Infertility evaluation is to determine the reason for which a couple cannot conceive. Evaluations must be sequential and preferably individualized according to history and clinical examination. Following is a list of investigations needed in infertility, categorized under female and male evaluations: FEMALE EVALUATIONS 1. Hormonal Profile (Day 2/3 of cycle) FSH (Follicle Stimulating Hormone) LH (Luteinizing Hormone) Estradiol (E2) AMH (Anti-Müllerian Hormone) – ovarian reserve TSH (Thyroid Stimulating Hormone) – thyroid function Prolactin – to exclude hyperprolactinemia Testosterone / Androgens – in suspected PCOS 2. Assessment of Ovulation Mid-luteal phase serum progesterone (Day 21) – to exclude anovulation Ultrasound follicular monitoring – serial transvaginal USG 3. Uterine and Tubal Assessment Transvaginal Sonography (TVS) – for uterus, ovaries, endometrium Hysterosalpingography (HSG) – to assess fallopian tube patency Sonosalpingography (SSG) – HSG alternative Hysteroscopy and/or Laparoscopy – for suspected endometriosis, adhesions, fibroids, polyps, etc. 4. Infectious Screening Swabs from vagina/cervix – for Chlamydia, Gonorrhea, etc. TB screening – GeneXpert/CBNAAT, chest X-ray, endometrial biopsy (particularly in endemic regions like India) MALE INVESTIGATIONS 1. Semen Analysis Volume, count, motility, morphology (WHO criteria) To be performed after 2-5 days of abstinence Repeat if abnormal 2. Hormonal Profile (if semen is abnormal) FSH, LH Testosterone Prolactin TSH 3. Scrotal Ultrasound (in case of suspected varicocele or structural abnormality) 4. Genetic Testing (in azoospermia/severe oligospermia) Karyotyping Y-chromosome microdeletion analysis CFTR mutation (in congenital absence of vas deferens) COUPLE-BASED INVESTIGATIONS 1. Blood Group & Rh Typing For future planning against Rh incompatibility 2. Infection Screening HIV, HBsAg, HCV, VDRL – required prior to ART 3. Counseling for Lifestyle Factors BMI, smoking, alcohol, stress, sleep, etc. Notes: Investigations may be initiated if the couple fails to conceive after 1 year of regular unprotected coitus, or earlier (6 months) if the woman is ≥35 years or with known risk factors (PCOS, endometriosis, etc.). Always interpret results in the clinical context. Both partners must be assessed together.