An approach to infertility investigation.

Infertility has been described as a major developmental crisis. It affects one out of every six couples of childbearing age in the United States. With infertility rates increasing, it is likely that nurse practitioners will encounter patients seeking help for this problem. Although eventual management of these patients requires specialists, nurse practitioners can initiate the workup and provide patient support and education. This article describes the first-level approach to infertility investigation. It provides guidelines for taking the history, doing the physical and ordering laboratory tests. A discussion of infertility as a crisis is included in order to help practitioners provide empathetic support to couples facing fertility problems.