title: ART in South Africa: The price to pay.
abstract: In developing countries especially in Sub-Saharan Africa, human immunodeficiency virus (HIV) infection -together with limited resources adds to the hindrances in becoming a parent. Although the South African's Bill of Rights proclaim that South Africans can "make decisions concerning reproduction"; access to and the use of Assisted Reproduction Technology (ART) are viewed in general as excessively expensive, accessible only to the privileged few. A dissection of cost-drivers within an ART laboratory, such as procedures; sperm preparations; laboratory supplies including embryo culture media and cryopreservation are discussed in the current overview. Subject to the nature of an ART practice, i.e. private vs. public/tertiary, the structure of a unit will vary with regards to patient demographics, costs and services offered. The average fees per procedure for 20 practices in the private sector in South Africa are: (i) IUI: € 542 ± €159, (ii) IVF: € 3,255 ± € 576 and (iii) ICSI: €3,302 ± € 625. Laboratory costs can contribute between 35 and 48% of ART fees payable in the private sector. Low-cost public ART services are available to citizens of the country at a few tertiary academic units. Some private practices also cater specifically for middle-income citizens. ART procedures need not be propelled towards the must-have and cannot-do without approach, but providers should also reflect on the validity of the techniques and equipment, without compromising treatment virtue.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Pretoria, Steve Biko Academic Hospital, Private Bag X323, Arcadia, 0007, South Africa.
authors.forename: C
authors.initials: C
authors.lastname: Huyser
authors.affiliation: Department of Obstetrics and Gynaecology, University of Pretoria, Steve Biko Academic Hospital, Private Bag X323, Arcadia, 0007, South Africa.
authors.forename: L
authors.initials: L
authors.lastname: Boyd
keywords: Affordable ART; HIV,; South Africa; cost-drivers; developing countries; laboratory costs
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