There are many causes of infertility, in general 50% of infertility is caused unilaterally by women, 30% by men, 20% by both partners, and unknown causes. Under normal physiological conditions, couples living together without contraception and having a normal sex life have a 20% chance of conception every month, a 70% chance of pregnancy in six months and an 80% chance of pregnancy in a year, and infertility without contraception for more than a year is medically called infertility and should be medically examined, which means that a couple with no fertility problems can’t get pregnant in any month. If you get married late, older, and want to get pregnant urgently, you can advance to six months after marriage for the relevant examination, it should be noted that there are many couples who have not been pregnant for a month or two after marriage or although married for a longer period of time, but the release of contraception for a shorter period of time, it is urgent to seek medical help for a completely unnecessary excessive examination may instead bring a series of problems that should not be. The first male examination is simple and economical: check whether the male internal and external genital development is normal, if there is no abnormality in the genital fertility examination and the sexual function is normal, the next step is for the male partner to do the semen examination first. If the semen examination is normal, basically the possibility of infertility caused by the male partner can be ruled out, then the female partner can start to find the cause. If the husband is found to have no sperm production ability, there is no need to check the woman again; if the semen test result is no sperm, the next step is to do a testicular biopsy. If the testicular biopsy result is no sperm production ability, it means that the male partner is not fertile and there is no need to continue to do other tests. If the testicular biopsy reveals the presence of sperm in the testicles, the vas deferens may be blocked and a vasectomy may be performed. There are many causes of female infertility, so the examination can only be done in a simple to easy and absolute to relatively progressive manner. It is important to note that if the patient has no clear indications, such as genital abnormalities, amenorrhea or extremely regular menstrual cycles, previous history of fertility surgery, etc., the test should be performed only if the patient has had a normal sexual life without contraception for more than one year after marriage or has been infertile for more than one year, because medical treatment is a double-edged sword, and while providing examination and treatment, it may also cause damage. This is why I always emphasize the importance of not overdoing medical treatment, but only proper medical treatment. At the first visit, a general gynecological examination is done to see if there are any genital abnormalities, vaginitis, uterine tumors and other gynecological diseases. If you have any disease, treat it first and then see if you can get pregnant. Examination of the fallopian tubes: A preliminary hysterosalpingogram should be done 3-7 days after menstruation to determine whether the uterine cavity is normal and whether the fallopian tubes are patent: there are uncertainties in this examination, and there are many factors affecting it, such as the horn of the uterus may be blocked, resulting in a pseudo inaccessibility of the fallopian tubes, or the timing may be wrong, resulting in a poor visualization of the fallopian tubes. Therefore, it is easy to do the imaging but difficult to do it well. In addition, it is easy to misdiagnose if the hospital and the doctor who does the imaging happen to be not very professional. Therefore, patients must go to a regular hospital to find a professional doctor who is very specialized in tubal examination, otherwise they will spend money and suffer and delay seeing a doctor. The most accurate laparoscopic bilateral tubal lavage can not only clarify whether the fallopian tubes are patent, but also understand the state of the pelvic cavity and the shape of the fallopian tubes; if the fallopian tubes are normal, women can further clarify the presence or absence of ovulation and understand the development of follicles, for women with normal menstrual cycles, it is recommended to start continuous monitoring of follicle development with ultrasound on day 5-7 of the menstrual cycle to confirm the diagnosis of normal ovulation. To be meaningful, follicle monitoring must be done continuously for one full cycle. If the menstruation is not normal and ovulation is not good, you can take blood for endocrine hormones. If the menstrual period is not normal, ovulation is usually not good. Hysteroscopy is performed to clarify the morphology of the uterine cavity and to assess the endometrial condition. Laparoscopy is both diagnostic and further therapeutic.