South Africa and region note increase in IVF cases

DESPITE the SADC region having a history of a healthy fertility rate, the health sector has noted an increase in the number of people opting for assisted technology procedures, among them in vitro fertility (IVF).

The South African Registry for Assisted Reproductive Techniques found no less than 5 000 IVF procedure attempts were performed in South Africa over the past few years.

“And that is the number that is collated,” obstetrician Dr Norma Sufumba said. She explained that while every facility was required to submit to a national registry procedures done according to requirement, some did so much later than others, others had less than perfect record keeping. “And, we have doctors - and institutions, which are not properly registered with the health authorities, so the numbers could much higher.”

IVF, she said, was used by a wide variety of people for many reasons, among these a genuine need, in cases where one or both people are unable to get pregnant and had tried other methods and failed. “But we have also seen a lot of people taking advantage of the availability of modern medicine,” she added.

She said studies have shown that less than 10% of South Africans - both men and women, needed assistance to reproduce: “But, the world view has changed, modern methods are more available, and people have access to it. And, there is also stigma attached to women who may take longer.”

Some women, men, and couples, opted to wait until much later in life to have babies and this meant the chances of conceiving and carrying babies healthily and to term became slimmer. “It is not impossible to have a baby - to carry it to full term as an older woman,” she said, it was more about the stigma associated with it. And, with the focus on health in the country not where it should be, the risks were high.

Obstetrician and gynaecologist at Mediclinic Southern Africa, Dr Kasturi Moodley, said: “Currently, infertility challenges affect at least one in every six couples in South Africa - an issue that statistics attribute equally to both men and women.”

Infertility, she said, could be connected to a number of variables, including social, medical and lifestyle factors. “By definition, a couple that has been trying to have a baby for 12 consecutive months with no success naturally, is deemed to be infertile.”

Saying it was not the silver bullet in reproduction, the doctor said when infertility was detected, baseline investigations, including ovarian reserve/hormonal profile, a fallopian tube test, and a semen analysis had to be conducted.

IVF, Moodley said, was suitable for any couple where the woman was 35 years-old and above and/or who has not had success with other procedures.

“IVF is also suitable for same sex couples in whom one partner would like to provide the egg and the other partner would like to use her uterus to grow an embryo - doing it in this way ensures that both partners play an integral part in the fertility process.”

A study conducted through the University of KwaZulu-Natal among the Zulu nation in 2020 and which provided a critical analysis of the African ways of managing infertility, found that infertile people were stigmatised in African communities because they were not regarded as complete social beings. It found that some suffered abuse in their communities, that infertility was the result of witchcraft and anger of the ancestors.

“From a Western perspective, infertility does not mean all infertile individuals cannot have children. Rather, in some cases they require some medical assistance and treatment. In searching for solutions or cure(s) to infertility, people resort to different kinds of treatment methods,” the report said.

IVF was just one among artificial reproductive technology methods for the treatment of infertility.

Said Moodley: “It is very important to note that an invasive fertility treatment is not always the only option recommended. Treating fertility issues is a highly personalised process that depends on several factors that will be unique to each couple.”

Healthy lifestyles, including what one ate in the long and short term, smoking, drugs and physical activity; and managing mental health said Dr Sifumba, were key in fertility. She said while age reduced the chances of conceiving it did not wipe it out; the prolonged use of certain drugs and medications affected fertility.

“IVF has been lauded as the be-all and end-all in the Western world, but in ours, where women throughout history have had up to 15 children and well into middle age and men into their old age, should not be the option.” She said it was key to understand this from early on in life if the rate at which IVF and other methods was to be managed and kept as a solution for only those who had no choice.