Results Shouldn’t Feel Like a Foreign Language
One of the things I try hardest to do at every follow-up appointment is make sure patients actually understand what their results mean — not just what the number is, but what it means for their fertility and their treatment options.
Here’s a plain-language guide to the tests I order most often and what I’m actually looking for in the results.
Blood Tests
AMH (Anti-Müllerian Hormone)
Think of AMH as your egg count — it reflects how many follicles (and therefore potential eggs) your ovaries currently have. A higher AMH means more eggs remaining; a lower AMH means fewer. It can be done on any day of your cycle.
Important caveat: AMH tells us about quantity, not quality. A woman with a low AMH can still have good-quality eggs and conceive. Age is the main determinant of quality. What AMH mainly tells us is how well you’d respond to IVF stimulation — whether we’d get 2 eggs or 12.
FSH (Day 3)
FSH is the hormone your pituitary gland produces to tell your ovaries to grow follicles. When ovarian reserve is low, the pituitary works harder — so elevated FSH on Day 3 suggests the ovaries aren’t responding easily. It must be interpreted alongside oestradiol (if oestradiol is high, it suppresses FSH artificially).
LH (Luteinizing Hormone)
An elevated LH:FSH ratio (greater than 2:1) on Day 3 is a classic finding in PCOS. LH also surges to trigger ovulation — this is what ovulation predictor kits detect.
TSH (Thyroid Stimulating Hormone)
For women trying to conceive, I aim for TSH below 2.5 — stricter than the general normal range. This small difference matters significantly for fertility and early pregnancy.
Prolactin
High prolactin suppresses ovulation. Can be caused by a tiny, benign pituitary adenoma (prolactinoma) — very treatable with medication. One elevated result needs to be repeated, as stress and timing can cause temporary elevation.
Day 21 Progesterone
Done 7 days after ovulation (Day 21 in a 28-day cycle, but adjusted for your cycle length). If progesterone is elevated, it confirms that ovulation did occur in that cycle.
Ultrasound
Transvaginal Ultrasound
The most informative single test in fertility. I assess:
- Uterus: shape, size, fibroid presence, lining thickness
- Ovaries: appearance, presence of cysts, polycystic morphology
- Antral Follicle Count (AFC): the number of small resting follicles visible — this correlates with AMH and ovarian reserve
Tubal Assessment
HSG (Hysterosalpingography)
Dye injected through the cervix, visualised by X-ray to see the uterine cavity shape and whether the fallopian tubes are open. Blocked tubes on HSG is a significant finding — IUI won’t work, and IVF becomes the recommended path.
One note: HSG can sometimes clear minor tube blockages — some couples conceive naturally in the cycles after an HSG.
Hysteroscopy
Direct camera inside the uterus — the gold standard for assessing the cavity. More accurate than ultrasound for detecting polyps, fibroids, adhesions, and septum.
Understanding Your Results Together
At Punit Fertility, Kandivali Mumbai, results are always explained in plain language at follow-up. You’ll leave knowing exactly what your tests mean and what the plan is from here.