'We're having trouble conceiving...'.

BACKGROUND

The growing trend for Australian women to delay childbearing has a significant impact on their individual fertility and the consequent need for assisted reproductive technology.

OBJECTIVE

This article defines infertility and highlights typical male, female, and unexplained combined causes of infertility. Initial fertility investigations best undertaken in general practice are outlined, and suggestions on when to refer a couple to a fertility specialist is clarified.

DISCUSSION: Initial assessment of the subfertile couple is best managed by the general practitioner whose relationship can facilitate quick understanding of how long the couple has been trying to conceive, age, and medical history. The woman can then undergo simple global blood and hormone tests while a semen analysis is appropriate for the man. On review, any abnormal tests can indicate referral to a fertility specialist for review and management.