TTC Guide

Reading your results

How to Read a Preconception Screening Panel

Being tested is one thing; being told what the numbers mean is another. Here is what each item aims for, what the value indicates, and what to watch out for — set out by a reproductive medicine specialist.

Ovarian reserve

AMH (anti-Müllerian hormone)Target: 3–5 ng/mL in the 20s to early 30s

What it indicates:A marker of how many eggs remain. Below 1.0 is treated as low; 1.0–2.0 as mildly low.

Watch out for:It says nothing about egg quality, which tracks your age. It cannot be measured accurately while on the combined pill (stop for 3 months first).

When AMH is highTarget: Above 4.0 in the 20s / 2.8 in the 30s

What it indicates:A trigger to assess for PCOS (JSOG 2024 criteria).

Watch out for:High AMH alone is not a diagnosis — cycle irregularity, ultrasound findings and hormone levels must all be present. No high-side assessment is applied from age 40.

Baseline hormones (measured during menstruation)

FSH / LH / E2Target: FSH under 10 mIU/mL, FSH > LH, E2 around 30–50 pg/mL

What it indicates:A high FSH can indicate falling reserve. LH above FSH, alongside irregular cycles, suggests erratic ovulation.

Watch out for:A leftover follicle from the previous cycle can push E2 up even during menstruation — retest if so.

ProlactinTarget: Under 30 ng/mL

What it indicates:High levels cause irregular cycles, infertility and miscarriage; medication normalises it.

Watch out for:It swings through the day — a marginally high value is retested. At 50–100 ng/mL a brain MRI may be needed.

Thyroid (TSH)Target: Under 2.5 μIU/mL

What it indicates:Keeping it in range lowers the risk of miscarriage and preterm birth.

Watch out for:If elevated, further bloods and levothyroxine follow. Extreme values are referred to a thyroid specialist.

Infections

ChlamydiaTarget: PCR negative, IgG and IgA negative

What it indicates:IgG positive means past infection; IgA positive means current. Without a treatment history, antibiotics are given.

Watch out for:A negative PCR does not exclude spread to the tubes or abdomen. Treating the partner at the same time prevents reinfection.

Rubella HI antibodyTarget: 1:32 or above

What it indicates:Below 1:32, vaccination is recommended before trying.

Watch out for:It is a live vaccine — avoid pregnancy for two months after. Check your partner too (men need no waiting period).

Syphilis, hepatitis B and C, HIVTarget: Negative

What it indicates:Screening for mother-to-child and sexually transmitted infection.

Watch out for:A positive result is referred for specialist assessment.

Other tests

25-OH vitamin DTarget: 30 µg/dL or above

What it indicates:If deficient, 25–50 µg (1,000–2,000 IU) daily. Reported to help cycle regularity and the implantation environment.

Watch out for:Fat-soluble and cumulative — avoid overdosing and retest after 1–2 months.

Anti-sperm antibodiesTarget: Negative

What it indicates:A positive result immobilises sperm, making natural conception very unlikely.

Watch out for:Most people test negative. Depending on severity, IVF may be required.

Cervical cytologyTarget: NILM (normal)

What it indicates:ASC-US/LSIL suggest dysplasia; HSIL/SCC suggest cancer. Anything but normal is referred on.

Watch out for:Progression from normal cells takes 5–10 years, so screening every 1–2 years catches it beforehand.

Transvaginal ultrasoundTarget: No abnormal findings

What it indicates:Assesses the ovaries and uterus, and looks for advanced endometriosis or fibroids.

Watch out for:Early endometriosis is invisible on ultrasound — severe period pain warrants treatment even with a normal scan.

HSG / tubal patency testTarget: Both tubes open

What it indicates:Checks the passage where sperm and egg meet.

Watch out for:Patency does not prove function, and it cannot detect endometriosis.

Semen analysisTarget: At or above the WHO 2021 reference limits

What it indicates:Volume, concentration, motility and morphology. Male factor is involved in up to half of all cases.

Watch out for:Never judged on a single sample. The limits are the 5th centile of men who fathered a child — not a pass/fail line.