ABSTRACT
Infertility is defined as a failure to conceive after 12 months of unprotected intercourse (1). It aff cts one in seven couples (2). After one year of unprotected intercourse, 85%–90% of couples will successfully conceive. Among the remaining couples, half of them will conceive during the second year. The National Institute for Health and Care Excellence (NICE) and the American Society for Reproductive Medicine (ASRM) recommend starting infertility investigations after 12 months of unprotected intercourse (3–5). This takes into account that natural conception may occur during the period of investigation. Earlier investigation is recommended after six months of trying to conceive in women over the age of 35 years (3) due to the age-related decline in fertility as well as diminishing assisted reproduction technology (ART) outcomes in this age category. Earlier assessment may also be justifi d when an infertility factor is known or when it is highly suspected in the female (such as oligo/amenorrhea, tubal or uterine disease, or endometriosis) or in the male (such as undescended testes) (3,4).
