Infertility is defined as not being able to conceive, having regular intercourse, over 6-8 months of time.  It affects approximately 10% of couples of reproductive age. The work-up of the female is related to her menstrual cycle, whereas the male work-up is unrelated to a cycle because sperm production (spermatogenesis) is constant.  The infertility work-up can be completed in as short a time as two months. Unfortunately, many physician training programs are no longer teaching their residents how to perform an infertility investigation because in today’s world of managed care office medicine doesn’t pay very well.  It’s easier and more profitable to skip the work-up, and shunt the couple directly to IVF (in vitro fertilization). As a procedure it’s reimbursed at a higher rate.