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Objective: To evaluate PPI as a strategy to make ART affordable. Design: Prospective descriptive study. Setting: Tygerberg Academic Hospital, Reproductive Medicine Unit. Population: All women ages 20-45 years attending the fertility clinic for ART (IVF/ICSI) treatment for female and male infertility problems Methods: Treatment involved CC 100mg from cycle day 3 to 7 or day 3 to 10 in combination with alternate day administration of hMG 150-225IU from cycle day 4, 6 and 8. hCG was administered when the leading follicle of ≥18mm was present and the retrieval followed 34-36hrs later. Cycle monitoring included only the ultrasound and urinary LH testing. Main outcome measures: LBR, CPR and also the direct costs of treatment to individual couple per cycle of ART. Results: Three hundred and seventy five (375) cycles of ART were performed. The LBR per ET and per cycle started were 17.7% and 10.6% respectively, while the CPR per ET and per started cycle were 24% and 14% respectively. A cycle cancellation rate of 8% was observed. A multiple pregnancy rate of 5.6% was recorded and there were no cases of OHSS. Direct costs of treatment per cycle were R7291 (563USD) (cycle costs R6000 – R8000). A cumulative pregnancy rate of 32% following three cycles of ART was also observed. Conclusion: The study shows that PPI can be a possible and viable strategy to make ART accessible with reasonable pregnancy rates at low cost. Tweetable abstract: PPI can be a possible and viable strategy to make ART accessible with reasonable pregnancy rates at low cost.

arc journal of gynecology and obstetrics

Public-Private Interaction Model; A Simple Strategy towards Making Assisted Reproduction Accessible in a Poor Resource Setting: A Prospective Descriptive Study