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Fertility blood tests What they can and can’t tell you

Even for healthy couples in their 20s and early 30s, the chance of getting pregnant in any one cycle is about 25% to 30%, so it can take several months.7 Here’s which blood tests are worth doing, what they can and can’t tell you, and when to see a specialist.

4 tests $86.85 Most results in 2 to 3 days

The short answer

No blood test can tell you your chance of getting pregnant naturally. Egg reserve tests such as AMH show roughly how many eggs you have left, and mainly predict how many IVF would collect.1,2 Four tests give you that baseline and check the hormones that run your cycle and your thyroid, which matter most if your periods are irregular or you have signs of a thyroid problem.1 Ask for AMH, FSH and LH, estradiol and TSH, drawn on day 2 to 4 of your cycle.

Before you go
If you have periods, have your blood drawn on day 2 to 4, counting the first day of bleeding as day 1. If they’ve stopped, any day works.1 No fasting needed. If you take biotin, stop it 3 days before.
What a result means
AMH and FSH show roughly how many eggs you have left. Low or normal, they can’t tell you whether you’ll get pregnant naturally, and they say nothing about egg quality.1,2
See a specialist
After 12 months of trying, or 6 if you’re 35 or older. Sooner if your periods are irregular or have stopped, you have endometriosis or you’ve had a pelvic infection.1 All the reasons
What it costs
$86.85 for all four, from one blood draw. That’s the whole cost, and it’s HSA and FSA eligible.
Egg reserve and hormone tests
$86.85 · 4 tests, one draw
Order

What the four tests look for

Three look at your egg reserve and the hormones that run your cycle, and one checks your thyroid. If your periods are regular and you haven’t been trying long, read them as a baseline, not an answer to whether you can get pregnant.1,2 US fertility specialists check LH and TSH only for a specific reason, such as irregular periods or signs of a thyroid problem.1 They’re here because LH comes in the same test as FSH and TSH is a cheap addition to the same draw, so you won’t need a second one if they turn out to matter.

  1. 01

    How many eggs you have left

    AMH test

    AMH comes from the follicles that hold your eggs, so it gives a rough idea of how many are left.2 It predicts how many eggs IVF would collect,2 but it’s a poor guide to your chance of getting pregnant naturally: across 11 studies, it did only a little better than chance.1

    Most useful if you’ve been trying for 12 months, or 6 if you’re 35 or older, or you’re planning IVF or egg freezing.1,2 It falls with age and runs lower after surgery on your ovaries,3 and hormonal contraception can lower it too.2 Any day of your cycle works.1

  2. 02

    A second look at egg reserve

    FSH and LH test

    FSH is the brain’s push on your ovaries. As the egg supply falls, the push gets harder, so a high FSH on day 2 to 4 points to a lower egg reserve.2 It varies from cycle to cycle, though, and many women with a lower reserve have a normal FSH.2

    LH comes in the same test. It isn’t part of the criteria for diagnosing PCOS.3

  3. 03

    An early rise in estrogen

    Estradiol test

    Estradiol is read alongside FSH. On day 2 to 4 it should be low. Above 60 to 80 pg/mL, it can be a sign of a lower egg reserve, and it can pull a raised FSH back into the normal range.2

    If your periods have stopped, FSH and estradiol together help show why, on any day.1

  4. 04

    An underactive or overactive thyroid

    TSH test

    Thyroid problems are a common cause of irregular periods.1 If your TSH is out of range, the lab adds free T4 from the same sample, then free T3 or thyroid antibodies if they’re needed.

    More likely if you have thyroid antibodies, past thyroid disease or another autoimmune condition. Guidelines differ on who needs it. US fertility specialists test it when your periods are irregular or you have signs of a thyroid problem.1 The American Thyroid Association advises it if you’re having trouble getting pregnant or have had repeated miscarriages, and checks every 3 to 6 months before pregnancy if you have thyroid antibodies.4

What blood tests can’t show

Egg reserve is one part of fertility. A full fertility evaluation also checks whether you ovulate, your tubes and uterus and, with a male partner, sperm.1 These are the parts blood can’t show, and what to do about each.

Sperm

Male factors play a part in about half of couples who have trouble conceiving.6 None of these four tests checks them.

If you have a male partner, ask for a semen analysis at the same time as your own tests.6

Whether you ovulate

A problem with ovulation is the most common cause of infertility in women.7 A blood draw on day 2 to 4 can’t show whether you ovulate.

Use a urine ovulation kit to find your fertile days, or ask about a progesterone test about a week before your period.7

Your tubes and uterus

Scarred or blocked fallopian tubes, from a past sexually transmitted infection or endometriosis, can cause infertility.7 Blood can’t show them.

