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Table 1 Criteria for early referral to specialist infertility clinic

From: Management of the infertile couple: an evidence-based protocol

In women In men
Age: < 35 years with > 18 months infertility. History of: Genital pathology
   ≥35 years with > 6 months infertility    Uro-genital surgery
     Sexually-transmitted infections
Length of menstrual cycle: < 21 days.    Systemic illness
   > 35 days    Chemotherapy/Radiotherapy
Menstrual abnormalities: Amenorrhoea  
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