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Abstract Since approximately 85% of couples may be expected to achieve pregnancy within that time interval without medical assistance, evaluation may be indicated for as many as 15% of couples. Earlier evaluation is warranted after 6 months of unsuccessful efforts to conceive in women over age 35 years due to the observed age related decline in fertility as a woman approaches age 40, and also may be justified based on medical history and physical findings. The National Institute for Health and Clinical Excellence NICE in the UK and the American Society of Reproductive Medicine in the USA have recommended the following essential tests: semen analysis, assessment of ovulation and evaluation of tubal patency by hysterosalpingogram or laparoscopy. |