Infertility is a medical condition defined by a couples’ inability to achieve a clinical pregnancy after 12 months of consistent, unprotected sexual intercourse [22].

According to the World Health Organization, infertility is a significant global social and public health issue, affecting approximately one in six individuals worldwide [23]. In developing countries, including those in sub-Saharan Africa, there is a higher prevalence of infertility due to various factors such as complications of pelvic inflammatory diseases, unsafe abortion practices, postpartum and iatrogenic infections [1]. Infertility rates of 30% to 40% have been reported in sub-Saharan Africa [5]. Infertility carries profound physical and psychological challenges for couples, including depression, stress, anxiety, and reduced social recognition [14].

In societies like Ghana, where very high value is placed on childbirth, infertility is particularly challenging, leading to stigma, social isolation, and marital instability. Infertility also impacts mental health, resulting in low self-esteem, deprivation, aggression, personality disorders, and even suicide especially among affected women.

A previous study in the North-East and Ashanti regions of Ghana showed that, many infertile married women, regardless of their education level, religious beliefs, or location, often attributed their infertility to supernatural causes. Despite recognizing some medical explanations, such as hormonal imbalances or previous contraceptive use, the incomprehensibility of their condition has often led them to supernatural reasoning [16].

Despite this distressing impact of infertility, there have been limited public health interventions for addressing infertility. Rather, majority of these interventions focus more on infectious diseases control, infant mortality reduction, and population control programs [5]. Globally, the use of Assisted Reproductive Techniques (ARTs) has continued to steadily revolutionize infertility management, including in developing countries such as Ghana. However, many individuals lack awareness of ART, also, there are barriers relating to accessibility, affordability, and regulation of these services [6]. Sociocultural attitudes, mistrust in the science, gender-related issues, and ethical concerns further hinder the practice and uptake of ART in the sub-Saharan African region.

Challenges in Ghana include limited availability of ART services, with only a few private institutions providing these services, often at high costs. The absence of a national regulatory framework, limited technology, and a scarcity of the expertise pose additional hurdles [6]. Existing literature is scarce in our context, particularly in accessing the knowledge level of ART.

This study therefore aimed to explore the level of awareness, attitudes, and perceptions of tertiary students in Ghana regarding Assisted Reproductive Techniques.

This multi-centered cross-sectional study primarily targeted students from Ghana's two largest institutions, the University of Ghana, Legon, in Accra, and the Kwame Nkrumah University of Science and Technology, Kumasi, along with students from other tertiary institutions. Online questionnaires, which were structured and pre-tested to ensure clarity and relevance of the questionnaire items, were administered to undergraduate and postgraduate students, excluding those in medical programs. To prevent duplication, responses were restricted to one email address per participant. Written informed consent was obtained from participants aged 18 and above, representing various public and private tertiary institutions before participation.

The minimum sample size was estimated, using the formula: N = Z2 P(1-P)/d.2

Where N is the sample size; Z is the statistical certainty at 95% confidence interval = 1.96; p is the prevalence of knowledge from previous similar study 0.61 [12]; d is the margin of error (5%), Hence the calculated sample size N is 86, plus 10% (7 ) giving the total of N = 93 participants per institution, summing to a total of 186 for the two major universities.

The resulting data was analyzed using SPSS software (version 27) and the findings were presented using graphs, frequency tables, and charts. Respondents’ baseline sociodemographic characteristics were reported using means and standard deviations for continuous variables, while frequency and percentage were used for categorical variables. The responses were compared based on socio-demographic parameters, institution of study, course of study, and relationship status in relation to the study's outcome variables. The association between these factors and the level of awareness, as well as attitudes towards Assisted Reproductive Techniques (ARTs), was assessed using the student t-test and Pearson chi-square.

Statistical significance was considered at a 95% confidence interval, with a p-value less than 0.05. The study protocol received approval from the Review Board of the Community Health Department at the University of Ghana Medical School, College of Health Sciences, Korle Bu.