Opening of an Assisted Medical Procreation Service in a Public Hospital in Africa: Experience of the Mother Child University Hospital Center in Libreville

Abstract

Context: The first assisted reproduction center (PMA) to emerge in Gabon was a private health facility in 2001. Then in 2016 a second private clinic followed suit. Despite this, in vitro fertilization (IVF) remained inaccessible to the greatest number because of the expensive cost of this care offer. Evidenced by the fertility rate in Gabon, which remains one of the lowest in the world, 4% in 2017. In order to provide a solution to this problem, the current government authorities have thought of setting up a fertility service in vitro in a public hospital. Methodology: faced with the many difficulties observed, we proceeded as follows: Opinion of an expert in the equipment of an IVF center in November 2019; Architectural changes to the service; Staff training ; Order of missing equipment in October 2020; Establishment of collaboration and partnership; then organization of an IVF TEST session in November 2021 “free for patients”. Result: The service laboratory is now fully functional. Staff have acquired skills and continue to improve. Over one year we carried out 44 cycles, we obtained 16 clinical pregnancies. That is a percentage of 36%. We noted 1 miscarriage, 3 deliveries, and 12 ongoing pregnancies including a twin.