These three tests may be used during a fertility evaluation, but each provides different information.

HSG (Hysterosalpingogram)
An HSG uses X-rays and contrast dye to examine the uterine cavity and determine whether the fallopian tubes are open or blocked. It is particularly useful when evaluating possible tubal-factor infertility.

SHG (Sonohysterogram / Saline Infusion Sonography)
An SHG uses ultrasound while sterile saline is placed inside the uterus. This helps provide a clearer view of the uterine cavity and lining and may identify polyps, fibroids, scar tissue, or abnormalities in the shape of the uterus.

Transvaginal Ultrasound (TVUS)
A transvaginal ultrasound uses an ultrasound probe placed in the vagina to examine the uterus, endometrial lining, ovaries, and follicles. It can help assess conditions such as ovarian cysts, fibroids, follicle development, and antral follicle count.

In simple terms:
• HSG: Are the fallopian tubes open?
• SHG: What does the inside of the uterus look like?
• TVUS: What do the uterus, ovaries, lining, and follicles look like?

Your healthcare provider may recommend one or more of these tests depending on your fertility history and individual needs.

Diminished Ovarian Reserve, commonly called DOR, means that the ovaries may have a lower number of remaining eggs or may respond less strongly to ovarian stimulation than expected for a person’s age.

DOR may be identified through a combination of age, medical history, AMH and FSH blood tests, antral follicle count, menstrual history, and previous fertility treatment response. A low AMH result alone does not determine egg quality or mean that pregnancy is impossible.

Because every fertility journey is different, test results should be reviewed as part of the complete clinical picture. An individualized plan may help clarify priorities, timing, and available fertility-care options.

Body mass index (BMI) is one factor that may influence reproductive health in both women and men.

In women, a higher BMI may affect hormone balance, menstrual regularity, ovulation, egg quality, and the body’s response to fertility treatment. It may also increase certain health risks during pregnancy.

In men, a higher BMI may be associated with lower testosterone, reduced sperm count or movement, increased sperm DNA damage, and sexual health concerns. However, these effects vary from person to person.

BMI is only a screening measurement. It does not fully reflect body composition, overall health, age, medical conditions, nutrition, stress, or other factors that influence fertility. Many people with a higher BMI conceive naturally, while people in other BMI ranges may still experience fertility challenges.

When appropriate, gradual and sustainable lifestyle changes may support metabolic and reproductive health. Fertility care should always be individualized rather than based on BMI alone.

Going through IVF can be both physically and emotionally demanding. While IVF relies on advanced reproductive technology, many patients choose to incorporate Traditional Chinese Medicine (TCM) as a complementary approach to support their overall fertility journey.

At Longevity Fertility Centre, every treatment plan is personalized based on your medical history, fertility diagnosis, laboratory results, and IVF timeline.

Traditional Chinese Medicine may help support IVF by:

• Promoting healthy blood circulation to the reproductive organs
• Supporting hormonal balance and menstrual cycle regulation
• Helping reduce stress and promote relaxation during treatment
• Supporting overall reproductive health before, during, and after IVF
• Providing individualized herbal medicine tailored to each patient’s unique needs

Many patients begin TCM several months before IVF to optimize their health, while others seek support during ovarian stimulation, embryo transfer preparation, or the post-transfer period.

Our comprehensive fertility assessments include a detailed review of your fertility history, bloodwork, ultrasound reports, and previous IVF treatment to develop an individualized, evidence-informed care plan.

If you’re preparing for IVF or have experienced unsuccessful cycles, we’re here to help you explore a personalized, integrative approach to fertility care.

What Are FSH, LH, Estrogen, and Progesterone?

FSH, LH, estrogen (estradiol, E2), and progesterone are the four key hormones that regulate the menstrual cycle and fertility.

FSH (Follicle-Stimulating Hormone) is released by the pituitary gland and stimulates ovarian follicles to grow. Each follicle contains an egg, and FSH helps the dominant follicle mature.

