Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years.Causes of infertility include male factors, ovulatory dysfunction, uterine abnormalities, tubal obstruction, peritoneal factors, or cervical factors.Generally, evaluation should be offered to couples who have not conceived after one year of unprotected vaginal intercourse.
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Cervical factors are also thought to play a minor role, although they are rarely the sole cause.
Evaluation of cervical mucus is unreliable; therefore, investigation is not helpful with the management of infertility.6The initial history should cover menstrual history, timing and frequency of intercourse, previous use of contraception, previous pregnancies and outcomes, pelvic infections, medication use, occupational exposures, substance abuse, alcohol intake, tobacco use, and previous surgery on reproductive organs.
Evaluation of the uterus and fallopian tubes can be performed by hysterosalpingography in women with no risk of obstruction.