Fifteen years ago the diagnostic study of cases of sterility was not regarded as a matter of any great complexity. The ordinary practice required only a routine pelvic examination of the wife, with a special outlook toward vaginismus, cervical stenosis, and so-called displacements of the uterus. A few more careful practitioners inquired about the potency of the husband and examined an occasional seminal specimen. Constitutional states, excepting obesity, received scant attention.
It happens that during the past fifteen years there has been a conspicuous awakening of interest in the problem of sterility. This originated probably from three noteworthy advances. First, Hühner's development of postcoital examination made clear the true extent of male responsibility, the essential mechanism of insemination, and the effect on spermatozoa of abnormal cervical secretions. Second, transuterine insufflation of gas and the injection of iodized oil provided a means of evaluating accurately the tubal element. Third, general progress