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Assisted reproductive technologies in Africa: first results from the African Network and Registry for Assisted Reproductive Technology, 2013

Published:November 22, 2018DOI:https://doi.org/10.1016/j.rbmo.2018.11.001

      Abstract

      Research question

      What were utilization, outcomes and practices in assisted reproductive technology (ART) in Africa in 2013?

      Design

      To initiate a data registry in Africa, retrospective summary data were collected in a cross-sectional survey.

      Results

      Forty ART centres from 13 countries collectively reported 25,770 initiated cycles. Regional ART utilization could not be established due to large inter-country variations and insufficient data. The pregnancy rate per aspiration for fresh non-donor IVF and intracytoplasmic sperm injection was 28.0% and 35.8%, with a preponderance of women under 35 years (57.3%). Deliveries were reported for only 56.1% of pregnancies; the remainder were lost to follow-up. A mean of 2.41 embryos were transferred. The multiple delivery rate was 26.7% (25.5% twins and 1.2% triplets). Most twins (52.7%) and triplets (73.7%) were born pre-term. Oocyte donation represented 7% of all fresh and frozen transfers.

      Conclusion

      This marks the beginning of an ART registry in Africa, Since ART utilization could not be established, the degree of access to ART remains speculative. Pregnancy rates were favourable but underpinned by a preponderance of young women and the transfer of multiple embryos. Efforts are needed to explore treatment barriers, improve pregnancy follow-up and reduce the high rate of multiples. This inaugural report from the African Network and Registry for Assisted Reproductive Technology (ANARA) indicates a willingness and ability of ART centres to voluntarily report and monitor utilization and outcomes of ART, which reflects a rising standard of ART in Africa. It is anticipated that more centres and countries will join ANARA to continue this trend.

      Keywords

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      Biography

      Silke Dyer is the Director of the African Network and Registry for Assisted Reproductive Technology and a member of the International Committee Monitoring Assisted Reproductive Technologies (ICMART). She is in clinical-academic practice at Groote Schuur Hospital, University of Cape Town. Her work focuses on improving infertility care in low-resource settings.

      Linked Article

      • Towards the global coverage of a unified registry of IVF outcomes
        Reproductive BioMedicine OnlineVol. 38Issue 2
        • Preview
          IVF is generally considered one of the best-registered procedures in medicine. Today, 40 years after its heavily criticized clinical introduction, IVF is available as a successful treatment for infertility almost all over the world. Over 8 million IVF children have been born, and over 2.5 million cycles are being performed every year, resulting in over 500,000 deliveries annually. There is much to be proud of in such distinct achievements, yet many challenges remain.
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