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.