Initial evaluation and treatment of infertility in a primary-care setting.

Infertility is a condition that primary-care physicians frequently encounter. The infertility work-up necessitates an understanding of the physiology and anatomy of the female and male partners. A systematic work-up can be initiated by a primary-care physician. Infertility problems are stressful for the couple, and initial assessment by their own physician may help them work through the process as well as prepare them if they need to seek the care of a reproductive endocrinologist for further assessment or for assisted reproductive techniques. Infertility services are expensive and are rarely completely covered by many health insurance plans; therefore, a cost-effective evaluation is important. In the managed-care environment, a primary-care physician can begin the investigation and decide which patients require more advanced assessment and treatment. Helping a couple through the stages of an infertility investigation is a professionally rewarding experience.