Table 1 Criteria for early referral to specialist infertility clinic

Age: < 35 years with > 18 months infertility.

History of: Genital pathology

   ≥35 years with > 6 months infertility

   Uro-genital surgery

   Sexually-transmitted infections

   Varicocele

   Cryptorchidism

Length of menstrual cycle: < 21 days.

   Systemic illness

   > 35 days

   Chemotherapy/Radiotherapy

Menstrual abnormalities: Amenorrhoea

   Oligomenorrhoea

History of: Ectopic pregnancy

Two abnormal results of semen analysis:

   Pelvic infections (PID)

   Sperm count < 20 million/ml

   Endometriosis

   Sperm motility < 25% (grade-a)

   Pelvic surgery (ruptured appendix)

   Sperm motility < 50% (grade-b)

   Developmental anomalies

   Sperm morphology < 15% normal

Abnormal P/V findings on examination

Abnormal findings on genital examination

Chlamydia antibody titre ≥ 1:256

Patient request or Anxiety

Mid-luteal progesterone < 20 nmol/l

FSH > 10 IU/l early follicular phase

LH > 10 IU/l early follicular phase

Patient request or Anxiety