Doctors: Inexpensive In-Vitro Fertilization Ready for Africa

Doctors are getting ready to introduce a cheap in-vitro fertilization procedure across Africa, where women often are ostracized as witches or social outcasts if they cannot have children, officials said Monday.

Millions of dollars go into family planning projects and condom distribution to prevent pregnancies in Africa, but experts said that more than 30 percent of women on the continent are unable to have children. An estimated 80 million people in developing countries are infertile worldwide.

"Infertility is taboo in Africa," said Willem Ombelet, head of a task force at the European Society of Human Reproduction and Embryology looking into infertility in developing countries. "Nobody has paid attention to this issue, but it is a huge problem and we need to do something."

At a media briefing at the society's annual conference in Barcelona, Ombelet said that he and colleagues were deciding in which countries to test the new procedure.

A small number of women already have been treated in Khartoum, Sudan, and other projects are expected to start soon in South Africa and Tanzania.

The cheap version of IVF costs less than US$200. Standard IVF treatments in the West cost up to US$10,000.

Instead of using expensive lab equipment and medicines, experts said cheaper options could also work. For instance, rather than using an expensive incubator to create an embryo, Ombelet said that a water bath could be used in Africa.

Less expensive medicines also would effectively stimulate women's ovaries to produce more eggs, and costs could be further cut by using cheaper needles and catheters.

But because fewer eggs would be produced by using the cheaper drugs, the success rate would also be lower. In developed countries, IVF is usually successful in about 20 percent of cases. But in Africa, Ombelet estimates it would probably be about 15 percent.

The inexpensive procedure has been used on cows and a small number of women. Researchers in the United States are working on developing an even cheaper IVF procedure that might be more effective.

Despite dozens of other health priorities — from AIDS to pneumonia to malaria — experts said it was worthwhile to introduce a cheap version of IVF.

In Africa, where infertility is more common than in the West, women often suffer the problem after complications from unsafe deliveries, abortions or infections.

"The cost of being infertile in Africa is much greater than in the West," said Oluwole Akande, an emeritus professor of obstetrics and gynecology at the University of Ibadan, Nigeria. Akande acknowledged the price of the procedure would still be available only to Africa's upper and middle classes.

He said that in many parts of Africa women who are unable to have children become social outcasts, are labelled as witches, and in extreme cases, are even driven to suicide.

Sembuya Rita, an infertility activist from Uganda, said it was essential for public health officials to address the issue. "It's a fundamental right for every person to have a child," she said.

Rita said that infertile women often were economically disadvantaged as their husbands left them for other women and were cut out of family inheritances.

Experts said that even if millions of women were treated with low-cost IVF, it would only result in a one to two percent boost in the overall population.

But with limited funds for public health, officials admitted it would be a tough sell.

"It's definitely going to be viewed as a lower priority," said Dr. Sheryl Vanderpoel, a reproductive health expert at the World Health Organization.

WHO has traditionally been focused on family planning and preventing sexually transmitted diseases rather than helping solve infertility problems.

Vanderpoel said that might start to change once it was clear that low-cost solutions were possible.

"If you remove the fixed costs, it is actually not that expensive to create an embryo in a dish," she said. "This doesn't come with all the bells and whistles, but it works.