First written document dealing with infertility may be found in the Kahoun papyrus (oldest Egyptian medical text), dated to 2200-1950 BC. The early attribution of infertility to women persisted for centuries and was often considered divine punishment. The only solution to infertility was prayer – to Egyptian Isis, Phoenician Astarte, Greek Aphrodite, or Roman Venus. During last two decades, there has been a marked increase in patient population in all infertility clinics the world over, but all infertility clinics may not be sufficiently equipped with the latest technology and expertise essential to offer the best possible help. Hence there is a need for patient selection, in order to categorize them in specific groups and then refer them to different levels of infertility care units for step-wise investigation and treatment. Where microsurgical techniques for tubal and peritoneal disease have failed or are unlikely to benefit the patient. Presence of dense peritubal adhesions, condition of the tubal wall, condition of the ciliary epithelium and degree of fimbrial damage. Bilateral Hydrosalpinx Already undergone tuboplasty and those with inaccessible ovaries H/o ectopic pregnancy Women with severe intrauterine adhesion refractory to surgical lysis of the adhesion

Hypogonadotropic anovulation,

 PCOS  

  Women with moderate to severe endometriosis;

 Those in whom medical or surgical therapy has failed; and Sometimes in cases of mild to moderate endometriosis in the presence of other factors contributing to infertility

Ø   Low concentrations of sperm

       (less than 10 million/ml),

Ø  Low motility (less than 30%),

Ø  Abnormal sperm morphology

       (presence of  > 60%  abnormal forms).

Ø     IVF is the end-point for many causes of infertility but should not be abused or embarked upon too early.

     IVF is a test of fertilization

ØART  gives hope to women with ovulatory dysfunction, tubal disease and a host of gynecological conditions.

Ø      Micromanipulation techniques such as ICSI have revolutionized the treatment of male factor infertility and couples with a history of poor fertilization in previous cycles.