For years, infertility in Rwanda was surrounded by stigma and silence—often wrongly blamed only on women. But with more awareness and access to medical treatment like In Vitro Fertilization (IVF), many couples are now finding hope and starting families.
Dr. Emmanuel Semwaga, an obstetrician, gynecologist, and IVF specialist at Mediheal Diagnostic and Fertility Centre in Kimihurura, shared insights into what causes infertility, how it can be treated, and the progress Rwanda has made in offering these services.
Understanding Infertility and IVF
Infertility has always existed, but people used to have little knowledge or access to treatment. In Africa, infertility was not widely seen as a medical issue until the early 2000s when specialized clinics began to appear.
The first IVF baby was born in 1978 in the UK, with techniques improving over the years. Rwanda’s access to IVF only became more available after 2014, when Mediheal opened the country’s first IVF center.
It’s a Couple’s Issue
Infertility is not just a woman’s problem, Dr. Semwaga explained. It often involves both partners. A healthy pregnancy requires both a viable egg and sperm, and male-related infertility is common.
Types of Infertility
Primary infertility: When a couple has never conceived despite trying for over a year.
Secondary infertility: When a couple had a child before but now struggles to conceive. This is more common in Rwanda and can result from infections, childbirth complications, or lifestyle changes.
Common Causes of Infertility
Infertility causes are grouped into:
Male factors: Low sperm count, poor movement, or shape issues.
Female factors: Hormone problems, blocked tubes, fibroids, PCOS, or conditions like endometriosis.
Mixed causes: Both partners have issues.
Unexplained infertility: All tests seem normal, but conception doesn’t occur.
Dr. Semwaga emphasized that untreated STIs like chlamydia and gonorrhoea often damage the fallopian tubes, making natural conception difficult. IVF is useful in such cases.
Lifestyle Matters
Obesity, smoking, alcohol, and drug use harm fertility. A healthy lifestyle supports reproductive health.
IVF vs IUI
IVF: Involves fertilizing eggs in a lab, then transferring embryos into the uterus. Mediheal’s success rate is around 80%.
IUI: Involves inserting sperm directly into the uterus, with a lower success rate of 1–5%.
Costs and Access
IVF in Rwanda costs around $4,500 to $6,000 per cycle, which is cheaper than in the U.S., where it can cost up to $35,000.
Efforts are underway to make IVF more affordable. Dr. Semwaga said discussions are ongoing with the Ministry of Health and insurance providers to potentially include IVF in public and private health coverage, like Mutuelle de Santé.
Challenges in Rwanda
Rwanda still has few IVF specialists, and only two IVF centers: Mediheal and a unit at King Faisal Hospital. Many couples previously had to travel abroad, which was costly and stressful.
Changing Perceptions
Thanks to awareness campaigns, more men are coming forward for fertility testing, helping shift the blame from women and reducing stigma.
Dr. Semwaga dismissed the myth that IVF babies are unhealthy, saying they are just as normal as naturally conceived babies.
Final Message to Couples
“Don’t give up,” Dr. Semwaga said. “There are solutions. Many couples who thought they would never have children are now happy parents.”
