Genetic causes and workup of male and female infertility. 3. Details of the clinical evaluation.

In the evaluation of male and female infertility the history, family history, physical examination, and endocrine and gonadal functional evaluations are the most informative measures. The cause of the infertility is never found in some 17.5% of couples and in almost one fourth of males. In over one third of cases male infertility is attributed to varicocele. In 40% of women infertility can be attributed to ovulatory or cervical factors, uterotubal disease, endometriosis and other pelvic disease, or a combination of these factors. For couples with primary infertility the fertility rate after seven years is only 36%; in such cases the neonatal death rate, frequency of low birth weight, and incidence of major malformations are several time greater than in the normal population.