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| Kenya in world super league as test tube baby technology registers major success |
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Just under two years since the first test-tube babies were born, a Kenyan doctor has for the first time hit the 30 per cent success rate being recorded in developed countries. “It is like a dream come true since we have managed to move from a success rate of 21 percent to the current one,” says a thrilled Dr Joshua Noreh, who made history in May 2006 by delivering the first test tube babies locally. A source at the Ministry of Health, which has put in place task force to come up with guidelines to regulate IVF in the country, says they are keenly following what is happening and the new development is good for the country. Speaking on anonymity because he is not allowed to make official statements on behalf of the ministry, he added that they are exploring ways of coming up with guidelines to make the service accessible to a majority of the poor deserving Kenyans. When Dr Noreh first did the IVF, only one out of the 8 women succeeded to conceive. Unfortunately, even this woman suffered a miscarriage. But after the delivery of the first test-tube babies last year, the percentage has been rising steadily, hitting the 30 percent mark in this year’s July and September cycles. The good news comes at time when two new IVF centres - Eldoret and Nairobi Hospital-have too started offering such services. Eldoret clinic delivered their first IVF baby about three weeks ago. The usually unassuming Dr Noreh attributes the impressive improvement in the results to the investment his clinic has made in laboratory work as well as collaboration with highly skilled doctors from European countries. They are also seeing an increasing number of young women rushing to take advantage of the service. Three of these women have flown from Britain to for the service here, since cheaper than in Europe. “In the past we have been, by and large, attending to older women, but as the service became widely known, many more young women are consulting us,” says Dr Noreh. Young women are known to have higher chances of conceiving than their older counterparts. In developed countries, some clinics register high success rates because they select such women. “For us, selection of patients does not arise as we want to attend to women of all ages,” Dr Noreh says. The improved success rate comes on the backdrop of other positive developments. The number of babies IVF born has reached 21, with more people rushing to take advantage of the technology. Of these, three couples have been blessed with a set of twins. Currently there are 19 on-going pregnancies, with more babies expected before the end of the year. Unlike in the past few months, couples are now going for donated eggs (incases where a woman has no eggs) or donated sperm (incases where a man has no sperm). So far, 13 couples have received donated eggs, with seven conceiving. Five of them have already delivered, with one delivering twins. On the donated sperm, at least one in every ten couples has had to do with such sperms. Since last year, 24 couples have used donated sperm. According to Dr Noreh, 30 per cent of couples presenting at his clinic have a man who has either poor sperm quality or lack of sperm at all. In this group, the situation of 20 percent of the men can be salvaged by injecting the poor quality sperm directly into the egg or through insemination. The remaining 10 per cent of the men usually require sperm donation. About 87 inseminations have been done, with 18 women succeeding to get pregnant. Success rate for this procedure is between 10 per cent and 15 per cent compared to 25 per cent in natural conception and 30 per cent in IVF. The number of older women seeking to have babies is on the increase as well. In the last two years, nine women aged over 40 years have benefited from the service. Out of this, three have delivered, one of them aged 51 years. The other 6 are expecting to deliver in a couple of months. Use of surrogate mother is also a new phenomenon at the country. In the past one year, three couples have sought to have children through surrogacy. Two of them have already gone through the IVF procedure. In most cases, surrogacy works when the woman does not have a uterus or the uterus is unable to sustain a pregnancy. Women who have had multiple miscarriages, or who have failed repeated IVF attempts for unexplained reasons can explore surrogacy. Surrogacy is of two kinds. The most common one is where the infertile woman provides the egg and the husband gives the sperm, which fertilized under IVF procedure. The resulting embryo is then transferred into the surrogate’s uterus for pregnancy to take place. In other cases, the surrogate mother provides the egg, but is inseminated with husband’s sperm. In such case, the infertile woman has no genetic relationship to the baby. Upon the delivery of the baby, the surrogate mother can at the time of birth register the baby as belonging to the commissioning couple. Or, as is the case in other countries, the commissioning couple adopts the baby from the surrogate mother. For a woman to qualify as a surrogate mother she has to possess certain characteristics: must be having children, is fertile, and has a healthy uterus. A woman who agrees to become a surrogate mother may do so for compassionate or financial reasons. Sisters, mother s or close friend of the couple are known to do on compassion basis. Otherwise, a woman may rent a womb for a fee. With IVF available in the country, everything is possible for a couple who desperately need a child. IVF is a procedure involving taking eggs from the mother and sperm from the man, and then fertilizing them in the laboratory. The resulting embryos are transferred back to the woman’s uterus two to five days later for them to develop normally. The first IVF baby in the world was born in July, 1978 in England. The technique is usually used to treat both women and men who are infertile. But it is normally the treatment of choice for a woman with blocked, damaged, or absent fallopian tubes - the avenue through which the egg travels from the ovary to the uterus for implantation to take place. At Nairobi IVF Centre, a couple has to pay Sh 300,000 to go through the IVF process. Dr Noreh says the money has to be paid in advance since it is used to buy the drugs to be used during the procedure. Arrangements can be made for couples to pay the money in installments prior to the procedure. The treatment starts by the woman being given hormones to stimulate her to produce more eggs, which are then retrieved from the ovaries. Sperms from the husband are too retrieved, cleaned and then used to fertilize the egg in specially designed dish. The fertilized eggs are set in a test tube, and then placed in an incubator at -37 degrees centigrade and five percent carbon dioxide level. Such conditions mimic those in the woman’s fallopian tubes. Here, the eggs are left to grow into embryos for three days, before high quality ones are selected for transfer into the woman uterus. Meanwhile, the woman is given replacement hormonal therapy such as estrogen tablets or progesterone hormone to make the uterus ready to receive the embryos and increase chances of implantation. Hormonal treatment goes on for two months, at time when the fetuses is able to produce hormones to support the pregnancy. Any failure results into the process being repeated, with the couple paying less than the initial fees. In most countries, the technique has a success rate of between 30 to 40 percent. One of the defining factors for a higher pregnancy rates under IVF includes the number of embryos transferred into the woman’s womb and the age of the woman. Women aged between 25 and 35 years are said to have high chances of embryo implantation, and hence high pregnancy rates of about 40 percent. Those in the age bracket 35 to 40 years have a success rate of between 20 and 30 percent. For this reason, only one embryo may be transferred to the first group, when at least two are required for the second group of women. In Kenya and most of the commonwealth countries, three embryos are transferred. Countries like Sweden and Demark have up to 50 and 45 years respectively, as the maximum age a woman can have a baby through assisted reproduction. In the United States, where the success rate is estimated to near the 50 percent mark, at least four embryos are transferred back to the woman’s womb. If all or many get implanted, then doctors revert to a process known as reduction, whereby the unwanted embryos are injected with a chemical that stops them from growing. Most countries in Africa and Europe do not support this process. In Britain, where 80 clinics offer IVF, only three resort to reduction technique. |
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