovarian reserve tests

A second category of single-use tests measures the level of FSH in urine to provide a one-off indication of ovarian reserve. This is a non-reimbursed home test based on a single urinary hormone marker, which is less accurate than a blood test carried out in a laboratory. This test cannot under any circumstances replace a full medical assessment, and an isolated result should not be interpreted as a verdict on your fertility.

In summary: a pharmacy test can be a useful starting point for getting to know your cycle better or for occasional reassurance, but it can never replace medical advice, especially if you have been trying to conceive for several months.

For a pharmacy test, the process is simple. It can be bought without a prescription from a pharmacy, para-pharmacy or online, and used at home by carefully following the instructions (timing in the cycle, time of day, reading time).

For a medical assessment, the first step is to consult a GP or gynaecologist, who will assess your situation and, if necessary, prescribe appropriate tests (blood test, ultrasound scan). Depending on the results and your plans, they may then refer you, if needed, to a specialist medically assisted reproduction (MAR) centre. Unlike tests available from pharmacies, this assessment prescribed by a doctor is covered by the French health insurance system under the usual reimbursement conditions.

There is no universal rule, but a few guidelines based on French recommendations can help you know the best time to seek advice:

• After 12 to 24 months of regular intercourse without pregnancy, for most couples.
• After 6 months of unsuccessful attempts if you are aged 35 or over.
• Even earlier in the case of very irregular cycles, known medical history (endometriosis, pelvic surgery...) or any particular concern.

Seeking advice earlier does not necessarily mean that something is wrong. On the contrary, it is a good way to give yourself more options and time, should support prove useful. An assessment that reveals no abnormalities can also reassure you about your ability to conceive.

Here is one point on which it is important to be particularly clear: only the doctor supporting you is able to put your AMH level, FSH level or follicle count into the context of your personal circumstances (age, medical history…).

Generally speaking, a result outside the usual range does not mean the end of the journey, but rather an opportunity to discuss it with your doctor, who may then suggest further tests or appropriate support if necessary.

Many women with atypical results go on to have pregnancies without particular difficulty, and conversely, a “normal” assessment is not an absolute guarantee. This is precisely why these results should be interpreted as part of a consultation, and never in isolation.

Whatever the outcome of your assessment, certain everyday foundations can help to actively support your hormonal balance and reproductive health. These include a varied and balanced diet, sufficient sleep, regular physical activity, stress management, and stopping smoking if this applies to you [4]. These are long-term approaches that work over time rather than in an emergency.

From a nutritional perspective, certain active ingredients are of particular interest in research into oocyte quality, such as coenzyme Q10, N-acetylcysteine (NAC) and tryptophan. It is with this in mind that we developed Ovo+, our supplement combining CoQ10, NAC and L-tryptophan, formulated to support women who wish to support their fertility on a daily basis.

To explore further the approaches you can adopt on a daily basis, read our article how to improve oocyte quality which details all these avenues.

Would you like to explore other approaches to fertility? Find all our guides and products in our Fertility collection.