Fertility Assessment

Fertility (sub-fertility) assessment aligned with NICE CG156, capturing reproductive history, menstrual and hormonal profile, lifestyle factors, and partner/semen analysis to guide investigation and treatment referral decisions.

Scoring

Instrument: NICE CG156 Fertility Assessment.

• Low concern — normal cycles, duration trying < 12 months (< 6 months if female partner ≥ 36), normal ovarian reserve, normal partner factors → continued attempts and lifestyle optimization.
• Moderate concern — one or two modifiable factors identified → targeted treatment or optimization.
• High concern — multiple abnormal investigations, a known cause (e.g. tubal, severe male factor), or age-related reserve decline → early specialist/ART referral.

What it covers

Demographics for both partners where applicable; reproductive history; menstrual cycle history; medical and surgical history; lifestyle factors (BMI, smoking, alcohol, caffeine); current medications and supplements; partner factors and semen analysis; hormone profile (FSH, LH, AMH, oestradiol, TSH, prolactin); investigations (ultrasound AFC, HSG, hysteroscopy); and clinical recommendation.

Common pitfalls

• Delaying investigation past the recommended timeframe for age — NICE CG156 recommends earlier investigation (at 6 months rather than 12) for women aged 36 and over, given the time-sensitivity of age-related fertility decline.
• Treating fertility assessment as a female-only evaluation — partner/semen analysis is a core, not optional, component; roughly half of sub-fertility cases involve a male-factor contribution.
• Acting on a single abnormal hormone value — several fertility- relevant hormones (FSH, AMH) can vary by cycle timing; results need correct cycle-day context to interpret properly.

Learn more

• FormExamples: fertility-assessment for the full implementation, clinical references, and worked examples.
• Endometriosis Assessment, Gynecology Assessment for related reproductive-health assessments.