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The European Society for Human Reproduction and Embryology (ESHRE) has set up a task force to make fertility treatment more accessible to developing countries.

The task force was discussed last week at the 24th Annual Meeting of ESHRE in Barcelona, Spain (6–9 July).

It aims to conduct pilot projects of Assisted Reproductive Technologies (ARTs), raise professional awareness in health workers from developing countries and increase the involvement of government and nongovernmental agencies in developing countries in providing low-cost fertility treatment.

The task force proposes setting up three levels of treatment, from preliminary tests and basic fertility treatment, to in vitro fertilisation (IVF) where eggs are fertilised in the laboratory and implanted back into the womb at a few days old, and finally more complex treatments where sperm are injected directly into eggs.

IVF will form the cornerstone of the treatment. While the procedure has moved forward in leaps and bounds in the developed world, it has not been used extensively in the developing world.

A pilot study of a system of low-cost IVF is already underway in Khartoum, Sudan, and Cape Town, South Africa. Another is to commence shortly in Arusha, Tanzania as part of the same study.

The pilot scheme — developed by the Low Cost IVF Foundation — aims to provide one cycle of IVF for less than US$200 and a complete start-up package of equipment for IVF treatment for around US$25,000 to developing country health centres.

Around 186 million women of reproductive age in developing countries (excluding China) are infertile, often leading to social isolation.

According to a report published in Human Reproduction last month (3 June), the introduction of IVF into developing countries is a "daunting task", as even basic data on infertility are scarce.

The author of the report, Dik Habbema, of the department of public health at the Netherlands-based Erasmus Medical Center, says that there are many questions about infertility treatment in low-income countries, particularly in Sub-Saharan Africa.

According to the article, cheap and effective ART has yet to be developed and tested. To be affordable, an IVF cycle should cost US$50–75 — much cheaper than in the developed world, where it can cost as much as US$10,000.

Around 186 million women of reproductive age in developing countries (excluding China) are infertile, often leading to social isolation.

Ian Cooke, emeritus professor of obstetrics and gynaecology at the University of Sheffield, United Kingdom, told SciDev.Net that a major issue in fertility treatment is accessibility, and even in developed countries, access to IVF is not universal.

He adds that developing world countries must address the lack of efficient screening and good health referral systems to make IVF treatments cheaper and more accessible.


Human Reproduction, doi 10.1093/humrep/den203 (2008)