Outcomes of assisted reproductive technologies at the Nairobi In Vitro Fertilisation Centre.

BACKGROUND Infertility is a common problem affecting up to ten per cent of married couples. A systematic evaluation of aetiologic factors forms the basis for choice of treatment and future fertility. On the global perspective, Assisted Reproductive Technologies (ART) has become internationally recognised treatment option for some infertile couples. A report on the current outcomes of ART practice at The Nairobi IVF Centre is presented. OBJECTIVE To describe the practice of assisted reproduction and present a report on the current outcomes. DESIGN A retrospective survey of data on assisted reproduction practice from August 2005 to July 2008. SETTING The Nairobi IVF Centre a private medical practice in Nairobi, Kenya. INTERVENTIONS Treatment of infertile couples by various assisted reproductive technologies including in vitro fertilisation (IVF), intra-cytoplasmic sperm injection (ICSI), uterine fresh embryo transfer (ET), and frozen/thawed uterine ET (FTET). MAIN OUTCOME MEASURES Fertilisation, embryo cleavage, ET, embryo freeze/thaw survival, preclinical pregnancy and clinical pregnancy rates, live births and other obstetric outcomes. RESULTS A total of 362 IVF cycles were performed. Following controlled ovarian hyperstimulation, an average of 12 oocytes were retrieved per patient while the fertilisation and subsequent embryo cleavage rates were 67 and 91.2% respectively. An average of three embryos were transferred and the embryo transfer rate was 93.3% per cycle started and 96.6% per oocyte retrieval. Surplus embryos were available for cryopreservation in 106 (50.1%) cycles. On thawing frozen embryos, the survival rate was 65.5%. Following ET, the overall pre-clinical pregnancies were 124 (36.2%) of which 99 (28.9%) developed into clinical pregnancies per cycle. Of the clinical pregnancies, 72 (73%) were singletons, 23 (23%) twin gestations and four triplets (4%). A total of 52 mothers have been delivered either by Caesarian section 45 (86.5%) or spontaneous vertex delivery seven (13.5%) to 61 live babies of whom 36 were females and 25 males. A further 28 IVF clinical pregnancies are ongoing, 26 following fresh embryo transfer and two from frozen/thawed embryos. CONCLUSION Our results on ART practice reflects a pregnancy outcome comparable to that reported by other fertility centres globally. Couples with infertility in East and Central Africa for whom ART treatment is indicated may now access the service locally.