A collaboration between Steve Biko Academic Hospital’s Reproductive Biology Laboratory, Belgium’s Hasselt University and a Belgian NPO aims to extend infertility care to underprivileged communities. 

 While the South African Constitution states that everybody has the right to bodily and psychological integrity, which includes the right to make decisions concerning reproduction, people who struggle with infertility do not necessarily enjoy their right to make decisions around reproduction, as a result of lack of access to infertility care.

 This was the view of Gerhard Boshoff, Acting Deputy Director of Medical Science at Steve Biko Academic Hospital's Reproductive Biology Laboratory, during the Access to Infertility Care symposium hosted by the University of Pretoria (UP) in collaboration with Hasselt University and the Walking Egg non-profit organisation, both based in Belgium.

 “Infertility care is the combination of the various processes and procedures of medically assisted reproduction, where couples or people who are having difficulty falling pregnant are assisted in this regard,” Boshoff said. “Unfortunately, the need for assistance far overshadows the access to these services. Less than 10% of the required assisted reproductive technology (ART) cycles are being offered in South Africa, according to the most recent national registry report.” 

According to the report, only 16 South African ART centres contribute to the registry, of which only four perform 500 cycles or more a year. However, based on the global need for 1 500 ART cycles a year per 1 000 000 population, South Africa should have 180 ART centres, each performing 500 ART cycles a year.

 Three of the 16 participants in the national ART registry publication are public-sector academic hospitals: Groote Schuur (Cape Town), Steve Biko Academic (Pretoria) and Tygerberg (Cape Town). The only other public-sector ART unit in South Africa, at Universitas Hospital (Bloemfontein), did not take part in the national registry report.

“Patients from any of the other provinces in South Africa are expected to travel over at least one provincial border to access ART services in the public sector, or visit a private facility at a premium, which is found only in a few of the larger cities,” Boshoff said. “Due to the necessity of multiple visits to an ART centre during a single ART cycle, the additional cost for travel and accommodation can be a significant extra expense for these patients. Apart from the lack of sufficient ART centres, affordability of reproductive health screening and subsequent ART procedures should also be considered.”

Professor Vanessa Steenkamp, Deputy Dean of Teaching and Learning at UP’s Faculty of Health Sciences, said that in recent years, the prevalence of infertility has been rising steadily, in South Africa and across the world, affecting people from all walks of life emotionally, psychologically and socially.

“Infertility can strain relationships, diminish self-esteem and evoke feelings of isolation,” Prof Steenkamp said. “To put this issue into perspective, let me share some statistics with you: in South Africa, about one in six couples experience infertility. Globally, this number stands at one in eight couples. These numbers are not just statistics – they represent real people, each with their own hopes, dreams and aspirations for starting or expanding their families.

“The importance of addressing infertility care cannot be overstated. It goes beyond the realm of medical treatment; it touches the very essence of human life and the pursuit of happiness. Access to infertility care holds the promise of transforming lives, not only by enabling the dream of parenthood, but also by alleviating the emotional burden that infertility carries.” 

Guests were invited to view a mobile IVF laboratory, designed as a part of Boshoff’s ongoing PhD research project, and supervised by Prof Carin Huyser of UP and Prof Willem Ombelet of Hasselt University and the Walking Egg. The mobile laboratory will use the Walking Egg’s simplified IVF culture system, which has been developed and tested in Belgium. The goal of this mobile laboratory is to provide ART services that are often inaccessible to infertile couples in low- and middle-income communities.

Prof Ombelet, who began his career researching infertility and IVF in Pretoria in 1984, said he was proud to be part of such monumental discussions about improving and enhancing healthcare via a seamless, cost-effective model.

“We are trying to prove to the world that IVF is affordable, even in a mobile unit; that it will work, and the results will be identical to high-cost, high-end IVF centres,” Prof Ombelet said. “The importance of our collaboration is that we can prove that it is cheap. Then we can look for grants and funding to explore the whole of South Africa, even go beyond South Africa, and show the world that it works. We can be an example for the rest of the world.” 

Find a fertility unit in a specific area or province

Read the World Health Organisation's fact sheet on infertility 

Read more about the Walking Egg