Definition of infertility: Infertility occurs when a woman has been living without contraception for at least 12 months without conceiving. Infertility is characterized by male-only factors in about 40% of cases, female-only factors in about 40%-55% of cases, bilateral factors in 10%-20% of cases, and unexplained causes in about 10% of cases. Because male fertility tests are convenient, non-invasive, and inexpensive, men are generally checked first and are not mentioned in detail here. In principle, the examination of women ranges from simple to complex, from non-invasive to invasive, and from economic to expensive. History taking (1), the time of non-contraception and non-pregnancy, which is the main complaint of infertility. (2), menstrual history: including the age of menarche, menstrual cycle, menstrual flow, duration, accompanying symptoms and the first day of the last menstruation, etc., which is important for the diagnosis of the presence or absence of ovulation, endometriosis or inflammation. (3) Marital and childbearing history: age of marriage, number of marriages, history of miscarriage, preterm labor, stillbirth, ectopic pregnancy, and gravidity; for those who have given birth in full term, they should know whether there is any abnormality in pregnancy, labor and postpartum, lactation, contraceptive history, and contraceptive methods and time, etc. The patient should be given a chance to talk alone. Patients should be given the opportunity to talk alone. (4) Sexual life history: frequency and time of sexual life, sexual life disorders and abnormal libido. (5) In addition to the past medical history, drug treatment history, and the occupation of both patients, etc., all need to be asked in detail. Physical examination (1), general examination (2), gynecological examination Ovulation disorder examination (1), ultrasound to monitor follicular development (2), diagnostic scraping (3), vaginal cytology (4), basal body temperature measurement: biphasic temperature suggests that there is ovulation, but it is not accurate. (5) Cervical mucus examination: it has some value in estimating the maturity of oocytes and predicting ovulation. Endocrine examination (1), sex hormone six: blood is collected on the third day of the menstrual cycle. Follicle stimulating hormone (FSH) Luteinizing hormone (LH) Prolactin (PRL) Estradiol (E2) Progesterone (P) Testosterone (T) (2) Hormone function test: This test is used for amenorrhea patients. Progesterone test: Positive test indicates that there is still a certain amount of estrogen in the body, which is classified as Ⅰ degree of amenorrhea; if it is negative, it is necessary to do the artificial cycle test again. Artificial cycle test: Withdrawal bleeding indicates that there is no problem with the endometrium, which is classified as Grade II amenorrhea. No bleeding suggests endometrial problems, mainly in endometrial tuberculosis or after repeated scraping, with scarring of the endometrium or adhesions in the uterine cavity. Pituitary excitability test: generally used to identify whether the pituitary gland or the hypothalamus is the problem; abnormalities indicate impaired pituitary function. Tubal Patency Test Tubal function test is the most important part of infertility test and is the prerequisite for infertility patients to choose the right treatment. Generally, it is performed 3-7 days after the patient’s menstruation. Now, the following methods are mainly used: (1), B ultrasound guided tubal fluids: more common, less traumatic, but due to the inability to see the internal and external appearance of the uterine cavity and fallopian tubes, if there is any obstruction, the part of the obstruction is not known. (2) Tubal iodine oil contrast (HSG): under fluoroscopy, 5 ml of iodine oil is injected into the uterine cavity through a catheter first, and if tubal filling is not seen, wait for 3-5 minutes before injecting the contrast agent and then take a photograph, and take another photograph after 24 hours to know the situation of the contrast agent dispersed in the pelvic cavity. It is possible to know the site of tubal obstruction and the morphology of the uterus and fallopian tubes at the same time. (3) Laparoscopic examination Pelvic inflammatory disease causing tubal obstruction, if the appearance of the fallopian tube is normal, it is simple intraluminal obstruction; it can also be manifested as tubal inflammatory mass, tubal umbilical end curling or adherence to the surrounding tissues; in the case of tubal hydrosalpinx, the tubes are thickened, with thin walls and fluid retention in the tubal cavity. Pelvic tuberculosis manifests as yellowish-white granular nodules on the peritoneum, caseous necrotic-like foci, and calcified spots; and endogenous heterotopia manifests as small rice-sized hemorrhagic spots in the pelvic cavity, small granulomas, or peritoneal defects. It is also important to note that tubal stenosis and tubal curls can also cause infertility. Under laparoscopy, tubal fluid can be visualized by the outflow of methylene blue from the umbilical end and tubal dilatation, which is more accurate than tubal fluid under B ultrasound. (4) Tuboscopy: it can visualize the whole fallopian tube to see whether there is any anatomical change, whether there is any adhesion and damage to the mucous membrane, and it can carry out biopsy and separation of adhesion, so that the diagnosis and treatment of tubal infertility can be significantly improved. Post-coital test After sexual intercourse in the near-ovulatory period, the posterior fornix and cervical mucus are taken. Post-coital test is a test to detect the penetration of sperm into the cervical mucus and the receptivity (i.e. compatibility) of the cervical mucus to sperm. Hysteroscopy The ultimate means of evaluating the uterine cavity and identifying associated lesions, hysteroscopy may be performed from 3 days after menstruation to pre-ovulation. To identify the cause of infertility, such as uterine adhesions, endometrial polyps, submucosal fibroids, and uterine longitudinal septum. And restore the normal anatomy and function. Immunologic examination such as anti-hyaline band antibody, ovarian autoimmune antibody, antiphospholipid antibody within serum, cervical mucus sperm antibody, endometrial antibody. Chromosomal tests Blood karyotyping requires special indications, such as primary amenorrhea or abnormal genital development. If repeated miscarriages or the production of malformed children, both husband and wife should be examined. Other monitoring Screening for diseases such as thyroid function, adrenal disease, diabetes mellitus.