TTC Guide

Worked examples

The Same Number Means Different Things

A result cannot be read from one number alone. Age, how long you have been trying, cycle pattern and the other values together decide what to do next. Six fictional cases below show how that reading works.

Every person and every value here is fictional. No real patient data is used. Always confirm the interpretation of your own results with the clinic that ran them.

No abnormal findings, 4 months trying / age 31

SituationCycles steady at 29–31 days. Four months of trying. Every test within range.

Results

  • AMH 3.6 ng/mL (age-appropriate)
  • Cycle 29–31 days
  • Chlamydia negative, rubella HI 1:64
  • 4 months trying

How to read itUnder a year in, with steady cycles she can predict ovulation herself. The relevant figure here is not a treatment success rate but the natural cumulative curve — with well-timed intercourse, about 81% conceive within six cycles.

What comes nextFocus on the two days before ovulation through the day itself, for six cycles. If nothing by then, get assessed.

Vitamin D deficiency and low rubella immunity / age 29

SituationEight months trying, regular cycles. Vitamin D 18 µg/dL, rubella HI 1:16, mild anaemia.

Results

  • 25-OH vitamin D 18 µg/dL (target ≥30)
  • Rubella HI 1:16 (target ≥1:32)
  • Mild anaemia
  • 8 months trying

How to read itNone of this blocks conception, but all of it belongs to the "sort it out beforehand" category. Rubella especially: once pregnant, nothing can be done. The vaccine is live, so it requires two months of contraception afterwards — which has to be planned into the timeline.

What comes nextVaccinate and use contraception for two months. Replete vitamin D meanwhile and retest in 1–2 months.

Low AMH / age 39, 18 months trying

SituationAMH 0.85 ng/mL, antral follicle count 5. Eighteen months without conceiving.

Results

  • AMH 0.85 ng/mL (below 1.0 = low)
  • AFC 5
  • 18 months trying
  • Age 39

How to read itThree factors stack here: age-related egg quality, reduced reserve, and an 18-month duration. But what is low is quantity, not quality — quality still tracks her age. A low count does not mean she cannot conceive. What matters most now is how the remaining time is used.

What comes nextThis is past the point for watchful waiting. Widen the treatment options early.

High AMH with polycystic appearance / age 27

SituationAMH 8.2 ng/mL, 26 antral follicles on one side, BMI 26.6. Cycles vary between 35 and 50 days.

Results

  • AMH 8.2 ng/mL (above the 4.0 cut-off for the 20s)
  • AFC 26 on one side
  • Cycle 35–50 days
  • BMI 26.6

How to read itA high AMH means plenty of eggs, which is not a disadvantage in itself, but it does trigger assessment for PCOS. Diagnosis requires cycle irregularity, ultrasound findings and hormone levels together — AMH alone decides nothing. The problem here is not quantity; it is that ovulation cannot be timed.

What comes nextComplete the assessment with hormones and ultrasound. Induced ovulation gets there faster than going it alone.

Endometriosis / age 35, 30 months trying

SituationA 32mm endometrioma on the right ovary and a 15mm fibroid. Severe period pain for several years.

Results

  • Right endometrioma 32mm
  • Fibroid 15mm
  • Severe dysmenorrhoea for years
  • 30 months trying

How to read itThe years of severe pain are the key detail. Endometriosis worsens until menopause, damaging tubes and ovaries throughout. And 30 months of trying is itself an independent marker of reduced fertility. Surgery can lower ovarian reserve, so the sequencing is a real decision.

What comes nextWeigh age, cyst size and reserve together with a specialist before deciding whether surgery comes first.

Irregular cycles / age 30, 5 months trying

SituationCycles ranging from 38 to 60 days. AMH 6.5 ng/mL, 24 antral follicles on one side.

Results

  • Cycle 38–60 days
  • AMH 6.5 ng/mL
  • AFC 24 on one side
  • 5 months trying

How to read itEgg quantity is comfortable. The problem is that ovulation cannot be timed — with cycles this variable, an app cannot predict it in principle. Five months without conceiving may not mean reduced fertility at all; it may simply mean the window has been missed.

What comes nextTrack follicles by ultrasound at a clinic. On the quantity side there is room, so this is not a situation to panic about.