A fertility evaluation checks your uterus with an ultrasound and your tubes with an X-ray called an HSG.7

Your age

It’s the single most important predictor of fertility.1 The chance of pregnancy each cycle starts to fall in your early 30s, falls faster after 37 and is under 10% by 40.7

If you’re 35 or older, see a specialist after 6 months of trying, not 12.1

Don’t wait to see a fertility specialist if you have

  • Irregular periods, or cycles shorter than 25 days or longer than 35
  • Bleeding between periods
  • Periods that have stopped
  • Endometriosis
  • A known or suspected problem with your uterus or tubes, such as a past pelvic infection
  • Repeated miscarriages
  • A partner with a known or suspected sperm problem
  • Past chemotherapy or radiation
  • Problems having sex

That’s US fertility specialists’ advice.1 Otherwise, go after 12 months of trying if you’re under 35, or 6 months if you’re 35 or older. Over 40, talk to a clinician now.1,7 If you could be pregnant and get sudden, severe pain in your belly or pelvis, shoulder pain or feel faint, go to an emergency room: it can be an ectopic pregnancy. If you have a positive test and get bleeding or pain in your pelvis, call your clinician.8

How to get tested, and what it costs

Order the four tests on their own, or get them inside the full Fertility Panel, which adds tests for PCOS, blood sugar, immunity and infections. The four tests take one blood draw; the panel also needs a urine sample.

Egg reserve and hormone tests
$86.85

The four tests on this page, from one blood draw. Have your blood drawn on day 2 to 4 of your cycle, if you have periods.

Best if you want your egg reserve, cycle hormones and thyroid checked.

Order the four tests
Fertility Panel
$429.45

The same four, plus androgen tests for PCOS, blood sugar, immunity to rubella and chickenpox, HIV, hepatitis and syphilis tests, a lead level, a pregnancy test, blood type, vitamin D, a urine test and a general health check. 22 tests. Fast for 12 hours first, and have your blood drawn on day 2 to 4 of your cycle if you have periods.

Best if your periods are irregular, or you want your pre-pregnancy blood tests done in one visit.

Order the panel
  1. 01

    Order online

    Pick the four tests or the full Fertility Panel. The price is the whole cost, and you can pay with an HSA or FSA card.

  2. 02

    Blood draw

    If you have periods, go on day 2 to 4, counting the first day of your period as day 1. The four tests need no fasting; for the panel, fast for 12 hours first. If you take biotin, stop it 3 days before. Go to any Labcorp location for free, or have blood drawn at home for $75.

  3. 03

    Get your results

    Most arrive in the Picardo app in 2 to 3 days, with an explanation of each one; AMH can take up to 10 days. Ask Picardo what they mean, and book a physician follow-up if you want one.

Already have results?

My AMH is low

It doesn’t mean you can’t get pregnant. In a study of 750 women aged 30 to 44 with no known fertility problems, those with an AMH under 0.7 ng/mL were as likely to be pregnant after 12 cycles of trying as the others.2 It mainly means IVF would likely collect fewer eggs, and your age still predicts your chances better than AMH does.2 Other studies have found a small drop with a low AMH, so the evidence is mixed.1

Check your AMH for your age

My AMH is high

A high AMH tends to go with PCOS, so it’s worth following up if your periods are irregular or you have acne or extra hair growth. On its own, it can’t diagnose PCOS.3 If you do IVF, it predicts a strong response to the drugs, which your clinic will plan around.2

Check your AMH for your age

My FSH was high

On day 2 to 4, a raised FSH can mean a lower egg reserve, but FSH varies from cycle to cycle, so one result isn’t reliable on its own.2 It shouldn’t rule you out of fertility treatment.1 If you’re under 40 and your periods are irregular or have stopped, an FSH over 25 mIU/mL can mean your ovaries are slowing down early, so see a clinician in the next few weeks.1

Check your FSH number

My TSH was a bit high

If yours is mildly high, talk it through with your clinician before you conceive: they’ll usually repeat it before deciding whether to treat it.4 If you already take levothyroxine, the target before pregnancy is 0.5 to 2.5 mIU/L, and call your clinician as soon as you have a positive pregnancy test, because the dose usually goes up.4

Check your TSH number

Everything came back normal

That’s reassuring about your egg reserve and thyroid, but it isn’t proof you’re fertile: these tests can’t check egg quality, ovulation, your tubes or sperm.1 Keep trying, and see a specialist after 12 months, or 6 if you’re 35 or older.1

Ask Picardo about your results. The app explains what each one means, and a physician can follow up if you want.

Questions people ask

What blood tests should I get if I’m trying to get pregnant?

