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BREAKING NEW GROUND . . . (From left) Dr Mhlanga, Sister Marechera, Dr Farayi and Mr Makurumure

Features Correspondent
Zimbabwean couples struggling to conceive have been offered a lifeline after the resumption of In-Vitro Fertilisation (IVF) locally.

Previously, they have had to travel to South Africa and other foreign countries in search of such corrective solutions. The programme was relaunched in June last year by renowned gynaecologist Dr Tinovimba Mhlanga and his team of experts. Positive results have started to show.

The first baby to be born through in- vitro fertilisation since the procedure was reintroduced in Zimbabwe last year at a top Harare’ hospital is now at home with his parents.

The baby boy was born at a clinic in Harare at 29 weeks on April 2, 2017 weighing just over a kilogramme. Although born prematurely and subsequently placed in an incubator, he did not require any assistance with breathing.

His parents, who had been trying to have a baby since they got married about five years ago, now have him at home with them after gaining sufficient weight to be discharged from hospital.

How exactly does IVF work?

In-vitro fertilisation, where a woman’s eggs and her husband’s sperm are brought together outside the womb in a dish in a laboratory, was successfully pioneered at The Avenues Clinic in the 1980s and 1990s by Dr Tony Robertson.

However, it was discontinued early this millennium and was reintroduced last year by a team led by Dr Mhlanga with assistance from Dr Robertson, who is now retired.

The baby’s mother, who wishes to remain anonymous, is overjoyed to have given birth to a healthy baby. “My husband and I had been trying to have a baby since we got married in 2012 without success. I had tried everything, including herbal medicines, to get pregnant. However, I had ovarian cysts and blocked fallopian tubes. It seemed in- vitro fertilisation was the only answer,” she said.

Thanks to the internet, she got knowledge of a possible solution. “I googled IVF on the internet to see where it might be available. I was thinking of going to Dubai. Then I heard a rumour last year that IVF might become available in Zimbabwe. I later read a newspaper article that said it was being reintroduced in Harare. “I phoned the Clinic to enquire about this and was given Dr Mhlanga’s phone number. After saving bit by bit for the procedure I was put on the IVF programme,” the elated mother said.

The journey, although worthwhile, was not easy. “I had to inject myself to stimulate the ovaries, which was tough, but it worked out well. A scan showed there were six follicles. I went to the Clinic for the egg retrieval. “After a few days I was told all my eggs had fertilised in the IVF laboratory. The doctors transferred three embryos into my womb. The other three were frozen,” she said.

After going through a few days of suspense, the couple received what was the first step towards their breakthrough. “After 10 days I had a blood test and it came out positive and I was so excited. I was also receiving pressure from my family to conceive so you can imagine how I felt when my pregnancy test came back positive.

“I was hoping for three babies from the three embryos. The doctors were hoping for just one. After six weeks I was told there was only one foetal heartbeat. I was sad about that,” said the woman.

With close monitoring, the pregnancy period had minimal complications. “At 29 weeks I gave birth to my baby. He was premature but did not have any health problems. He breathed on his own. However, he was below a normal birth weight and was kept in an incubator with oxygen,” she said.

She was full of praise for the IVF team and the hospital, where the procedure was carried out. She has since expressed her intention to come back later in the year to have one of her frozen embryos transferred to her womb, in the hope of having another baby.

The woman also said she would like to donate eggs to the programme for the benefit of women who are unable to produce eggs themselves.

Dr Mhlanga said the IVF procedure was now on par with those in other countries.

The IVF team includes a nursing sister and counsellors. Sr Florence Marechera plays a key role, as the programme’s coordinator and one of its counsellors. “Sr Marechera is the backbone of the programme. She organises everything. The counsellors do an excellent job in counselling patients, which is an important role as undergoing IVF can be traumatic,” Dr Mhlanga said.

In Zimbabwe, Dr Mhlanga said, on average the procedure costs around $3 500. It may go up to about $4 000 after factoring in the laboratory and admission fees.

If going for a second cycle, using her frozen embryo, a patient will pay about $500. The lifecycle of the frozen embryo in Zimbabwe is up to 10 years but in countries such as Australia it can go for up to 20 years because of advanced equipment. “Getting the frozen eggs ready takes about four hours, but the actual insemination process takes less than 10 minutes. “A patient can then be admitted for an hour or two afterwards, to undergo counselling,” Dr Mhlanga explained.

He added that the pregnancy rate from the programme was now about the same as in countries where IVF was well established. “More births under this programme are expected in the coming months. Internationally, there is a 40 percent chance of women aged between 20 and 35 becoming pregnant through IVF,” he said.

Patience was cited as a key element in the process as the results differ with each person. “It is important for women who go through the procedure to be patient. If they do not become pregnant when the procedure is first carried out, they should try again. It might take several attempts,” he said.

A major challenge his team had experienced was that many of the women who had been accepted on the IVF programme were over 40, making it even more challenging.

The success rate internationally with women over 40 was only about 5 percent. There are stringent requirements for the procedure to deemed a success. “The environment must be clean, even the slightest pollution can affect the success of the procedure.

“The Clinic has paid attention to ensuring the needs of the laboratory are met. It has given the IVF programme priority in terms of theatre use and provided the materials we need, including a special bed. “The Clinic also monitors how the project is run in terms of patient safety. Admission is smooth and patients are well looked after,” Dr Mhlanga said.

Medical laboratory scientist Mr Tinei Makurumure is the embryologist. He plays a vital role in ensuring conditions are right in the laboratory for the fertilisation process and in monitoring the development of the embryo in the laboratory.

The team has been receiving help from partners in Australia who run a similar programme in Melbourne. Mr Makurumure said improvements had been made in the laboratory on the recommendation of an embryologist from Melbourne, during a visit.

One of the improvements was the acquisition of a newer version Intra Cytoplasmic Sperm Injection (ICSI) microscope, which is used when injecting sperm into an egg in the laboratory, in cases where the sperm quality was such that fertilisation could not occur without a direct injection of sperm into the egg.

The top Harare Clinic has since renovated the laboratory to meet global standards.