Ovulatory disorders can arise from any level of the hypothalamic-pituitary-ovarian axis. Ovulatory dysfunction may result from a lack of available oocytes or of follicles. Pelvic imaging, which is often undertaken at the time of examination by transvaginal ultrasound scan, can confirm normal pelvic organs and also provide an assessment of ovarian morphology, in particular polycystic appearance. Semen analysis for the male partner must be considered an absolute minimum. It is important to consider tubal patency if ovulation induction is planned and, in women with risk factors for tubal disease, prior assessment should be considered mandatory either by laparoscopy or contrast imaging. Liaison with endocrine colleagues is recommended when more complex endocrine disorders are involved. General fertility advice is important, including advice (for both partners) on weight management, smoking, alcohol and drugs, as is confirming an up-to-date smear result and female folic acid supplementation.