title: Assisted reproduction services provision in a developing country: time to act?
abstract: OBJECTIVE
  To conduct a survey in a developing country to gauge the extent of subfertility and the current state of assisted reproductive technology (ART) service provision and explore factors limiting access to ART services.
  
  
  METHODS
  Cross-sectional online survey.
  
  
  METHODS
  The study was co-ordinated at the Aga Khan University Hospital, Nairobi, Kenya.
  
  
  METHODS
  One hundred eighty-eight obstetricians and gynecologists registered with the Kenya Obstetrics and Gynecology Society were invited to complete the survey.
  
  
  METHODS
  None.
  
  
  METHODS
  None.
  
  
  RESULTS
  A total of 47 responses (25%) were received after completion of the survey. The overall rate of subfertility was 26.1% among the gynecology consultations, with 50% attributed to tubal factors and 15% due to male factors. Assisted reproductive service provision (IVF/intracytoplasmic sperm injection) was severely limited to only three units, despite the reported high rate of tubal disease. The high cost of treatment, patients' limited finances, and limited local services were almost universally cited as the main barriers to ART services in Kenya.
  
  
  CONCLUSIONS
  The demand for ART in developing countries is not in doubt. Simplified, less costly, and more accessible ART approaches need to be considered in developing countries, even though the benefits and outcomes of such approaches may not be apparent immediately.
authors.affiliation: Aga Khan University Hospital, Nairobi, Kenya. alfred.murage@aku.edu
authors.forename: Alfred
authors.initials: A
authors.lastname: Murage
authors.forename: Murwa C
authors.initials: MC
authors.lastname: Muteshi
authors.forename: Francis
authors.initials: F
authors.lastname: Githae
mesh_terms: D003430:Cross-Sectional Studies; D003906:Developing Countries; D006801:Humans; D007246:Infertility / Q000208:ethnology* / Q000628:therapy*; D007630:Kenya / Q000208:ethnology; D010820:Physicians; D027724:Reproductive Techniques, Assisted / Q000639:trends*; D011795:Surveys and Questionnaires