The infertility workup and diagnosis.

Infertility affects a significant number of couples. The traditional workup of the infertile couple involves performing a semen analysis, assessing ovulation with a postcoital test to evaluate sperm-mucus interaction, obtaining a hysterosalpingogram to assess uterine structure and tubal patency, and performing laparoscopy to rule out endometriosis and pelvic adhesive disease. In 1988 new techniques were added to our armamentarium, including the use of the sperm penetration assay (hamster test) to rule out occult male factors, the combination of multiple ovarian sonograms and luteinizing hormone surge detection kits to evaluate subtle problems of dysfolliculogenesis, labelled antiimmunoglobulins for the evaluation of sperm antibodies and diagnostic hysteroscopy for evaluating occult uterine pathology.