Investigations for infertility

Infertility is a problem affecting approximately 10% of the population with variable incidences across the world. Although it is not an identifiable physical disease, its psychological impact on the affected couple can be severe, sometimes leading to social disability. Investigating infertile couples requires tact and sensitivity on behalf of the clinician and history taking is very important to establish the plan of investigation. A clear protocol should be designed where the role of each level of health care is well determined and information provided to the couple on the proposed plan of action. Investigations should be carried out in a reasonably short space of time so that an appropriate modality of treatment, or at least reassurance, can be provided to the couple. Some of the investigations are controversial and in the presence of multiple methods of investigating one aspect, the cost, safety, convenience and evidence-base should help in deciding on the appropriate method.