52. Advanced Fertility Testing Before IUI or IVF: Everything You Need to Know About Male and Female Fertility Tests

Season #2 April 13, 2026

Advanced Fertility Testing Before IUI or IVF: Everything You Need to Know About Male and Female Fertility Tests

Episode 52 | Her Fertility Podcast | Fertility Journey Series

Episode Overview

Before your doctor can recommend IUI or IVF, there's a set of advanced fertility tests that build the picture of what's actually happening in your body. In this episode of the Fertility Journey Series, Jess Tims walks through every test you're likely to encounter — for both the male and female partner — explaining what each one measures, how it's done, and what to make of the results. Jess also shares her own emotional experience with the HSG exam, and why preparing yourself emotionally for these appointments matters just as much as preparing physically.

"You don't want to waste any more time just because you don't know something. Ask. Ask your practitioner, ask about your insurance coverage, ask what comes next. Knowledge is how you advocate for yourself." — Jess Tims

What You'll Learn in This Episode

The advanced fertility tests typically prescribed before IUI or IVF — for both partners
What a semen analysis measures: sperm count, motility, and morphology — and why all three matter
What DNA fragmentation testing is and why Jess recommends it if it's available to you
How the female hormone panel works and why it's often done in two parts across your cycle
What AMH (anti-Müllerian hormone) is, what it estimates, and its important limitations
What the HSG exam is, how the procedure works, and why it's typically required before IUI or IVF
Jess's personal experience with the HSG — including what she wishes she had known beforehand
Why emotional preparation for fertility testing is as important as physical preparation
How to use test results alongside your inner guidance to make the best decision for your journey

The Tests at a Glance

Test

What it measures

Who it applies to

Semen analysis

Sperm count, motility (movement), and morphology (shape)

Male partner

DNA fragmentation

DNA abnormalities in sperm that could affect embryo development

Male partner (optional add-on)

Hormone panel

Reproductive hormone levels; progesterone tested separately in the luteal phase (around day 20)

Female partner

AMH test

Estimated ovarian reserve (egg count) via anti-Mullerian hormone level

Female partner

HSG exam

Whether fallopian tubes are open or blocked (using dye and imaging)

Female partner (typically required before IUI/IVF)

Male Fertility Testing

Semen analysis

A semen analysis is painless, non-invasive, and yields a significant amount of data. It can be ordered through your primary care physician, via a specialist referral, or done at home through services like Legacy (discount link in the show notes). The analysis measures:

Sperm count — the total number of sperm in the sample
Motility — how the sperm are moving (stationary sperm can't reach the egg)
Morphology — the shape of the sperm. Because the egg is the strongest cell in the female body, it takes a healthy, well-formed sperm to break through and fertilize it

DNA fragmentation analysis

An optional but valuable add-on to the standard semen analysis. This test examines the DNA makeup of the sperm for abnormalities that could affect embryo development — issues that wouldn't show up in a standard analysis. Jess recommends requesting this if it's accessible to you.

Female Fertility Testing

Advanced hormone panel (blood test)

This blood test measures your reproductive hormone levels. Many practitioners split it across two points in your cycle:

Cycle days 1–3 (during your period): hormones are at their baseline, giving a clear resting reading
Around day 20 (luteal phase): progesterone is tested here because this is when levels are highest and most meaningful

Coverage and protocols vary by practitioner and insurance provider. Ask your provider exactly which hormones they're testing and when, so you're not missing key data.

AMH test (anti-Müllerian hormone)

AMH is secreted by the follicles inside your ovaries. Your practitioner measures it via blood test to estimate your ovarian reserve — how many follicles you have remaining. Key things to understand about your AMH result:

It is a point-in-time reading — AMH levels can change as your overall health changes
It estimates quantity, not quality. There is currently no test that can directly measure egg quality
It is measured relative to your age — what's considered 'normal' shifts across different life stages
An exact egg count is not possible with current technology; AMH is the best available estimate

If your AMH comes back low, the next episode of the Fertility Journey Series is a full deep-dive on diminished ovarian reserve — what it means, your options, and how to move forward.

HSG exam (hysterosalpingogram)

The HSG exam checks whether your fallopian tubes are open or blocked. It is typically a mandatory test before IUI or IVF. During the procedure:

A dye is inserted into the uterus
Your body is positioned so the dye travels upward through the fallopian tubes
The path of the dye is monitored on a screen to identify any blockages

Experiences with the HSG vary widely. For Jess, it was physically painful and emotionally significant — it was the first time she fully faced the reality of her infertility diagnosis. She went alone and wasn't prepared for the physical sensations or the emotional weight of the day.

"I didn't set myself up with the support I needed for that day. Everybody's experience is different — but I would encourage you to bring support with you if you can, because you never know what will come up."

