The Gynecology and Obstetric Department at Rwanda Military Hospital, Kanombe, will, starting next week, begin offering infertile couples with intra-uterine insemination (IUI) and in vitro fertilisation (IVF) services. The services will be covered by Mutuelles de Santé and various health insurance packages, according to the hospital’s management. A group of women were yesterday morning waiting to meet the screening team at the hospital’s maternity ward. When The New Times sought to speak to them, they were all unfortunately not willing to answer our questions. Maj Dr Théogène Rurangwa, an obstetrician gynecologist and head of the fertility initiative, said that IUI and IVF services come at a time when there are many infertile couples who could not afford these services due to exorbitant costs involved. People who seek treatment overseas usually spend at least Rwf7 million for the operation. Though, there is no national data available, figures at Rwanda Military Hospital indicate that 10 per cent of patients who seek obstetric services are those who have trouble conceiving or sustaining a pregnancy. Dr Rurangwa said the rate is very high and the issue needs special attention. He said the hospital has a waiting list of 100 patients who were diagnosed in over a period of three years, and that the number is expected to increase now that the hospital has services that they need. “Normally, if a couple had sex for more than a year without conceiving, they should seek medical treatment to check on where the problem might be. There are chances that it can be diagnosed,” he said. He said that, in cases of ejaculatory dysfunction, discordant couples, cervical and male factor infertility, one should consider trying IUI or IVF. “With IVF, live birth rate is about 30 per cent per treatment cycle, but that figure varies depending on age,” he said. He explained that with IUI, the doctor places sperms into the uterus (womb) at the time of ovulation. This procedure is often combined with stimulating drugs to increase chances of conception. On the other hand, IVF involves combining sperm and eggs in a laboratory to create embyros. The embryos are then assessed for quality and one or more is placed into the uterus. Rurangwa added that the main causes of infertility are damage, or blockage, to the woman’s fallopian tube, ovulation disorders and endometriosis; while in men, it could be the sperm quality, or small count, overexposure to certain environmental factors, such as pesticides and other chemicals, radiation, alcohol and drug abuse, among others. Fertility Initiative is a donation from American medical volunteers who offered the laboratory equipment. The facility include embryo incubators, microscopes, air filters and refrigerators, among others. Dr Selwyn Oskowitz, a reproductive endocrinologist at Boston’s Beth Israel Deaconess Medical Center, Harvard Medical School, heads the team of the American volunteers. He said that fertility services to be offered at Rwanda Military Hospital, Kanombe, is the same as any other from world-class clinics. “Apart from carrying out fertility services, we have included intensive exchange of expertise with local teams that will continue to offer the services even after our departure. We are hoping that the fertility department will be the new centre of excellence at Rwanda Military Hospital. Using successes and discoveries in Rwanda, we aim to develop a model upon which this mission can be extended to other regions that are poorly resourced,” he said. editorial@newtimes.co.rw
