The Gambia is a developing country. Fertility care, if available is very basic in the Gambia. Conventional methods of infertility treatment involve the surgical repair of blocked fallopian tubes, success rates of which being doubtful, and blind hormonal stimulation with Clomid.

Medical staff in Gambia are already overstretched and infertility is not a priority. Infertile women may be wrongly or over prescribed with drugs.

Long term, or overprescribed use of Clomid, which is an over the counter drug in the Gambia, may lead to complications or high risk multiple pregnancies.

In the absence of laparoscopic techniques in the Gambia, tubal surgery always involves laparotomy. Succesrates being questionable.

Higly controversial is the procedure of D&C (dilation and curettage). D&C as an infertility treatment has long been eliminated from the reproductive medicine textbooks, and government hospitals and most private clinics no longer offer this procedure as infertility treatment.

Still, many Gambian women feel that the process of cleaning out the womb (‘kono kuwo’, ‘stomach washing’ in Mandinka) will remove any blockage that might prevent a pregnancy or affect its viability and some are willing and able to offer large sums for the procedure. Sadly as of to date some doctors still perform D&C for these reasons.

We aim to educate health care professionals with the current insights and guidelines for infertility care and create a standardised process for diagnosis and treatment.

Modern assisted reproductive techniques such as IUI and IVF until recently were not yet available in the Gambia.  Those who can afford will have to travel to Dakar or Europe.