The first principle in consultations for subfertility is that the problem should be considered a ‘couple problem’ and the couple should be seen together if at all possible. Secondly, it should be remembered that couples often feel very stressed at this time. They also often feel that it is not fair that they should be singled out with a fertility problem whereas all their friends manage to conceive with ease. There are often pressures from parents, especially as siblings may be producing grandchildren. It is therefore important for the clinician to be understanding during the consultation.

A good starting point is to inquire about the couple's occupations. This is an area about which they both know more than the doctor, and therefore can discuss it confidently. Having broken the ice, one should then move on to the general history, such as for how long they have been having unprotected intercourse, their ages, and any previous history of fertility.

It is then logical to concentrate on the female partner's medical/menstrual history. Her age of menarche, initial cycles, the use of the oral contraceptive pill, other methods of contraception, and subsequent and current menstrual cycle lengths, and the duration of menstruation should all be recorded. Any abnormal intermenstrual bleeding should be identified, for example endometriosis is often associated with premenstrual spotting.

Other symptoms of ovulation such as mid-cycle pain or spotting, and premenstrual symptoms should be asked about.