Table 2.

Practice points

• Couples should be referred for assessment of their subfertility if they have failed to conceive after one year of frequent unprotected intercourse

• Unexplained infertility should be treated initially with superovulation and intrauterine insemination except if a couple has more than three years of subfertility or if the woman is aged ⩾38 years (in which case early recourse to in vitro fertilisation is recommended)

• Women with endometriosis who fail to conceive should have surgical ablation of their deposits except in severe disease, when in vitro fertilisation is recommended after treatment of endometriomas

• Fibroids are a cause of subfertility. Surgery should always be considered if no other explanation for subfertility is found and is essential if the fibroid is intracavity