A Note on Emotional Preparation

Advanced fertility tests are medical procedures, but they're also emotionally loaded moments on your journey. Going in informed — knowing what to expect physically, having someone with you, and giving yourself permission to feel what comes up — makes a meaningful difference. At Her Fertility, support options include a full resource library, one-on-one sessions, and a monthly online support circle.

Resources Mentioned

🧬 Legacy at-home semen analysis (use code 'HERFERTILITY'): https://www.givelegacy.com/sperm-testing-kit?_clarm_vid=v_mo1v8s5xf03dqd

🎓 Free Masterclass — Come Back to Yourself: www.herfertility.support/free

💜 Fertility Frequency Collective: www.herfertility.support/collective

🎙️ Next Episode: Diminished Ovarian Reserve Explained: www.herfertility.support/podcast

📸 Follow Jess on social media: @herfertilitysupport

DISCLAIMER

The Her Fertility podcast is for general educational and informational purposes only and should not be taken as medical advice, diagnosis or treatment. Please consult your healthcare professional regarding any symptoms or medical problems you are experiencing.

Episode Transcript

Welcome to the Her Fertility podcast. If you've been told to just trust the medical system, or on the flip side to only focus on holistic healing and neither feels like the full picture, this space is for you. I'm your host, Jess Tims. After navigating my own infertility journey, I left my corporate career to create Her Fertility support.

Because women deserve more than rushed appointments and one dimensional answers. Here we bridge the gap between clinical care and holistic healing, combining science and research with nervous system mindset and deep human connection. Because you don't have to choose one path. You get to use all of it, and when you do, everything changes.

Let's begin.

This is the third time I am recording this podcast episode. I don't know what keeps happening, but something is interfering with. The information on advanced fertility testing. In this episode, I am going to share the advanced fertility testing that your practitioner is likely to prescribe for you if you have been diagnosed with infertility. And these are all tests that will be done before you do advanced procedures like IUI or IVF. So let's get into it.

we're gonna start with the easy one, which is male fertility. If you are the male partner, you can expect to have a semen analysis. And the wonderful thing about the semen analysis is it is a painless procedure that's gonna give you a lot of data. Now you can ask for a semen analysis from your primary care physician.

They might refer you to a specialist. Or you can opt to do an at home semen analysis through a company like Legacy, and I will include a link for a discount to Legacy Below. I don't get anything from them. They're just nice enough to give the listeners of this podcast a discount.

So that you can get your semen analysis done in the comfort of your own home, which is awesome and way less awkward than going into a clinic. And the basic semen analysis will give you three markers for your sperm health. It will give you sperm count or how many sperm are in the sample.

It will give you motility or how the SPO are moving if there's no movement, they're not gonna get very far. And then the analysis will also see the sperm morphology or the shape of the sperm. And it is fascinating the different shapes and formations that sperm can take on.

They don't always look like the little fish we see. Sometimes they have. No tail or two tails. Sometimes they have two heads, some have like a blunt head. And it's really important that sperm have a good shape because the egg is the strongest cell in the female body and it takes a strong, healthy sperm to break through that egg to fertilize it.

All three markers are really important to your sperm health, and in addition to those three markers, you can also opt for a DNA fragmentation analysis of sperm, and that is where they will look at the sperms DNA makeup to see if there are any abnormalities in the DNA, which could be causing problems with an embryo I'm all for having the most data possible about our bodies.

So I say go for the DNA fragmentation if it's available to you. Now for the female partner, the advanced fertility testing that's gonna give you more data about your body comes in three parts.

First, you're gonna have an advanced hormone panel, which is a simple blood test that will test your reproductive hormones. Some practitioners like to do this test in two parts at the first part of your cycle, typically within the first three days of your cycle. So once your period starts, you'll go in for a blood test, and that's because your hormones are at their lowest point.

While you're on your period, so they can test hormones and see their levels at that point. And then some practitioners will also have you come back during your luteal phase, later in your cycle, typically around day 20 to test for your progesterone, because progesterone is highest in the luteal phase, and so they can get a good reading on your progesterone level at that point in time.

Now it is important to remember that all practitioners work differently, and all insurance providers cover different things. So you wanna get familiar with what is covered for you and what you have access to from your practitioner. And if you have questions, ask them because you don't want to waste any more time just because you don't know something. So in addition to having an advanced hormone panel or blood test, you'll also have your A MH level tested. Now A MH stands for anti malian hormone. And it is the hormone that is secreted by the follicles that are inside your ovaries.

So you are born with all of your beautiful eggs inside your ovaries, but they're not exactly mature eggs. They're actually follicles. And during ovulation, a few of those follicles will start to mature to become a fully beautiful egg, to be released during ovulation. And typically only one egg is released, sometimes two.

