An IVF Task Force set up by the Ministry of Health in Kenya came and visited our clinic on Tuesday . They wanted to learn what they should do in order to regulate the provision of IVF services in Kenya.
They had numerous concerns , including whether it would be cost effective to provide IVF; and how to prevent exploitation of ignorant infertile couples.
Now I am not a big believer in regulation, but I did make the following suggestions.
1. Invest money in patient education, so patients have realistic expectations of what IVF can offer - and equally, what it cannot, so they will not be taken for a ride.
2. Set up an IVF clinic in the government hospital. It's possible to provide inexpensive cost-effective IVF services in a government hospital by not trying to ape the West. Kenyan women marry at a much younger age; and many of them have tubal factor infertility. The clinic should be run by a young gynecologist, who only does IVF and nothing else, so he quickly acquires the expertise and experience needed. He can start by selecting young women; and superovulating them with clomid or low-dose HMG, so the cost of the drugs is minimal. The capital equipment cost for starting a basic IVF clinic is about US $ 20000. Most hospitals already have an ultrasound scanner and the manpower - they just need to buy the CO2 incubators and the microscopes and a laminar flow hood. Once they start getting pregnancies ( after ironing out the teething problems), they can get more ambitious and start freezing embryos and offering ICSI. With this model, it would be possible to offer basic IVF services for less than US $ 300 per cycle on a cost recovery basis - since the manpower costs are zero ( doctors are already employed by the hospital) and the disposables and culture media would come to less than this amount.
3. This approach would create a win-win situation. It would allow the government to help infertile women - a basic service any Dept of Family Planning and Welfare should provide !
Once the government starts providing IVF services, this will automatically help to put a cap on how much private clinics can charge. Also, it will allow medical colleges to train the next generation of gynecologists, so they can provide IVF services for the future.
I am sure the Indian government could adopt a similar approach too !