Couple fertility assessment

What is a couple fertility assessment?

A couple fertility assessment is a coordinated set of investigations for both partners, designed to identify the most likely reasons for difficulty conceiving and guide the next clinical step. Fertility is a shared concern: roughly a third of cases involve a female factor, a third involve a male factor, and a third are a combination of both or remain unexplained. Investigating both partners together saves time and avoids the common pattern of one partner being tested while the other waits months for a referral.

The assessment is led by Mr Hikmat Naoum, Consultant Gynaecologist (MRCOG), and coordinated from 117a Harley Street. Blood tests and imaging for the female partner are done on site. Male blood tests are also drawn at the clinic, and semen analysis is arranged through a partner laboratory with results returned to Mr Naoum for review.

When should couples seek assessment?

NICE guidelines recommend investigation after 12 months of regular unprotected intercourse without conception. If the female partner is over 35, 6 months is a reasonable point to start. Earlier assessment makes sense if either partner has a known condition that could affect fertility:

• Endometriosis or polycystic ovary syndrome
• Irregular or absent periods
• Previous pelvic surgery or ectopic pregnancy
• Known male factor (undescended testes, varicocele, previous chemotherapy)
• Recurrent miscarriage

If you are unsure, book an initial consultation to discuss whether a full couple assessment is the right starting point.

What the assessment covers

The exact investigations depend on your history and clinical picture. Below is the typical scope for each partner.

Female partner

• Clinical history. Menstrual cycle pattern, previous pregnancies, medical and surgical history, medications, lifestyle factors.
• Hormone blood tests. Drawn at the clinic. Typically includes FSH, LH, oestradiol, AMH (ovarian reserve), prolactin, thyroid function, and progesterone. Timing within your cycle matters for some markers; the clinic will advise when to attend.
• Pelvic ultrasound. A transvaginal ultrasound assesses ovarian reserve (antral follicle count), uterine anatomy, and checks for fibroids, polyps, or ovarian cysts. This can usually be done on the same day as your consultation.
• Tubal assessment. If there is clinical suspicion of tubal disease, Mr Naoum will discuss options including HyCoSy (a contrast ultrasound of the fallopian tubes) or referral for laparoscopy.

Male partner

• Clinical history. Medical and surgical history, medications, lifestyle factors, previous fertility investigations.
• Blood tests. Hormone bloods (FSH, LH, testosterone, prolactin, thyroid) are drawn at the clinic alongside the female partner if attending together.
• Semen analysis. This is arranged through a partner laboratory. The clinic provides the referral and instructions on sample collection. Results are returned to Mr Naoum for interpretation alongside the female results.

How the pathway works

The assessment runs across a small number of visits, typically over 2-4 weeks:

• Step 1: Initial consultation. Book online with a £100 deposit. At this visit, Mr Naoum takes a detailed history from both partners, carries out an examination of the female partner if appropriate, and maps out the investigation plan. If an ultrasound is needed, it can often be done the same day.
• Step 2: Investigations. Blood tests are taken at the clinic at the right point in the menstrual cycle. Semen analysis is booked at the partner lab. Some of this may overlap with the first visit; some requires a separate appointment.
• Step 3: Results review. Once all results are back, a follow-up consultation reviews the findings together and sets the direction: lifestyle advice, medical treatment, surgical intervention, or referral to a fertility specialist for assisted reproduction.

What happens after results

The outcome depends on what the investigations show. Common next steps include:

• Ovulation support if cycle irregularity is contributing.
• Surgical correction of fibroids, polyps, or endometriosis deposits that are affecting fertility.
• Referral for IVF or ICSI if the assessment indicates assisted reproduction is the most appropriate path. Your investigation results transfer directly to the fertility clinic.
• Lifestyle and timing advice if no clear cause is identified but modifications could improve the chance of natural conception.

Mr Naoum discusses all options honestly, including what is realistic and what timelines to expect. If further specialist input is needed, he can refer within the clinic group or to a dedicated fertility centre.

Why investigate privately?

NHS fertility investigation is available, but it takes time. Many couples wait 3-6 months for an initial appointment, then longer for test results and follow-ups. The female and male pathways often run separately through different departments, which adds further delay.

A private couple assessment coordinates both partners from one clinic, compresses the investigation timeline from months to weeks, and keeps the same consultant across every appointment. If you are over 35, or if the emotional weight of waiting is affecting you, faster answers make a meaningful difference.

Frequently asked questions