Reviewing infertility care in Sudan; socio-cultural, policy and ethical barriers

Keywords:

Barriers, infertility, private ART, accessible public care.

D.S. Khalifa1, M.A. Ahmed2

1Lecturer of Epidemiology & Reproductive Health, School of Medicine and Health Sciences, Ahfad University for Women, P.O Box 12755, Khartoum, Sudan.

2Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Khartoum, P.O Box 102, Khartoum, Sudan.

Abstract

This is a facility based survey that reviews infertility care in Sudan. Both authors interviewed lead physicians of functioning ART clinics. There are seven functioning privately owned fertility centres in Sudan, all situated in Khartoum state. The first centre was established in 2000. Public hospitals provide consultation and baseline inves- tigations only. All centres have ICSI setups and do not offer standard IVF. The success rate claimed by centres is between 25-30%. HBV screening is routine in all centres while HIV screening is routine in only two centres. However, one centre declines further treatment for HIV positive couples. Centres are not affiliated with any local or regional body for reporting or quality assurance. Currently, there are common significant barriers to infertility care men- tioned by all centres – high cost and inaccessibility. The cost of one cycle of IVF/ICSI treatment with drugs starts at 2,500 USD in all centre. Couples with male factor infertility have a better chance obtaining funding for ARTs compared to couples with female factor infertility. Cost reducing recommendations include: government subsidies for fertility drugs and lab media, centres sharing embryologists and cryogenic banking.