Infertility evaluation must be medically
precise and couple focused. The goal is to
identify correctable issues and guide the
couple toward effective options, whether
natural or assisted.

STEP 1: Medical History

A full history from both partners
includes:
– Menstrual cycle details
– Sexual frequency and timing
– Past pregnancies or losses
– Surgeries, infections, lifestyle factors

Male Evaluation

Semen Analysis: The first-line test. Assesses
sperm count, motility, shape, and quality.
Collected after 2–7 days of abstinence.
Repeat testing may be needed.

Further Testing

May include semen culture, hormone levels
(FSH, LH, testosterone), scrotal ultrasound,
antisperm antibodies, and genetic testing
(karyotype, CFTR gene).

Female Evaluation

Hysterosalpingography (HSG):
X-ray with contrast to assess the uterine
cavity and fallopian tubes. Detects blockages
or anomalies.

Ultrasound
Transvaginal imaging to assess ovaries,
uterus, and follicles. Also used for ovulation
tracking.

Ovulation & Hormonal
Assessment

– Ovulation predictor kits (LH surge)
– Day 21 progesterone test
– Cycle tracking or ultrasound
– Hormone panels: FSH, LH, AMH, prolactin,
thyroid function, and androgens

Genetic Testing (if indicated)

In severe male infertility: karyotyping,
Y-chromosome microdeletion, and CFTR
gene mutation analysis.