None of them can tell you your chance of getting pregnant naturally, so if your periods are regular and you haven’t been trying long, think of them as a baseline.1,2 AMH, with FSH and estradiol on day 2 to 4 of your cycle, shows your egg reserve. It’s most useful after 12 months of trying, or 6 if you’re 35 or older, or if you’re planning IVF or egg freezing.1,2 US fertility specialists add TSH and LH for a specific reason, such as irregular periods or signs of a thyroid problem.1 If your periods are irregular, a clinician will usually add prolactin and tests for PCOS too.1,3

Can a blood test tell me if I’m fertile?

Not on its own. Egg reserve tests show roughly how many eggs you have left, not how good they are, and they predict your chance of getting pregnant naturally poorly.1,2 What they give you is a baseline for your egg reserve, and if you’re thinking about IVF or egg freezing, they help predict how many eggs a cycle would collect.2

What day of my cycle should I get tested, and do I need to fast?

Day 2 to 4, counting the first day of your period as day 1, because that’s when FSH and estradiol are read. AMH works on any day, and if your periods have stopped, any day will do.1 No fasting is needed for these four, but if you take biotin, stop it 3 days before. If you’re on the pill, ask a clinician how to read the results: hormonal contraception can lower AMH, and the day 2 to 4 timing is meant for a natural cycle.2

When should I see a fertility specialist?

After 12 months of trying if you’re under 35, or 6 months if you’re 35 or older. Over 40, talk to a clinician now.1,7 Don’t wait at all if your periods are irregular or have stopped, or you have endometriosis, a known or suspected problem with your tubes or repeated miscarriages.1

Should my partner be tested too?

If you have a male partner, yes. US guidelines say both partners should be checked at the same time, including at least one semen analysis, because male factors play a part in about half of couples who have trouble conceiving.6 None of the four tests here checks sperm.

Should I take folic acid before I get pregnant?

Yes. US guidelines recommend 0.4 to 0.8 mg (400 to 800 mcg) of folic acid a day for anyone who could become pregnant, starting at least 1 month before you conceive and continuing through the first 2 to 3 months of pregnancy.5 If you’ve had a pregnancy affected by a neural tube defect, or take some seizure medicines, ask a clinician what dose you need: this advice doesn’t cover you.5

Can I get these tests without seeing a doctor first?

Yes. Order them online, get a blood draw at a Labcorp location or at home, and most results arrive in the Picardo app in 2 to 3 days. You can book a physician follow-up if you want to talk them through.

What happens if a result is off?

The app explains what it means and what usually comes next. A low AMH or high FSH is worth talking through with a fertility specialist, but it isn’t a reason to give up: neither predicts natural pregnancy well, and neither should rule you out of treatment.1,2 A thyroid problem can be treated, and a clinician will aim to get it in range before you conceive.4 A physician can follow up if you want one.

Sources

  1. 1 Practice Committee of the American Society for Reproductive Medicine. Fertility evaluation of infertile women: a committee opinion. Fertil Steril. Published online October 20, 2026. doi.org/10.1016/j.fertnstert.2026.08.686
  2. 2 Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. 2020;114(6):1151–1157. doi.org/10.1016/j.fertnstert.2020.09.134
  3. 3 Teede HJ, Tay CT, Laven JJE, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. J Clin Endocrinol Metab. 2023;108(10):2447–2469. doi.org/10.1210/clinem/dgad463
  4. 4 Korevaar TIM, Leung AM, Alexander EK, et al. American Thyroid Association 2026 guidelines for thyroid disease in preconception, pregnancy, and postpartum. Thyroid. 2026;36(5):481–544. doi.org/10.1177/10507256261445624
  5. 5 US Preventive Services Task Force. Folic acid supplementation to prevent neural tube defects: US Preventive Services Task Force reaffirmation recommendation statement. JAMA. 2023;330(5):454–459. doi.org/10.1001/jama.2023.12876
  6. 6 Schlegel PN, Sigman M, Collura B, et al. Diagnosis and treatment of infertility in men: AUA/ASRM guideline (2020; amended 2024). Linthicum, MD: American Urological Association; 2024. www.auanet.org/documents/Guidelines/PDF/2024%20Guidelines/Male%20Infertility%20Unabridged%20Final.pdf
  7. 7 American College of Obstetricians and Gynecologists. Evaluating infertility. ACOG patient FAQ. Last reviewed May 2026. Accessed October 28, 2026. www.acog.org/womens-health/faqs/evaluating-infertility
  8. 8 American College of Obstetricians and Gynecologists. Ectopic pregnancy. ACOG patient FAQ. Last reviewed April 2026. Accessed October 28, 2026. www.acog.org/womens-health/faqs/ectopic-pregnancy

Updated 4 Nov 2026.

This is general health information, not medical advice: talk to your clinician about your results and before changing any treatment.