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Fertility testing guide · 2026
Fertility testing goes wrong in a predictable way: the right tests on the wrong days, and no plan for what the answers change.
A sensible female fertility workup in Bangkok runs on two cycle timings plus a set of tests that can be drawn any day. On cycle day 2–4: FSH, LH and estradiol. Seven days before the expected next period: progesterone, to confirm ovulation. Any day: AMH, TSH, free T4, prolactin, ferritin, vitamin D, rubella immunity and, where relevant, an STI screen. Ultrasound for antral follicle count and uterine assessment completes the picture. Testing should generally begin after 12 months of trying, or after 6 months if you are 36 or older or have a known risk factor.
| Day 2–4 bloods | FSH, LH, estradiol |
|---|---|
| Mid-luteal blood | Progesterone, 7 days before expected next period |
| Any-day bloods | AMH, TSH, free T4, prolactin, ferritin, vitamin D, rubella IgG |
| Imaging | Pelvic ultrasound for antral follicle count and uterine assessment |
| Do not forget | Semen analysis for the male partner — roughly half of cases involve a male factor |
| Price | Listed on the MedEx lab test catalogue — same price nationwide |
Most guidance suggests investigating after 12 months of regular unprotected intercourse without conception, reduced to 6 months if the female partner is 36 or older. Earlier assessment is appropriate where there is a known reason to expect difficulty: absent or very irregular periods, previous pelvic infection or surgery, endometriosis, known tubal disease, previous chemotherapy or radiotherapy, or a male partner with known issues.
If you are simply planning ahead rather than actively trying, a baseline AMH plus a general health checkup is a reasonable starting point — but understand that it estimates response to treatment rather than natural conception chance.
Counting the first day of full flow as day 1, a draw on day 2, 3 or 4 provides:
These are only interpretable together. Ordering FSH alone remains one of the most common wasted tests in fertility workups.
Book cycle-timed fertility bloods at home in Bangkok or nationwide.
Confirming ovulation requires a progesterone drawn seven days before your expected next period — day 21 in a 28-day cycle, day 28 in a 35-day cycle. Counting backwards is more reliable than counting forwards because the luteal phase length is relatively fixed.
A single low result most often reflects mistiming rather than anovulation, so it is usually repeated in the following cycle before any conclusion is drawn. Where cycles are irregular, a clinician may use home LH kits to time the draw instead.
AMH for ovarian reserve, drawable any day. TSH and free T4, since thyroid dysfunction is common, treatable and affects both conception and pregnancy outcomes. Prolactin, particularly where periods are irregular or absent. Ferritin, since iron deficiency is very common and worth correcting before pregnancy. Vitamin D, frequently low even in Thailand. Rubella IgG, because vaccination must happen before rather than during pregnancy.
An STI screen is also part of a complete workup: chlamydia in particular can cause tubal damage without symptoms. Where a genetic carrier screen is relevant — thalassaemia is important in Thailand — see MedEx genetic testing.
Blood tests cannot assess whether the fallopian tubes are open, whether the uterine cavity is normal, or whether endometriosis is present. Those require imaging — pelvic ultrasound first, then hysterosalpingography, saline infusion sonography or laparoscopy as indicated.
They also say nothing about the male partner. A semen analysis is a simple, early and essential test: a male factor contributes in roughly half of couples. Testing one partner and not the other delays the answer by months.
Once the panel is complete, the productive step is a structured review with a clinician who can sequence what comes next. Book a doctor consultation or a specialist teleconsultation rather than adding more tests.
After 12 months of regular unprotected intercourse without conception, or after 6 months if you are 36 or older. Start earlier if periods are absent or very irregular, or if there is known pelvic disease, previous surgery, endometriosis or prior cancer treatment.
FSH, LH and estradiol are drawn on cycle day 2 to 4. Progesterone is drawn seven days before the expected next period. AMH, thyroid function, prolactin, ferritin, vitamin D and rubella immunity can be drawn on any day.
It is the most useful single marker of ovarian reserve and predicts response to fertility treatment, but it is a weak predictor of natural monthly conception chance once age is accounted for. It should not be read in isolation.
No. Tubal patency requires imaging such as hysterosalpingography or saline infusion sonography, and the uterine cavity is assessed by ultrasound or hysteroscopy.
Yes. A male factor contributes in roughly half of couples, and a semen analysis is quick and inexpensive. Testing both partners together avoids months of delay.
The blood draws can be collected at home in Bangkok or at MedEx sites nationwide. Ultrasound and semen analysis require attendance at a facility.
Both partners, tested together, gets to the answer faster.
Medical disclaimer: This article is general health information and does not replace medical advice, diagnosis or treatment. Laboratory reference ranges differ between laboratories and results must be interpreted alongside your symptoms, medicines and medical history. Speak with a qualified clinician before starting, stopping or changing any treatment. Service details, inclusions and prices can change — confirm them with MedEx before booking.
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