Infertility evaluation is the structured medical assessment of individuals or couples who are unable to conceive after a defined period of regular, unprotected sexual intercourse. It is a critical step in identifying the underlying causes of subfertility and guiding appropriate treatment strategies. Infertility may arise from female factors, male factors, combined causes, or remain unexplained despite thorough investigation, making a systematic and comprehensive evaluation essential.

The evaluation process begins with a detailed clinical history that includes menstrual regularity, duration of infertility, previous pregnancies, miscarriages, pelvic infections, surgeries, and use of contraception. Lifestyle factors such as body weight, smoking, alcohol intake, stress levels, and occupational exposures are reviewed, as they can significantly affect reproductive potential. A parallel assessment of the male partner is fundamental, as male factors contribute to infertility in a substantial proportion of cases.

Female infertility evaluation focuses on four core areas: ovulation, ovarian reserve, tubal patency, and uterine anatomy. Ovulatory function is assessed through menstrual history, hormonal profiling, and ovulation tracking. Disorders of ovulation, including hormonal imbalances and endocrine conditions, are among the most common causes of infertility.

Assessment of ovarian reserve provides insight into the quantity and quality of remaining eggs and is particularly important in women of advanced reproductive age. Tubal patency evaluation identifies blockages or damage that may prevent fertilization, often resulting from previous infections, surgery, or endometriosis. Uterine cavity assessment evaluates structural abnormalities such as fibroids, polyps, adhesions, or congenital anomalies that may interfere with implantation or pregnancy maintenance.

Male infertility evaluation includes semen analysis to assess sperm count, motility, morphology, and volume. Additional investigations may be required if abnormalities are identified, including hormonal testing or genetic screening.

Infertility evaluation also considers unexplained infertility, where all standard investigations appear normal. In such cases, subtle factors affecting egg quality, sperm function, or implantation may be involved.

A thorough infertility evaluation allows targeted treatment planning, whether medical, surgical, or assisted reproductive techniques. Early and accurate diagnosis improves success rates, reduces unnecessary interventions, and provides couples with clarity and realistic expectations regarding fertility outcomes