26 June 2005

Ethiopia: Bethel to Start in Vitro Fertilisation

Bethel Hospital is launching Ethiopia's first in vitro fertilization (IVF) and embryo transfer service, in August, for people experiencing fertility problems.

The Hospital has employed an Italian gynaecologist-obstetrician, paid a monthly salary of 30,000 Br, according to Yigeremu Asfaw (MD), owner and managing director of Bethel Teaching General Hospital. With a sub-specialty in fertility, Dr Leonardo Formigli will be assisted by two Ethiopia specialists in gynaecology and obstetrics, each with a salary of 20,000 Br.

One of these specialists is the owner of the hospital himself. The Ethiopian specialists will screen out the people who require IVF and an embryo transfer. The Hospital has allocated a 3.6 million Br annual budget for the new service.

Bethel Hospital has imported one million Birr worth of medical equipment for laparascopy and hormonal assay set up from Germany and an incubator from Italy. Laparascopy is a surgical technology that enables the examination of internal organs or the performance of minor surgery by inserting a fibre-optic instrument through the abdominal wall.

The cost of the infertility treatment at Bethel Hospital, located at the western end of Addis, known as Keranio, will be 10,000 to 15,000 Br. Dr Yigeremu said it is cheaper than what patients would have paid, 12,000 dollars, in the United States and Israel and the 5,000 dollars in India or South Africa. If only artificial insemination is conducted, whereby the sperm cell is injected into the uterus by using a syringe, the cost will reduce to as low as 2,500 Br. Increasing number of women in Ethiopia became affected by infertility.

Explains Wouhabe Marai (MD), Obstetrician and Gynaecologist at the Ghandi Memorial Hospital: "Infertility is the inability to conceive despite unprotected and adequate sexual intercourse for at least one year."

The main factors to infertility of the woman are tubal blockage, ovulation disorders and cervical problems. In men, it is the inability to produce enough volume of sperm required for fertilization, which is two millilitres, and producing inactive, short tailed or two headed sperm cells.

According to Dr Woubale 40 to 45pc of the factors to infertility are observed on females, and 30 to 45pc on males. It is only 10 to 13pc where both may have the problem.

"Ten per cent of the factors are unexplained," he said.

Infertility treatment in Ethiopia is poorly developed, he said, but among the ways to treat the problem are surgery of tubal blockage and drug treatment for ovulation disorders in women, and injection of testosterone and vitamin E for men.

Under the new treatment to be launched by Bethel, the causes of infertility will be investigated by blood and hormonal tests and radiology of the uterus, and analysis of semen for its sperm content. Then the egg cell is given a gonadothropine hormone to mature up to 20mm in diameter to be ready for fertilization.

The matured egg fuses with the sperm outside the womb and stays in the incubator at 37 degrees Celsius and five per cent carbon dioxide concentration atmosphere which simulates the womb environment. After 48 hours, the fertilized egg will be transferred to the uterus, which, according to Dr. Yigeremu, is the biggest challenge in the general medical process. Once the fertilized egg is planted into the wall of the uterus, the IVF process is said to be successful.

A vial of human menopausal gonadothropine hormone costs 10 dollars and contains 75 International Unit (IU) of Follicular Stimulating Hormone and 75 IU of luteinizing hormone. An individual will require 25 to 30 vials of this hormone to complete a cycle of treatment. The hormones, to be imported from a Swiss company called IBCA, are to be procured by the patients themselves.

Says Yigeremu: "The chance for successful fertilization in the in vitro fertilization process is only 20pc.

"This is not the failure of the medical technology but rather a fact because, out of 100 couples who have had sexual intercourse for a month, it is only one in 25 that conception occurs."

About 40 people have registered for IVF treatment since May 2005, Yigeremu disclosed. The hospital anticipates treating 120 people a month when it begins the service.

Bethel Hospital was established in February 2001.

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