**2. Position of genital tract infections in infertility work-up**

International societies didn't include infections as a definite cause of infertility. Practically, local gynecologic examination should be an essential routine step in infertility evaluation. Both speculum and bimanual examinations can detect or suspect a wide variety of lower or upper genital tract infections. With the extensive routine use of transvaginal ultrasonography (TVS) in all gynecologic clinics, unfortunately many gynecologists miss the five basic steps of gynecologic examination which can detect definite infertility causes (inspection of the external genitalia, palpation of the external genitalia, palpation of the vaginal walls and fornices, bimanual examination and vaginal speculum examination). Moreover, many women don't prefer local gynecologic examination due to fear or inconvenience. Gynecologic examination is a cheap valuable basic step that should not be ignored. Moreover, local examination can detect many vaginal and cervical disorders. For instance, some congenital anomalies like transverse or longitudinal vaginal septae, Gartner's cyst in one of the fornices which occludes the external os or congenital vaginal atresia. Practically and literally, genital tract infection detected by speculum examination can be a direct cause of female subfertility.
