By Firmain Eric Mbadinga
Sarah Bouloungui, 38, clutches her purse tightly, her lips quivering and eyes filled with a mix of hope and apprehension as she awaits her turn in the crowded waiting room of the Centre Hospitalier Universitaire (CHU) Mère-Enfant Jeanne Ebori in Gabon's Libreville.
She is among the scores of women who troop to the centre daily, hoping medical science will help them fulfil their desire to become mothers.
It has been 46 years since the world reacted with disbelief to the birth of the first test-tube baby, Louise Brown, at Oldham in northwest England.
This seminal, magical moment in medical history is now as much an accessible reality for Africa as for the rest of the world, providing hope to millions of women who can't naturally conceive for various reasons.
Cost barrier
In-vitro fertilisation (IVF), the term that has replaced the initial coinage "test-tube baby", has been proven to have a decent success rate even in the most challenging cases, including age and medical conditions.
What remains a challenge is the cost of such treatment. IVF is a limited possibility in terms of ease of access and is often unaffordable for the majority in several African countries.
But Gabon, a Central African nation of just over two million people, has embraced this revolution with a structured plan, starting with training medical staff, building infrastructure and acquiring the required equipment.
Gabonese couples struggling to have children because of medical reasons and wanting to exercise the option of IVF need no longer leave their country.
"Before coming to CHU, I tried everything else possible. I visited several gynaecologists and was diagnosed with endometriosis (thickening of the uterus lining). I received treatment for it and was told I could get pregnant, but I didn't," Sarah tells TRT Afrika.
Test of fortitude
Sarah's journey to motherhood was fraught with medical and societal challenges.
"Imagine a marriage without children; it's hard. Your neighbours, friends, and acquaintances know you are married. Your parents-in-law accuse you of having had several abortions before you married their son. It's hard to live with," says Sarah, her voice choking with emotion.
Before opting for IVF, Sarah had to convince her husband, who was mainly concerned about its reliability.
Once Sarah's husband made up his mind, the couple entrusted themselves entirely to the medical teams at the CHU. After a lengthy and expensive process, their hope bore fruit. Sarah became a mother a few months ago.
"This is the greatest gift of my life. When I see this baby, I say: 'Thank you, God, for remembering me'," she says, tears of joy streaming down her face.
Successful pregnancies
CHU Mère-Enfant Jeanne Ebori is Gabon's first hospital to offer IVF. Since 2022, when the unit was set up, its MAP (medically-assisted procreation) service has so far achieved a success rate of 37%.
To date, at least 130 couples have received treatment there, with 70% of the IVF procedures resulting in 30 successful pregnancies leading to healthy childbirth.
"We estimate that 20-30% of couples in Gabon are infertile. Once a woman reaches the age of 40, the percentage of conception per cycle becomes very low. There's also the problem of infections and other diseases," explains Dr Jean-François Meyé, director of CHU Mère-Enfant Jeanne Ebori.
Despite the societal stigma and challenges, many women like Urlette Etima, 33, and Emarence Koumba, an evangelist, have chosen to take a leap of faith with IVF. "There's always hope. I believe that in life, you have to take a chance and overcome the barriers," says Urlette, a former bank executive who has turned entrepreneur.
Married for two years, Emerance and her husband Gauthier trust Dr Orphelia Makoyo and her team to give them the best chance to become biological parents.
Procedure
During a typical IVF procedure, the first step is to extract the oocytes of a patient who is unable to become pregnant naturally. The removed oocytes are then fertilised with sperm in vitro, or outside the woman's body, in a laboratory.
"If fertilisation is successful, the egg or eggs obtained can be implanted in the patient's uterus," explains Dr Makoyo.
Although IVF has helped many in Gabon and other African countries to become parents against all odds, there are still mental hurdles to cross.
"To some Africans, IVF is a form of cultural archaism that they can't understand. A change in perception or mentality will come, but it will take generations," Chadian sociologist Félix Mbété tells TRT Afrika.
Increase in number of IVF seekers
In Gabonese society, deeply rooted in tradition, women are frequently held responsible for infertility when couples struggle to conceive.
To prevent this, Dr Aurélie Engangoye, an infection specialist at the International Medical Research Centre in Franceville, urges women to care for themselves before considering having a child.
''In some cases, infection leads to reproductive complications and other illnesses. For men, a reduction in the quality and quantity of sperm is also a factor," she tells TRT Afrika.
For more than two years, Dr Meyé has been noting a consistent increase in the number of couples resorting to both male infertility treatment and IVF, although it is expensive.
The procedure currently costs between 2 and 3.5 million CFA franc (US $3,318-5,792) in Gabon, a country where the minimum wage is 150,000 CFA franc (US $248).
Yet, for women like Sarah, the journey, despite its challenges, is worth every step. For them, it's not just about becoming mothers. It's about breaking barriers and changing perceptions, one baby at a time.
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