---
name: fertility-assessment
description: Use when asked to administer, score, or explain a Fertility Assessment — a NICE CG156-aligned sub-fertility evaluation covering reproductive history, hormonal profile, and partner factors — grounded in FormExamples/form-examples.
---

# 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](https://github.com/FormExamples/form-examples/tree/main/forms/fertility-assessment) for the full implementation, clinical references, and worked examples.
- [[endometriosis-assessment]], [[gynecology-assessment]] for related reproductive-health assessments.