TY - JOUR T1 - Predicting human conception: the elusive ‘fertility test’ JF - BMJ Sexual & Reproductive Health JO - BMJ Sex Reprod Health DO - 10.1136/bmjsrh-2020-200762 SP - bmjsrh-2020-200762 AU - Richard A Anderson AU - John Joseph Reynolds-Wright Y1 - 2020/09/03 UR - http://jfprhc.bmj.com/content/early/2020/09/02/bmjsrh-2020-200762.abstract N2 - The ability to control human fertility has changed completely in the last half century, from the development of reliable contraceptive methods to assisted reproduction. The assessment of an individual’s fertility, however, has progressed remarkably little in the last several decades. While the reproductive potential of both men and women is predicated on successful production of gametes, the likelihood of conception in women (or ‘fecundability’) is primarily determined by the release of a single egg each month. Conversely, in men it is based on the continuous production of large numbers of motile sperm with the ability to traverse the female reproductive tract and successfully fertilise that egg. Assessment of infertility therefore focuses on ovulation, spermatogenesis, and the patency of the fallopian tubes. The assessment of ovulation is now complemented by the ability to assess aspects of how many follicles the ovary contains (the ovarian reserve) through the measurement of circulating anti-Müllerian hormone (AMH), and the assessment of the ejaculate has progressed through several versions of the WHO Semen Analysis Manual, albeit with significant debate.1However, there are remarkably scarce data on how well these parameters of human gonadal function predict the likelihood of natural conception in the normal population. The concept of a ‘fertility test’ has huge appeal and potential commercial value, particularly with the current growth in direct to consumer marketing – but is … ER -