They attend orientation courses and training programs at the national and local level. They follow FPAI guidelines to ensure that each couple is systematically and thoroughly evaluated. Because most clinics have very basic laboratory services, medical officers usually refer infertility clients to government and private laboratories for diagnostic tests. FPAI has negotiated discounted fees with these laboratories for couples they refer. Clients can easily afford semen analyses, blood tests, some hormone tests, and sonographic evaluations.
Some couples find it too expensive, however, to go for repeat sonography for follicular study.
Once the diagnostic tests are complete, the medical officer scrutinizes the results and in difficult cases consults a senior medical volunteer or honorary before deciding on treatment. If surgery is needed, the couple is referred to a government hospital or private doctor. If the couple chooses adoption, the medical officer supports their decision and refers them to an adoption agency. FPAI has succeeded in providing infertility services to poor and marginalized people throughout India who have never before had access to such services. During 1998, FPAI clinics registered 1,314 new cases of infertility, continued to treat 1,454 existing cases, and reported 87 live births.