In vitro fertilization at a public hospital in Nigeria

ObjectiveTo assess the results of an in vitro fertilization program newly established within a conventional infertility program at a university hospital in Nigeria.MethodsFrom June 1, 2007, to June 30, 2011, following unsuccessful conventional treatments, 600 couples were offered in vitro fertilization with (if needed) intracytoplasmic sperm injection in batches of 30 couples. The outcomes measured were duration of ovarian stimulation and rate of ovarian hyperstimulation syndrome; numbers of follicles aspirated, oocytes retrieved, oocytes fertilized, and embryos transferred; and clinical pregnancy rate.ResultsThe mean duration of stimulation was 11.8 ± 1.6 days and 1% of the women had severe ovarian hyperstimulation syndrome. The mean number of follicles aspirated was 8 ± 2.8; of oocytes retrieved 6 ± 3.2; and fertilized 3 ± 1.8. The maximum number of embryos transferred per woman was 3. The rates of clinical pregnancy and multiple pregnancy were 30% and 6.0%. The rates of abortion and ectopic pregnancy were 6.6% and 0.6%. The preterm delivery rate was 2.5%.ConclusionSuccessfully conducting an assisted reproduction program at a public health facility is feasible in a low-resource country. Treating couples in batches was cost effective, with a low complication rate.