Investigation of the infertile couple

Although the exact incidence of infertility in Canada is unknown, mathematical models predict that approximately 10% to 15% of couples will fail to achieve a pregnancy after one year of unprotected intercourse. The diagnosis requires assessment of both male and female partners. During the initial visit, a comprehensive history should be elicited and a thorough physical examination performed. The couple should receive complete information about the proposed diagnostic evaluation, and any misinformation that may have been gained from friends and the media should be corrected. When the primary evaluation and treatment has failed to result in a pregnancy, the couple should be referred to a specialist.