Clinical recommendation	Evidence rating	Comments
Infertility evaluation should begin after 12 months of regular, unprotected intercourse in a female younger than 35 years, after six months between 35 and 40 years of age, or immediately if older than 40 years or if the patient has risk factors for infertility.1,9,10,12	C	Expert opinion and consensus guidelines
Evaluation of infertility should include semen analysis, history and physical examination focusing on menstrual history, past infection, sexual dysfunction, surgical history, and medication use.9	C	Expert opinion and consensus guidelines
Clomiphene or letrozole with intrauterine insemination should be used as first-line therapy for unexplained infertility.17,28	A	Guidelines with grading based on consistent evidence from randomized controlled trials showing improved live birth rates compared with expectant management
All women who are obese should be counseled on lifestyle modifications and weight loss to improve spontaneous ovulation and response to ovulation induction.23	C	Expert opinion