Investigations for infertility

Infertility affects 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 and can lead to social disability. The clinician needs to be tactful and sensitive in his/her investigation of the infertile couple, 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. The value of some investigations can be questioned and the cost, safety, convenience and evidence-base should help in deciding on the appropriate method.