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 indicatesA marker of how many eggs remain. Below 1.0 is treated as low; 1.0–2.0 as mildly low.

Watch out forIt 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 indicatesA trigger to assess for PCOS (JSOG 2024 criteria).

Watch out forHigh 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 indicatesA high FSH can indicate falling reserve. LH above FSH, alongside irregular cycles, suggests erratic ovulation.

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

ProlactinTarget: Under 30 ng/mL

What it indicatesHigh levels cause irregular cycles, infertility and miscarriage; medication normalises it.

Watch out forIt 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 indicatesKeeping it in range lowers the risk of miscarriage and preterm birth.

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

Infections

ChlamydiaTarget: PCR negative, IgG and IgA negative

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

Watch out forA 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 indicatesBelow 1:32, vaccination is recommended before trying.

Watch out forIt 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 indicatesScreening for mother-to-child and sexually transmitted infection.

Watch out forA positive result is referred for specialist assessment.

Other tests

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

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

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

Anti-sperm antibodiesTarget: Negative

What it indicatesA positive result immobilises sperm, making natural conception very unlikely.

Watch out forMost people test negative. Depending on severity, IVF may be required.

Cervical cytologyTarget: NILM (normal)

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

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

Transvaginal ultrasoundTarget: No abnormal findings

What it indicatesAssesses the ovaries and uterus, and looks for advanced endometriosis or fibroids.

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

HSG / tubal patency testTarget: Both tubes open

What it indicatesChecks the passage where sperm and egg meet.

Watch out forPatency does not prove function, and it cannot detect endometriosis.

Semen analysisTarget: At or above the WHO 2021 reference limits

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

Watch out forNever judged on a single sample. The limits are the 5th centile of men who fathered a child — not a pass/fail line.