Infertility is the inability of a couple to achieve pregnancy after one year of unprotected intercourse (or six months for women aged 35 or older). A recent report from the WHO reveals that approximately 17.5% of adults, which is about 1 in 6 people globally, face fertility issues. 1 

When faced with infertility, both partners are involved in the evaluation process to identify and treat the underlying causes. Lifestyle changes, such as tracking menstrual cycles and making healthy choices, can increase the chances of pregnancy. This article discusses the evaluation of infertility in couples, focusing on both male and female partners.

Evaluation of Male infertility

Male infertility assessment aims to identify the root cause to guide treatment. It typically involves 

  • A medical history review

  • Physical examination 

  • Semen analysis

Additional tests may be required, including blood tests to measure hormone levels, genetic tests to check for abnormalities, transrectal ultrasound to identify blockages, post-ejaculation urine tests, and testicular biopsies to examine the presence of sperm.

Evaluation of Female infertility

Female infertility evaluation includes

  • A medical history review, physical examination, and preliminary tests

  • Menstrual history is important to determine ovulation patterns

  • Blood tests can assess hormone levels related to fertility

  • Tests to evaluate the uterus and fallopian tubes, such as hysterosalpingogram, sonohysterogram, and laparoscopy, may be conducted

  • Pelvic ultrasound can provide additional information

  • Genetic testing may be recommended to assess the possibility of genetic abnormalities

Genetic counseling

Genetic counseling is often advised to inform couples about potential genetic or chromosomal abnormalities and their impact on fertility. In some cases, in vitro fertilization (IVF) with embryo genetic testing may be an option to prevent passing on abnormal genes.

Emotional support during infertility evaluation

Infertility can cause emotional distress, and seeking support from counselors or support groups can be beneficial. It is essential to address any anxiety or depression symptoms and consult a healthcare provider for appropriate treatment options.

Infertility treatment

There are various treatment options for male and female infertility, with many cases achieving successful pregnancy through interventions. However, there are instances where treatment may not be effective, leading couples to consider alternative options such as egg donation, adoption, or gestational carriers/surrogates.


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1. 1 in 6 people globally affected by infertility: Who (no date) World Health Organization. Available at: https://www.who.int/news/item/04-04-2023-1-in-6-people-globally-affected-by-infertility (Accessed: 19 June 2023).