Fertility Testing & Assessment
Tests that tell
your story.
Your fertility assessment is built around you. Your specialist orders the diagnostic tests that fit your situation, reviews every result, and shapes your plan from what they learn.
- PersonalizedYour specialist orders the tests that fit your situation. Not every test is for every patient.
- Mostly CoveredMost diagnostics are covered. AMH and a few specialty tests are private.
- Specialist-ReviewedEvery result is reviewed by your fertility care team, with REI oversight on every plan that needs it.
Your Fertility Assessment
Recommended by your specialist and built around you.
Your workup is built from four kinds of tests: bloodwork, imaging, semen analysis (when sperm is part of the picture), and genetic screening. Your specialist chooses which apply to you. Coverage and out-of-pocket cost depend on the specific tests; what’s covered by OHIP or MSP is noted on each card below.
Just want a baseline snapshot? A Fertility Check is a standalone $250 service you can book on your own initiative.
See Fertility CheckWhat we may test
Four pillars of the workup.
Blood Work· For patients with eggs
Hormone and ovarian reserve testing
Blood work gives your specialist a window into how your ovaries are working and what may be affecting your fertility. Your tests are timed to specific days of your cycle for the most accurate read.
What we may test
- AMHAnti-Müllerian Hormone. A reliable marker of ovarian reserve, drawn at any point in your cycle.
- FSH and LHFollicle Stimulating and Luteinizing Hormones. Drawn early in your cycle to assess the signals your brain is sending to your ovaries.
- EstradiolThe dominant form of estrogen. Helps interpret FSH and LH results in context.
- ProgesteroneConfirms ovulation when drawn in the second half of your cycle. Helps interpret FSH and LH results in context.
- TSHThyroid hormone. Imbalances can interfere with ovulation and pregnancy.
Ultrasound & Sonohysterogram· For patients with a uterus
A clear look at your uterus and ovaries
Imaging lets your specialist see the structures involved in conception and pregnancy. Most patients have at least one diagnostic ultrasound. A sonohysterogram is added when we want to look more closely at the shape of your uterus and whether your fallopian tubes are open.
What we look for
- Antral Follicle CountThe number of small follicles in each ovary, paired with AMH for a fuller picture of ovarian reserve.
- Pelvic and Internal UltrasoundA detailed look at your uterus and ovaries, including any ovarian cysts or uterine fibroids.
- SonohysterogramA specialized ultrasound where a small amount of sterile fluid is gently placed in the uterus to map its shape and check that the fallopian tubes are open.
Semen Analysis· For patients with sperm
Three measurements that shape the plan
When sperm is part of the picture, a semen analysis is one of the most useful first tests. It measures numerous parameters including three that matter most: the amount of sperm, the amount that are moving, and the total number of moving sperm in the entire sample. Results often change the recommended care plan.
What we measure
- ConcentrationThe number of sperm per millilitre. If very low, additional testing may be recommended.
- MotilityThe percentage of sperm that are moving. Sperm that can’t reach the egg can’t fertilize it.
- Total Motile CountThe total number of moving sperm in the entire sample. If low, IUI or IVF may be recommended.
- DNA FragmentationTests the integrity of sperm DNA. Recommended in certain situations including recurrent loss or unexplained infertility.
Genetic Screening· For everyone
Information that shapes your plan
Genetic carrier screening is offered to everyone at Twig, always starting with a session with one of our certified genetic counsellors. They walk you through what’s tested, what results may mean for you, and what next steps look like before any tests are ordered.
Common screening pathways
- Genetic CounsellingRequired before screening. A live webinar by our in-house genetic counsellor or a one-on-one session that walks you through what’s tested and if testing is right for you.
- Carrier ScreeningA blood test that screens for hundreds of inherited conditions, including cystic fibrosis, spinal muscular atrophy, fragile X, and many others. Done once, early in your care.
- KaryotypeA chromosome-level test, ordered when there’s a personal or family history that suggests it.
At The Clinic
What a workup visit looks like.
This describes an ultrasound and bloodwork visit. Visits for semen analysis follow a different flow, which your team will walk you through.
- 01
Check in
You’re greeted at reception. Health card scanned. Forms reviewed.
- 02
Change room
For an ultrasound visit, a private space with a gown, robe, and slippers. For a semen analysis, a private collection room.
- 03
Testing
Ultrasound and bloodwork typically run together in the same visit (15 to 20 minutes). A semen analysis visit is shorter.
- 04
Specialist reviews
Your results are reviewed by your fertility specialist. Your nurse messages you with what’s next.
Common Questions
Quick answers about your workup.
No. You can book a consult directly. Your specialist will order the diagnostic tests that fit your situation.
Most are. In Ontario, most hormone bloodwork and diagnostic ultrasounds are OHIP-covered. AMH and a few specialty tests are self-pay. In BC, coverage is similar through MSP, with some tests self-pay. Your care team confirms costs before any self-pay tests are ordered.
No. Your specialist orders only the tests that are useful for your situation. Some patients need just a few; others need more. The point of the workup is to gather enough information to build a confident care plan, not to test for its own sake.
We will walk you through preparation in advance. Some tests are timed to specific days of your cycle, others are not. Your nurse confirms timing and any prep details by message before each visit.
Most patients describe it as cramping similar to a period, lasting a few minutes during the procedure. Many people take ibuprofen 30 minutes beforehand. The procedure itself takes about 10 to 15 minutes and you can go straight back to your day.
DNA fragmentation testing measures the integrity of sperm DNA. Higher fragmentation is associated with poorer embryo quality and higher rates of pregnancy loss. We typically order it when there is recurrent pregnancy loss, recurrent implantation failure, a history of unsuccessful past IVF cycles, or to guide whether ICSI may help in IVF.
Most patients complete their workup over two to four weeks, depending on which tests are ordered and where you fall in your cycle. Some tests have to be timed to specific days of your menstrual cycle, which can stretch the timeline by a few weeks. Your care team gives you a personalized roadmap at your first visit so you know what to expect.
A Fertility Check is a standalone $250 snapshot you can book on your own initiative. It includes AMH bloodwork, an ultrasound (or semen analysis), and a virtual review with a fertility specialist. A workup is a deeper diagnostic phase ordered by your specialist after your first consult, based on your specific situation, with tests selected just for you.
Most patients pay $150 to $400 out of pocket across their full workup, depending on which tests are ordered. AMH is typically the largest single self-pay item ($125). Your care team confirms every cost with you before any private test is ordered.
Most blood and imaging results are available for you to view on your portal the same day or within three to five days. Genetic carrier screening results typically take four to five weeks. Once all of your results are ready, they will be reviewed with your fertility specialist at your comprehensive review appointment.
Yes. Partners are welcome at any appointment, in person or virtually.
Get Started
Ready to map out a plan?
Book a consult. Your specialist will recommend the right diagnostic tests, review every result, and shape your plan from there.