Estrogen (Estradiol, E2) is produced by the developing follicle. It thickens the uterine lining and signals that the egg is approaching maturity.

A high estrogen level triggers the LH (Luteinizing Hormone) surge, which causes ovulation, usually within 24–36 hours, releasing the mature egg.

After ovulation, the empty follicle becomes the corpus luteum, which produces progesterone. Progesterone prepares and maintains the uterine lining for implantation. If pregnancy does not occur, progesterone levels fall, and menstruation begins.

Hormone testing helps evaluate ovulation, ovarian reserve, irregular cycles, PCOS, and fertility. FSH, LH, and estradiol are typically measured on days 2–4 of the menstrual cycle, while progesterone is best measured about 7 days after ovulation.

Understanding these hormones is an important step in assessing reproductive health and identifying potential fertility concerns.

The endometrium is the inner lining of the uterus where an embryo implants. Its thickness changes throughout the menstrual cycle in response to estrogen and progesterone.

A thinner uterine lining may sometimes be associated with lower implantation potential, particularly during IVF or frozen embryo transfer. However, thickness is only one part of the fertility picture. Blood flow, hormone levels, uterine health, embryo quality, age, cycle timing, and medical history may also affect the chance of pregnancy.

Possible factors linked with a persistently thin lining include hormonal concerns, reduced uterine blood flow, previous uterine procedures, inflammation, or scar tissue.

If an ultrasound shows a thin lining, the result should be reviewed together with the timing of the scan and your overall fertility history. One measurement alone does not provide the full picture.

When it comes to fertility, there’s no shortage of advice—but not all of it is accurate. Here are a few common myths we often hear:

Myth #1: If you have regular periods, you’re definitely ovulating.
Not always. While regular cycles often suggest ovulation, they don’t guarantee that an egg is being released every month.

Myth #2: Fertility is only a woman’s concern.
Male factors contribute to nearly half of all infertility cases. Evaluating both partners is an important part of a fertility assessment.

Myth #3: Low AMH means you can’t get pregnant.
AMH measures ovarian reserve, not egg quality. Many women with low AMH have gone on to achieve successful pregnancies.

Myth #4: Age only affects female fertility.
Male fertility also changes with age. Sperm quality and DNA integrity can gradually decline over time.

Myth #5: If pregnancy hasn’t happened after a few months, something must be wrong.
For healthy couples under 35, it can take up to a year to conceive naturally. If you’re over 35, or have known reproductive concerns, it’s a good idea to seek an earlier evaluation.

Understanding the facts can help you make informed decisions and avoid unnecessary stress. Every fertility journey is unique, and a personalized assessment is often the best place to start.

Many women worry after hearing they have a low AMH or low ovarian reserve, but it’s important to understand that egg quantity and egg quality are not the same thing. Egg quantity refers to how many eggs remain in your ovaries. Tests such as AMH and antral follicle count (AFC) estimate your ovarian reserve. A lower egg count doesn’t necessarily mean you can’t get pregnant—it simply means there are fewer eggs available. Egg quality refers to how healthy those eggs are. Healthy eggs are more likely to fertilize, develop into healthy embryos, implant successfully, and lead to a healthy pregnancy. While egg quality naturally declines with age—especially after 35—it isn’t measured by AMH alone. One of the most common misconceptions is that low AMH equals poor egg quality. Fortunately, that’s not always true. Many women with low AMH still conceive naturally or have successful IVF outcomes. Supporting your fertility involves more than looking at one lab result. A healthy lifestyle, good nutrition, quality sleep, stress management, and appropriate medical care all play important roles. Traditional Chinese Medicine may also help support reproductive health by promoting healthy menstrual cycles and improving overall wellness. Every fertility journey is unique. Rather than focusing on a single number, it’s important to evaluate the whole picture—including your age, hormone levels, menstrual history, and overall health.