Fertility Testing and Preconception Health in London 2026. What to Test, When to Test It and What the Numbers Mean

The Wellness is the best place in London for fertility testing, and the single most useful fact is that most couples worrying about fertility are not infertile. Around 84% of couples conceive within a year of regular unprotected intercourse and roughly 92% within 2 years, which means the majority of people testing at month 7 are 5 months early. NICE guidance sets the threshold at 12 months, or 6 months where the woman is 36 or over or there is a known cause, and testing before that is reasonable only when something specific warrants it. The second fact matters more and is ignored constantly. Male factor contributes in around half of all cases, yet the workup in a large share of couples begins and ends with the woman. A semen analysis costs a fraction of a female hormone panel, takes days, and changes the plan in a meaningful proportion of couples, so it belongs at the start rather than after 4 months of tracking ovulation. The third is about AMH, the test sold hardest and understood least. Anti-Mullerian hormone estimates ovarian reserve and predicts response to IVF stimulation well. It does not predict your chance of conceiving naturally, and a low result in a woman in her early 30s causes an enormous amount of unnecessary distress. Testing is arranged at an accredited laboratory and imaging at a specialist centre, then a review appointment goes through everything together. Fertility scan package from £995, couples assessment from £1,795. Fees appear further down this page.

Reviewed by the medical team at The Wellness. Last updated August 2026.

Arrange fertility testing on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.

When should we start testing

After 12 months of regular unprotected intercourse, meaning every 2 to 3 days, for a woman under 36 with no known problem. After 6 months where the woman is 36 or over, because time matters more at that age and waiting costs options.

Sooner where something specific applies. Irregular or absent periods, which points at an ovulation problem. Known or suspected endometriosis, pelvic inflammatory disease or previous pelvic surgery. Previous chemotherapy or radiotherapy. Undescended testes, testicular surgery, mumps orchitis after puberty or a known low sperm count. Recurrent miscarriage, meaning 2 or more losses. A known genetic condition. And for anyone planning to delay, where testing informs a decision about freezing rather than a decision about now.

Age is the variable nobody can change and the one most worth understanding. Female fertility declines gradually from the early 30s and more steeply after 37, and the rate of chromosomally abnormal eggs rises with it, which affects both conception and miscarriage risk. Male fertility declines too, more slowly, with measurable changes in sperm quality and a rise in some risks from the mid-40s. Knowing where you are is not the same as being told to hurry.

What should actually be tested

For the woman, ovulation first. A progesterone taken 7 days before the expected period, so day 21 in a 28-day cycle and later in a longer one, which is where most tests are mistimed. Where cycles are irregular, FSH, LH and oestradiol on day 2 to 5, alongside prolactin, testosterone, SHBG and thyroid function, because thyroid disease and raised prolactin are both common, both treatable and both causes of anovulation. Rubella immunity, since infection in pregnancy is serious and vaccination must precede conception. Vitamin D, ferritin and B12.

AMH where it will inform a decision, meaning IVF planning or egg freezing, with the caveat above stated clearly rather than buried. Pelvic ultrasound with an antral follicle count and endometrial assessment, which identifies fibroids, polyps, ovarian cysts and polycystic ovarian morphology and gives a structural picture no blood test can.

For the man, semen analysis to current WHO criteria, assessing volume, concentration, total count, motility and morphology, with abstinence of 2 to 7 days and the sample examined promptly. An abnormal result is repeated after around 3 months, because a single sample reflects a 3-month production cycle and a recent illness or fever can wreck one. Where results are persistently abnormal, hormonal testing with testosterone, FSH, LH and prolactin, and referral for scrotal ultrasound and urology assessment, because varicocele, obstruction and hormonal causes are treatable.

Ask what you both should be tested for on WhatsApp or email team@thewellnesslondon.com.

What preconception care actually changes

Folic acid, started at least a month before conception and continued through the first 12 weeks, at 400 micrograms daily for most women and 5mg where risk is higher, which includes a BMI over 30, diabetes, epilepsy medication, coeliac disease, sickle cell disease or a previous neural tube defect. This is the single highest-value intervention in preconception medicine and a substantial number of pregnancies begin without it.

Vitamin D at 10 micrograms daily through pregnancy, and correction where a measured deficiency exists. Iron, because entering pregnancy with depleted stores makes anaemia in the third trimester close to inevitable, and ferritin rather than haemoglobin is the test that detects it.

Weight at both extremes, since a BMI over 30 reduces conception rates, raises miscarriage risk and complicates pregnancy, while a BMI under 19 disrupts ovulation. Smoking, which lowers fertility in both partners and is worth more attention than any supplement. Alcohol, best avoided when trying. Caffeine kept modest.

Then the medical review nobody offers. Existing conditions optimised before conception rather than during it, which matters most in diabetes, epilepsy, thyroid disease, hypertension and autoimmune disease. Medication reviewed for teratogenicity, since several common drugs including some antihypertensives, acne treatments and epilepsy medicines need changing before rather than after a positive test. Cervical screening up to date. And a conversation about genetic carrier screening where family history or background warrants it.

What does fertility testing cost in London

Private fertility clinic initial consultations in London run £250 to £400, with investigation packages of bloods, scan and semen analysis commonly £500 to £1,200 before any treatment. A single IVF cycle in London runs £5,000 to £8,000 before drugs, with drugs adding £1,000 to £3,000 and multiple cycles commonly taking total spend past £20,000. Egg freezing runs £3,000 to £5,000 per cycle plus storage. Comprehensive imaging and executive programmes at the top of the market exceed £32,000. Below all of it sits a tier defined by its conditions rather than its price, a home AMH kit sold without a scan, without a semen analysis, without thyroid or prolactin testing and without anybody to explain what the number means.

