This refers to a number of methods used to bring about pregnancy and subsequent delivery in situations when the ordinary (conventional) methods of the infertility treatment have all failed or are expected to fail because of the nature of the casual factors in the infertility which are the barrier to the sperm and egg union. Thus, ART can be defined as an assemblage of procedures and processes which allow a by-pass of the barrier or obstacles to pregnancy occurring by the ordinary (conventional) infertility treatment method in a couple where otherwise the chance of pregnancy occurring would have been zero.

Types of Assisted Reproduction Technology (ART)

In-vitro fertilization and Embryo Transfer (IVF and ET)

Intracytoplasmic sperm injected (ICSI)

Intra-Uterine Insemination (IUI)

Sex selection

Pre-Implantation Genetic Diagnosis (PGD)




Couples with infertility are assessed together as couples rather than as either the wife or the husband alone. It is preferred that husband and wife will visit the clinic together but where this is not possible, then either the wife or husband could start the initial visit.

Infertility in a marriage context is when a husband and wife in spite of regular sexual intercourse of an evenly spread interval of three times weekly cannot achieve a pregnancy during a one year duration. This is true in the case, where the wife is 34 years or less and has regular monthly menstruation. If the woman was 35 years or more or (has delayed menstruation or no menstruation for over six months without being pregnant) or had operations in the past on the fallopian tubes (like ectopic) uterus or ovaries or operated for a burst appendix or complications of an abortion, the couple should present for assessment after six months of the co-habitation and not one year. However, in the marriage, where the woman is already 40 years or more, the couple should present for assessment even much earlier within the six months because the capacity to achieve pregnancy naturally without some form of assistance is considerably much less in the older women especially those who are already above 40 years.

At the initial visit the details of the history (which is general and medical including past illness and operations) are obtained from the couple (both while they are together and also separately) and an examination is performed on the couple but each separately. This is always followed by some laboratory test which is both routine and specialized viz.


These include commonly

  1. Haemogram: This is an assessment of blood capacity, quality and its variants.
  2. Assessment of the bladder and kidney function
  3. Screening for evidence of infections either currently or in the past including some particulate infection
  4. Screening for endocrine diseases like diabetes sand thyroid malfunctions
  5. Screening the ovaries in he woman for capacity to ovulate the reserve and potential to respond to stimulation with drug which are all deduced from test like 3rd day and 22nd day hormone assay and in combination with ultrasound scan in appropriate cases
  6. Screening of the testes and male accessory gland in the man for sperm production capacity past or current infections and the quality of the sperm through examination of the seminal fluid, hormone assay and ultrasound scan of the testes and male accessory glands in the appropriate cases
  7. Screening of the uterus and fallopian tubes for normal uterine cavity, fallopian tubes potency and mobility with the special x-ray examination known as hysterosalpingography (HSG) and where appropriate sonohysterography or and laparoscopy and hysteroscopy in a complementary manner in principle, at St. Augustine Medical Centre laparoscopy is used to assess the further details of the abnormal or uncertain findings on HSG reports.

These entire tests are preformed and results are obtained within one week at the hospital’s laboratory and a diagnosis is made as the cause of the infertility in the couple. The meanings and implication of this diagnosis in either the man or woman or both and the intended format of the treatment are fully explained in a common easily understood language without medical jargons.


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