In Kenya, more than 100 test tube babies are born each year in the main hospitals and designated centres. According to Alfred Murage, a fertility consultant at the Aga Khan University Hospital, IVF is restricted to women who are unable to conceive due to infertility or genetic problems.

“At Aga Khan, we attend to up to 100 couples every year who suffer from mostly infertility. I believe that there are many more but they cannot afford the cost of IVF,” said Dr Murage.

Infertility could be due to fallopian tube damage or blockage that makes it difficult for an egg to be fertilised or for an embryo to travel to the uterus; or due to ovulation disorders that result in fewer or no eggs for fertilisation; or uterine fibroids (non-cancerous tumours) that are common in women over the age of 30 years; impaired sperm production or as a result of genetic disorder.

Although the IVF cost depends on the type of egg stimulation (injection or tablets) and the facility it is being conducted in, the process from the time the egg is harvested to fertilisation with the sperm in the laboratory until embryo implantation in the womb, costs between $3,897 and $4,454.

“However, that does not guarantee success,” said Dr Murage. “Women below the age of 35 have a higher success rate of 35 per cent compared with women over the age of 35.”
For women over 35, he said, the chances are between 15 and 20 per cent while for those over 40 years, it is 10 per cent or below.

“This is because at age 35 and below, women are considered to be more fertile and producing more eggs than later in life,” he noted. “In men, however, the success rates are higher at age 50 and below.”

According to Dr Murage, fertility medications are usually prescribed to women to control the timing of the egg ripening and to increase the chances of collecting multiple eggs during one of the woman’s cycles. This is referred to as ovulation induction. Multiple eggs are desired because some eggs will not develop or fertilise after retrieval.

Egg development is monitored using ultrasound to examine the ovaries, and urine or blood samples are taken to check hormone levels.

“The eggs are retrieved through a minor surgical procedure from the ovaries while sperm is usually obtained by ejaculation and prepared for combining with the eggs,” said Dr Murage. “The sperm and eggs are then placed in incubators in the laboratory to enable fertilisation to occur.”

The eggs are then monitored to confirm that fertilisation and cell division take place. The fertilised eggs are considered embryos that are transferred into the woman’s uterus from one to six days later, but in most cases the transfer occurs between two and three days following egg retrieval.

Couple’s or donor’s egg
“These steps are followed by rest and observation for early pregnancy symptoms,” he added. “A blood test and potentially an ultrasound will be used to determine if successful implantation and pregnancy have occurred.”

IVF may be done with a couple’s own eggs and sperm or with donors’ for the case of genetic disorder. Although the number of embryos that should be transferred during any single IVF cycle is still a subject to debate, Dr Murage said that transferring three embryos per IVF cycle will yield optimal results.

“Transferring more than three eggs is believed to result in excess numbers of multiple pregnancies increasing the possibility of additional complications,’’ he said.