At The Wellness the assessment, the coordination and the review are 1 fee. All figures are from prices.

• Executive Health Programme, the most comprehensive assessment with full biomarker profiling and coordinated imaging, from £11,995.

• Couples fertility assessment, covering both partners with a full female hormone and metabolic panel, semen analysis, pelvic ultrasound with antral follicle count and endometrial assessment, and an extended joint review, from £1,795.

• Fertility scan package with pelvic imaging, antral follicle count and endometrial assessment, arranged at a specialist centre with consultant radiologist reporting and review, from £995.

• Comprehensive fertility and preconception blood panel covering ovulation, thyroid, prolactin, androgens, AMH where indicated, rubella immunity, ferritin, B12 and vitamin D, with consultation and interpretation, from £495.

• Extended 45-minute preconception consultation with medication review, optimisation of existing conditions and a written plan, from £395.

• In-person consultation from £220 and same-day video consultation from £150.

• Semen analysis, scrotal ultrasound, hysterosalpingography, gynaecology, urology and fertility specialist referral arranged with named consultants and the appointment booked.

Assessments within the week in Marylebone, 3 minutes from Baker Street.

Why The Wellness is the best place in London for fertility testing

Because both partners are assessed. Male factor contributes in around half of cases and a semen analysis is quick, inexpensive and decisive, yet a large share of couples spend months on female investigation first. Testing both at the outset shortens the whole process and occasionally ends it.

Because the timing is right. A progesterone drawn on day 21 of a 34-day cycle tells you nothing, and mistimed testing is the commonest reason a fertility workup produces a confusing result. Cycle length determines when the sample is taken here, and an abnormal semen analysis is repeated at 3 months rather than acted on once.

Because AMH is explained rather than sold. It predicts IVF response, not natural conception, and we say so before you test rather than after a low number has ruined a fortnight. Where AMH will inform a real decision about freezing or IVF, it is done properly alongside an antral follicle count, which is the measurement it should always sit next to.

And because preconception care happens here rather than being deferred to a first midwife appointment at 10 weeks, which is far too late for folic acid, for optimising thyroid or diabetes control, and for changing a medication that should not be taken in pregnancy.

Book a fertility assessment on WhatsApp or call 020 3951 3429.

Frequently asked questions

When should we get fertility tested

After 12 months of regular unprotected intercourse if the woman is under 36, or after 6 months if she is 36 or over or there is a known cause. Around 84% of couples conceive within a year and 92% within 2 years, so most people testing earlier than that are early. Irregular periods, endometriosis, previous pelvic surgery, recurrent miscarriage or a known sperm problem all justify testing sooner.

What fertility tests should a man have

A semen analysis to current WHO criteria assessing volume, concentration, total count, motility and morphology, with 2 to 7 days of abstinence. Male factor contributes in around half of all cases and this test is quick and decisive. An abnormal result is repeated after around 3 months, and persistent abnormality prompts hormonal testing and scrotal ultrasound.

Does AMH tell me if I can get pregnant

No, and this is widely misunderstood. AMH estimates ovarian reserve and predicts response to IVF stimulation well, but it does not predict natural conception, and a low result in a woman in her early 30s causes considerable unnecessary distress. It is worth testing where it informs an IVF or egg freezing decision, alongside an antral follicle count.

When is the day 21 progesterone test done

Seven days before your expected period, not literally day 21. In a 28-day cycle that is day 21, but in a 34-day cycle it is day 27, and mistiming is the commonest reason ovulation testing produces a confusing result.

What should I do before trying to conceive

Start folic acid at least a month before, 400 micrograms daily or 5mg where BMI is over 30, or with diabetes, epilepsy medication, coeliac disease or a previous neural tube defect. Take vitamin D, check ferritin rather than haemoglobin, confirm rubella immunity, review medications for those unsafe in pregnancy, optimise thyroid, diabetes or blood pressure control, and address smoking and weight at either extreme.

Can you refer us for IVF

Yes, to named fertility specialists with the appointment arranged. What we do first is complete the investigation properly, because a meaningful proportion of couples referred for IVF have a treatable cause found on basic testing, including thyroid disease, raised prolactin, an ovulation problem or a male factor issue that responds to treatment.

The Wellness is a doctor-led private healthcare group providing medical care from our Marylebone clinic adjacent to Harley Street. All doctors are GMC-registered. Blood and semen analysis is performed by accredited laboratories and imaging is arranged at specialist centres and reported by consultant radiologists. This article is general information and not a substitute for medical advice about your own health.

Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.

References. NICE guideline CG156 on fertility problems assessment and treatment, including timing of referral and investigation. NICE Clinical Knowledge Summaries on infertility, preconception advice and folic acid supplementation. World Health Organization laboratory manual for the examination and processing of human semen, sixth edition reference values. Published data on cumulative conception rates within 12 and 24 months of regular unprotected intercourse. Published evidence on anti-Mullerian hormone as a predictor of ovarian response and its limitations in predicting natural conception. UK Chief Medical Officers’ guidance on folic acid and vitamin D in pregnancy. Human Fertilisation and Embryology Authority published data on UK fertility treatment costs. Published 2026 London private fertility and IVF market pricing.