Clinical recommendationEvidence ratingReferences
Men with low-volume ejaculate may benefit from postejaculatory urinalysis and transrectal ultrasonography to rule out retrograde ejaculation and ejaculatory duct obstruction.C4
Transvaginal ultrasonography can be used to obtain an antral follicle count and predict ovarian response to gonadotropin stimulation.C5,19
Postcoital testing has not been shown to improve pregnancy outcome.B21
Varicocele repair has not been shown to increase the likelihood of conception.A26,27
Laparoscopic ovarian drilling for ovulation induction may be beneficial in women with polycystic ovary syndrome who have not responded to other therapies.A29,32
To achieve ovulation, clomiphene citrate (Clomid) in an initial dosage of 50 mg per day is administered starting on day 3 to day 5 of the menstrual cycle and continued for five days.C29
Women with endometriosis may benefit from laparoscopic ablation, laparotomy, or ovulation induction with or without intrauterine insemination and in vitro fertilization.A3538
Women with unexplained infertility may benefit from intrauterine insemination, clomiphene citrate therapy, or intrauterine insemination with either clomiphene citrate or gonadotropin therapy.A39,40