Pelvic exam, to look for abnormalities or infection. A postcoital test, which is done soon after intercourse to check for problems with sperm surviving in cervical mucous (not commonly used now because of test unreliability). Hysterosalpingography or sonosalpingography, to check for tube patency
Sonohysterography to check for uterine abnormalities.There are genetic testing techniques under development to detect any mutation in genes associated with female infertility.Initial diagnosis and treatment of infertility is usually made by obstetrician/gynecologists or womens health nurse practitioners. If initial treatments are unsuccessful, referral is usually made to physicians who are fellowship trained as reproductive endocrinologists. Reproductive endocrinologists are usually obstetrician/gynecologists with advanced training in reproductive endocrinology and infertility (in North America). These physicians treat reproductive disorders affecting not only women but also men, children, and teens. Usually reproductive endocrinology & infertility medical practices do not see women for general maternity care. The practice is primarily focused on helping their women to conceive and to correct any issues related to recurring pregnancy loss. Definition
There is no unanimous definition of female infertility, because the definition depends on social and physical characteristics which may vary by culture and situation. NICE guidelines state that: "A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility, should be offered further clinical assessment and investigation along with her partner."
Acquired hemolytic anemia can be divided into immune and non-immune mediated forms of hemolytic anemia. Immune
Immune mediated hemolytic anaemia (direct Coombs test is positive)
Autoimmune hemolytic anemia
Warm antibody autoimmune hemolytic anemia
Idiopathic
Systemic lupus erythematosus (SLE)
Evans syndrome (antiplatelet antibodies and hemolytic antibodies)
Cold antibody autoimmune hemolytic anemia
Idiopathic cold hemagglutinin syndrome
Infectious mononucleosis and mycoplasma (atypical) pneumonia
Paroxysmal cold hemoglobinuria (rare)
Alloimmune hemolytic anemia
Hemolytic disease of the newborn (HDN)
Rh disease (Rh D)
ABO hemolytic disease of the newborn
Anti-Kell hemolytic disease of the newborn
Rhesus c hemolytic disease of the newborn
Rhesus E hemolytic disease of the newborn
Other blood group incompatibility (RhC, Rhe, Kidd, Duffy, MN, P and others)
Alloimmune hemolytic blood transfusion reactions (i.e., from a non-compatible blood type)
Drug induced immune mediated hemolytic anemia
Penicillin (high dose)
Methyldopa

Non-immune
Non-immune mediated hemolytic anemia (direct Coombs test is negative)

Drugs (i.e., some drugs and other ingested substances lead to hemolysis by direct action on RBCs, e.g., ribavirin )
Toxins (e.g., snake venom; plant poisons such as aesculin)
Trauma
Mechanical (from heart valves, extensive vascular surgery, microvascular disease, repeated mechanical vascular trauma)
Microangiopathic hemolytic anemia (a specific subtype with causes such as TTP, HUS, DIC and HELLP syndrome)
Infections (Note: Direct Coombs test is sometimes positive in hemolytic anemia due to infection)
Malaria
Babesiosis
Sepsis
Membrane disorders
Paroxysmal nocturnal hemoglobinuria (rare acquired clonal disorder of red blood cell surface proteins)
Liver disease

Drug induced hemolysis
Drug induced hemolysis has large clinical relevance. It occurs when drugs actively provoke red blood cell destruction. It can be divided in the following manner:
Drug-induced autoimmune hemolytic anemia
Drug-induced nonautoimmune hemolytic anemiaA total of four mechanisms are usually described, but there is some evidence that these mechanisms may overlap. References


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