Thinking about booking your first couples fertility test? Follow this London consultant’s step-by-step

Looking at booking a couples fertility test in London this year? You’re probably not the only ones!

With many of us in the city starting to try later, navigating mixed messages online and wanting a proactive approach to reproductive health, a clear specialist-led testing baseline that gives actionable next steps is something that feels like a non-negotiable right now.

At Fitzrovia Fertility, our go-to in London, this shift is something Dr. Neerujah Balachandren, Consultant Gynaecologist and Subspecialist in Reproductive Medicine, sees a lot. At their boutique clinic in the heart of Marylebone, Fitzrovia Fertility focuses on bespoke, evidence-based testing and care, with time to explain what your results actually mean for you as a couple. 

Curious? Hop over to their website to learn more about their fertility assessments and to book in.

Now, if you’re considering your first couples fertility test in London, here’s what the process looks like, step by step – with the expert perspective from Dr. Balachandren.

Step 1 – Booking your test

Wondering when to book a couples fertility test? Timing depends on age, cycle patterns, and medical history. Here’s the nutshell.

After one year of trying:

For couples under 35, with regular menstrual cycles (usually under 35 days), no known gynaecological or andrology issues, and no previous concerns, fertility testing is generally recommended after around one year of trying to conceive.

After 3-6 months of trying:

Earlier testing is advised if a female partner is aged 35 or over, or if either partner has a known medical history that could affect fertility. This includes:

• Endometriosis and polycystic ovary syndrome (PCOS)
• previous pelvic surgery or infection
• irregular or absent periods
• a history such as undescended testicles

If you are not having periods, or they are very infrequent, a hormone profile can be done as soon as you feel ready to start trying.

For couples thinking about fertility preservation, testing can take place as soon as you wish to explore that option.

Looking for reassurance? 

Another common group booking a fertility assessment in London are couples who feel overwhelmed by information and want clarity. Many struggle to understand cycle timing, which tests are useful, and when to take action. 

Dr. Balachandren often sees couples at Fitzrovia Fertility who simply need clear, correct guidance. In some cases, no investigations are needed at all, just reassurance and practical advice.

Step 2 – Prepping for your appointment

Come to your appointment prepared with your timeline, medical history, medications, and questions. Writing these down helps you leave with clear answers.

We love a checklist, so here’s one you and your partner can use: 

• For female partners – Track your cycle and past hormone use. Bring details of cycle regularity, symptoms, and any long-term contraception.
• For male partners – Optimise semen testing conditions. Follow abstinence guidance, avoid heavy alcohol, and carefully follow sample instructions.

If you or your partner have had previous IVF cycles or have undergone fertility preservation, bring a summary of that prior treatment, including protocols, doses, hormone levels, and outcomes.

Step 3 – Attending together

A couples fertility test always begins with a detailed consultation, and your specialist will take a full medical, gynaecological, reproductive, and lifestyle history for both partners before arranging any investigations.

What investigations might be carried out?

For the female partner, investigations usually include:

• hormone panel blood tests (including AMH, FSH, LH and oestradiol)
• rubella immunity if not previously checked
• thyroid function tests (with thyroid peroxidase antibodies if not assessed in the last six months)
• a full blood count
• haemoglobinopathy screening (to look for inherited genetic conditions affecting the haemoglobin in the blood)
• a pelvic ultrasound scan

For the male partner, investigations will start with:

• a semen analysis

How long does it all take? 

The initial consultation usually lasts around one hour. If a pelvic ultrasound scan is performed on the same day, allow an additional 30 minutes.

At Fitzrovia Fertility, blood test results are often available the same day. 

Semen analysis results are typically ready within 48–72 hours.

Step 4 – Follow-up appointment and explanation of your results

Once results are back, results are reviewed with the same consultant who carried out your initial assessment, and you’ll have a follow-up appointment with them to discuss findings and next steps.

Couples will typically be advised to start pre-conception vitamins if they haven’t already. Women aged 35 and over, or those with a lower egg reserve, may also consider additional supplements.

Each result is explained clearly, including what falls within the normal range and what may affect future options.

You’ll receive a written summary after your appointment outlining results, interpretation, and recommended next steps, giving you a clear record to refer back to.

Step 5 – Deciding your next steps

Your next steps will depend on your results and circumstances. 

Some couples are advised to continue trying naturally with reassurance and guidance. Others may discuss fertility treatment or fertility preservation options such as egg or embryo freezing.

If you choose to proceed, your consultant will create an individualised treatment plan. You’ll then meet the Clinical Nurse Specialist and administrative team, who explain costs, medication timing, scans, blood tests, and HFEA consent forms.

Complex cases and cycles with unexpected outcomes are reviewed in a multidisciplinary team meeting to ensure the most appropriate plan.

We’ve covered how Fitzrovia Fertility’s expert consultants build fully personalised treatment plans for patients in more detail – read up here for the latest.

Your couples fertility test London go-to

A specialist-led couples fertility test in London at Fitzrovia Fertility is built around you, and is not a one-size-fits-all checklist.

Specialists are chosen to answer clear clinical questions based on your history. For example, if your cycles are irregular, your consultant might suggest:

• hormone blood tests
• a pelvic ultrasound to look for signs of polycystic ovary syndrome (PCOS)

If PCOS is then identified, further relevant tests, such as HbA1c to assess metabolic health, may then be added. This step-by-step approach avoids unnecessary testing and keeps results meaningful.

Timing matters too. Hormone tests done at home taken on the wrong day of the cycle can be misleading, and semen analysis results can be affected by things like:

• recent illness
• heavy alcohol intake
• not following the recommended abstinence window

Your assessment at Fitzrovia Fertility brings everything together – from the right history, the right tests and careful interpretation in context. This joined-up view simply isn’t possible with stand-alone or at-home tests.

For example, Dr. Balachandren often sees patients who were told they had a “low egg reserve” after an AMH test taken soon after stopping long-term contraception. 

Without specialist interpretation, results like these can cause unnecessary worry and pressure to make quick decisions.

Want to get started? Visit the Fitzrovia Fertility website to learn more, and book your couple fertility test in London today.