A history and examination should be performed for both partners. Initial assessment should take into account three main factors regarding the ability to fall pregnant.

• The regularity of the woman's cycle, which will give good circumstantial evidence for ovulation.
• Tubal patency may need to be assessed. This is usually the domain of the specialist gynaecologist, if women are having difficulties falling pregnant.
• Semen analysis, which can be done by referring the male partner to MFC – GP Semen Analysis Request Form

If there are any obvious concerns with the regularity of ovulation or the sperm analysis, then early referral may be necessary.

For women with irregular cycles the following information may be useful. 85% of women who have a long or erratic cycle will have PCOS. These women do not always fit into the classical picture of sub-fertility, obesity and hirsutism. The diagnosis is usually based on the clinical features, the appearance of the ovaries on ultrasound scan and the biochemical and hormone results. A baseline screen for such women would include LH, FSH, oestradiol, progesterone, prolactin, thyroid function tests (TSH and thyroxine for women with severe oligomenorrhoea or amenorrhoea) and 17hydroxyprogesterone. Other less common causes for irregular cycles includes hyperprolactinaemia (arising from either a micro or macro adenoma of the pituitary) and late onset congenital adrenal hyperplasia.