- The Washington Times - Thursday, July 17, 2008

BARCELONA (AP) | Doctors are getting ready to introduce a cheap in vitro fertilization procedure across Africa, where women are sometimes ostracized as witches or social outcasts if they cannot have children.

Millions of dollars go into family-planning projects and condom distribution to prevent pregnancies in Africa, but researchers 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 Dr. 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 last week at the society’s annual conference in Barcelona, Dr. Ombelet said he and colleagues were deciding where 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.

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.

Ms. Rita said infertile women in Africa can face particular economic hardships. Their husbands may leave them for other women and they can be cut out of family inheritances.

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

Instead of using expensive lab equipment and medicines, researchers said, cheaper options could work. For instance, a water bath could be used in place of an expensive incubator to create an embryo, Mr. Ombelet said.

Less expensive medicines also would effectively stimulate women’s ovaries to produce more eggs, and spending could be further trimmed by using low-cost needles and catheters.

But because fewer eggs would be produced by using cheaper drugs, the success rate would be lower. In developed countries, IVF is usually successful in about 20 percent of cases. In Africa, Mr. Ombelet said, it probably would 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 - researchers said it was worthwhile to introduce a budget version of IVF.

In Africa, where infertility is more common than in the West, the problems often follow 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. Mr. Akande acknowledged that the price of the procedure still would 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 labeled as witches, and in extreme cases are driven to suicide.

Researchers said that even if millions of women were treated with low-cost IVF, it would only result in a 1 percent to 2 percent boost in the overall population.

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

“It’s definitely going to be viewed as a lower priority,” said Dr. Sheryl Vanderpoel, a reproductive health specialist at the World Health Organization.

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

Dr. Vanderpoel said that might start to change once it is clear that low-cost solutions are 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.”

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