An office setting is perfectly adequate for the initial outpatient management of the infertile couple. The preliminary history, physical findings, and laboratory data may be obtained within a reasonable period of time, usually 3 to 4 months, allowing for the 72 to 74 day duration of the spermatogenic cycle with an additional 12 to 20 days for transport of sperm through the genital duct system. The cost to the patient will vary according to the number of visits necessary, the lab data obtained, and the complexity of the problem. In my practice, the initial consultation; three semen samples; FSH, LH, testosterone, complete blood count, blood urea nitrogen, and creatinine determinations; and the follow-up evaluation to review the data usually cost the patients $250. If hospitalization is required for scrotal exploration, testicular biopsy, or spermatic vein ligation, an additional cost of $900 to $2000 is average for hospital and physician costs in our community. An additional 6 to 12 weeks usually elapses after diagnosis of the problem is established and therapy is begun. The results of therapy (pregnancy) usually average an additional 6 to 8 months; if pregnancy is not achieved within 12 months after therapy is begun, we usually recommend that the couple consider other alternatives such as artificial donor insemination and/or adoption. The following flow sheet provides the urologist with a checklist and guidelines for the assessment and successful treatment of the infertile couple.