Infertility is one of the most commonly occurring problems that you may encounter when you perform your daily activities in the community. The initial contact with an infertile couple is very important in outlining the general causes of infertility, and discussing the subsequent evaluation at your level. If a couple comes to you for the first time, you should ask for the medical and surgical history of both partners, as shown in the box below.

Information to include in case history

Do they have children (together or apart)?
Is the woman's menstrual cycle regular?
Do they have adequate sexual relations? The couple should try to have sexual intercourse every two days during the fertile period of her menstrual cycle.
Do they have any risk factors for infertility, i.e. use of an IUCD, history of PID, pelvic surgery, or an endocrine disorder, such as pituitary, adrenal and thyroid function?
Information on genital surgery, infection, trauma and history of mumps for the male partner.

If you find any abnormalities which need further evaluation, you can refer the couple to the health facility or hospital. In the meantime, explain the basic requirements for conception to the couple.