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Philosophiae Doctor - PhD / Infertility is currently a serious problem that is escalating, not only in South Africa, but also worldwide. In Cape Town, a culturally diverse, urban community of approximately 1000 couples are referred to the Groote Schuur Hospital Infertility Clinic annually. Although infertility is primarily regarded as a medical condition, the treatments have emotional effects on infertile couples due to the recurring highs and lows that often accompany treatments. This study aimed to qualitatively explore and understand the emotional and psychological experiences of infertility and its treatments (specifically In Vitro Fertilisation and Embryo Transfer). Social constructionism is based on the premise that realities are not constructed in a vacuum but rather undergo a process whereby the subjective and inter-subjective experiences over time and through cultural processes come to be regarded as truths. These truths become internalised and function as lenses through which we see ourselves, compose and invent ourselves accordingly, making sense of what would otherwise have been chaotic and meaningless experiences. Additional aims were to examine women's experiences of infertility care whilst undergoing treatment and describe their experiences of coping with infertility and In Vitro Fertilisation and Embryo Transfer (IVF-ET). Semi-structured, in-depth individual interviews were conducted with 21 women presenting with primary infertility at a fertility clinic. This study utilised an ethnographic case study design. The results of the study suggested that women perceived themselves as not conforming to a dominant belief system that promotes motherhood as the most important role for women. The women described their 'failure' to fulfill socio-cultural expectations as emotionally turbulent. Some of the psychological responses to infertility included feelings of disappointment, shock, denial, devastation, anger, frustration, sadness, inadequacy, poor self-image and self-esteem. The women's personal accounts of their experiences of In Vitro Fertilisation and Embryo Transfer (IVF-ET) revealed that they found the treatment to be highly stressful, with emotional bouts of anxiety, nervousness, excitement and optimism. A psychological synopsis of infertility and IVF-ET is infertility and IVF-ET presents. The findings in this study suggest the need for the incorporation of 6 presented. This diagrammatic representation shows the intensity of the emotional rollercoaster that psychosocial intervention into infertility management. Greater attention to the psychological and emotional repercussions of infertility treatment could lead to a more personalised approach which, in turn, would optimise patient satisfaction and also prepare couples for the demands of the program by informing them about better ways of coping.

An audit of Couples attending the Infertility Unit at Inkosi Albert Luthuli Central Hospital (IALCH), Durban Objectives To determine the patient profile, causes of infertility and the success rates of medical and surgical treatment of infertility thus emphasizing the need for assisted reproductive treatment Methods Data was obtained retrospectively from the medical records of 281 couples that presented to Inkosi Albert Luthuli Central Hospital Infertility Unit between January 2004 and December 2006. Information was recorded on a structured proforma and data analysed using SPSS version 15.0 Results The causes of infertility were anovulation (32.7%), tubal factor (30.3%), male factor (11.7%), endometriosis (7.8%), uterine factor (4.3%) and unexplained infertility in 7.1% of cases. Couples with both male and female factors contributed to 6.1% of infertility cases. Twenty two percent of patients with severe male factor and tubal infertility could not be offered any treatment because of the unavailability of assisted reproductive technology (ART). The pregnancy rate was 24.3% after medical treatment and 14.3% after surgery. When both modalities were employed, the pregnancy rate was 26%. The overall pregnancy rate was 16% with 84% of couples requiring further treatment. Conclusion Anovulation and tubal factors were the major causes of infertility. This audit illustrates that the majority of couples (84%) require gonadotrophins and / or assisted reproductive services to achieve conception. A dedicated infertility unit should provide a full range of services including ART. A significant proportion of couples are denied this health service in the public sector in KwaZulu Natal. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2011.

This thesis explores how fertility clinics engage in various textual and visual strategies to locate nature and kinship in the context of the assisted conception technologies they offer. In particular, competing paradigms of modern technology solving problems of the body versus the “naturalness” of having a baby means that fertility clinics must mobilize particular understandings of nature and technology to bridge this gap. Additionally, fertility clinics draw upon culturally meaningful themes such as “birds and bees” to structure relationships among assisted conception technology participants. I argue that fertility clinic websites are public sites of discourse through which clinics both attempt to attract potential clients and shape understanding of assisted conception technology by offering particular explanations as real and natural.