Initial investigation of the infertile couple

Abstract

Infertility is defined as a failure to conceive aer 12 months of unprotected intercourse (1). It aects one in seven couples (2). Aer one year of unprotected intercourse, 85%-90% of couples will successfully conceive. Among the remaining couples, half of them will conceive during the second year. e National Institute for Health and Care Excellence (NICE) and the American Society for Reproductive Medicine (ASRM) recommend starting infertility investigations aer 12 months of unprotected intercourse (3-5). is takes into account that natural conception may occur during the period of investigation. Earlier investigation is recommended aer six months of trying to conceive in women over the age of 35 years (3) due to the age-related decline in fertility as well as diminishing assisted reproduction technology (ART) outcomes in this age category. Earlier assessment may also be justied when an infertility factor is known or when it is highly suspected in the female (such as oligo/amenorrhea, tubal or uterine disease, or endometriosis) or in the male (such as undescended testes) (3,4).