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Referrals

Infertility referral checklist

Baseline evaluation, urgent criteria, and referral note elements for infertility.

Last reviewed 2026-01-05|fertility | reproductive | workup

Minimum pre-referral workup

  • Duration of trying to conceive and timing of intercourse.
  • Semen analysis for partner.
  • Ovulation assessment based on cycle history and/or progesterone.
  • TSH and prolactin when indicated.
  • Pelvic ultrasound and STI screening if risk factors.

Urgency tier

  • Female age 40 or older or rapidly declining fertility history.
  • Amenorrhea or oligomenorrhea with suspected endocrinopathy.
  • History of PID, ectopic pregnancy, or pelvic surgery.
  • Known uterine or tubal abnormalities.
  • Severe male factor findings on semen analysis.

Referral packet checklist

  • Duration of infertility and prior pregnancies or losses.
  • Menstrual regularity and ovulation assessment results.
  • Semen analysis results and partner history.
  • Relevant labs and imaging reports.
  • Comorbidities, medications, and lifestyle factors.

Pre-referral optimization tasks

  • Optimize preconception counseling, including folic acid and chronic disease control.
  • Address modifiable factors such as smoking, alcohol, weight, and intercourse timing.
  • Set follow-up to confirm all baseline tests are complete before specialist review.