And that egg is released, it comes down the fallopian tubes for the chance to meet sperm and create an embryo. Now your doctor can test your A MH level throughout blood test, and what that will give them is an estimate of how many follicles you have in your ovaries.

This is also known as your ovarian reserve, and the idea here is that the higher the level of a MH, the more follicles you have and vice versa. The lower level of a MH, the less. Follicles you have in your ovaries. Now it is important to know a couple things about a MH. This is a point in time reading and a MH levels can change not because the number of eggs you have changes, but because the overall wellbeing and health of your body changes.

So the amount or level that's secreted by the follicles can change and, and some practitioners will say this as like your egg quality or your egg health changes. Now the frustrating part about this is we can't actually count the exact number of eggs you have. We don't have science to do that.

Instead, practitioners will measure your A MH level. And they might do an ultrasound to see the health of the ovaries and to see that, yes, in fact there are follicles in the ovaries, but we don't have the technology available to us yet to actually count the number of follicles you do have. So practitioners will make their best educated guests based on the data they can gather on your body to say you have a.

Normal range of ovarian reserve, or you have a suboptimal range of ovarian reserve and ovarian reserve is tied to your age. This is a statistic that is measured based on your age, because statistically speaking, younger women have more eggs and older women have less eggs, and so this is something that's tied to your age and will be measured.

According to your age. Now, in the next episode of the Her Fertility podcast, we are going to do a deep dive on low ovarian reserve. So if you get your A MH tested and it's low and you are diagnosed with low ovarian reserve, we are gonna deep dive into that so that you know more about the decisions you will be making at that point in your fertility journey.

But regardless of what your fertility journey brings you, in addition to testing your hormones, your practitioner is also going to want to see that your fallopian tubes are open. And this is typically a mandatory test. If you are gonna do IUI or IVF. And practitioners will want to see that your fallopian tubes are open, because if they're not, that could be what's blocking you from getting pregnant.

And there's a variety of reasons why there might be a block or a sub block in the fallopian tubes. And so an HSG exam is the exam that will test for that, and essentially they put a dye. Into the uterus, and then they use the force of gravity and tilt your body so that your head is lower than your feet, and the dye runs up through your uterus and then through the fallopian tubes, and they monitor that on a screen to see if the tubes are blocked or if they are.

Open now. I shared my full experience with the HSG exam here on the Her Fertility podcast, and I will say that everybody's experience with this exam is different. For me, it was pretty painful. It's not for everybody and I didn't have any blocks, but I still experienced pain. But for me, it also was a pretty emotional experience because it was the first time in my fertility journey where I was doing an advanced fertility test.

I went to my appointment alone. I didn't feel very prepared for the exam. I didn't know that it could be painful. I didn't ex. Fact that there would be like discharge of the dye afterwards. And I didn't bring like a pad or anything with me for that. And it was really the first time where I had to face the reality that I had in fertility.

And so emotionally, it was a really challenging day. It's a day I will never forget. Um, and I was definitely, I definitely didn't set myself up with the support that I needed. For that day. So again, everybody is different, but I would encourage you to set yourself up with support if you can, because you never know what's gonna come outta left field for you when you're doing these advanced fertility tests.

And here at Her Fertility support, we have multiple ways of supporting your fertility journey. So whether you're someone like me who likes to do things on your own, we have a full library of resources for you. Um, we also, of course, do one-on-one support. And we have our fertility support circle, which is a group support that meets online once a month.

And so seek out the support that you need during this time. You are not going to be in this moment forever. This is a moment in so use the resources we have to support you during this time because infertility was never meant to be navigated alone.

And when you have the support, it just makes this journey that much less of a struggle. And so once you have the data from these advanced fertility tests, you will then be able to make the best decision for you moving forward. You will likely have a recommendation from your practitioner.

You will likely have a recommendation from your medical provider, but as we talked about in the last episode of this Fertility Journey series. It's also important to listen to your inner guidance, so if you didn't listen to that one, go back and listen because regardless of what your next steps are, it is unique to everybody and so you can tune into what is the best next step for you.

And if you are enjoying this Fertility Journey series all here on the podcast, I would love to hear from you. I would also love to know what your journey has brought you and what information I can provide to support you through that. So find me on social media at Her Fertility support, and I look forward to bringing you the low ovarian reserve episode next.

Thank you for joining me on this week's episode of the Her Fertility podcast. I am so grateful you're here. If you found this episode valuable, then I'd love for you to join me on the next one, share it with a friend, and rate the episode with a five star review so that the podcast can reach the women who need it most.

If you have any questions about what you just heard, please connect with me on social media. At Her Fertility support, find the right type of support for your fertility journey in the show notes below.