The ugly side of assisted birth tech (ART) shows up in Kenya

By Gatonye Gathura

The ugly side of test-tube baby technology has been documented in Kenya, as the country’s first children from the procedure celebrate their 11th birthday tomorrow.

The case involves a 34-year old woman who was diagnosed with a grossly malformed 13-week embryo conceived through the test- tube technology in Nairobi.

The technology has been linked to increasing rates of genetic defects in test tube infants across the world compared to their naturally conceived counterparts.

Telling of their experience in the Nairobi case, local doctors say an increase of genetic defects has been noted in babies conceived through Assisted Reproductive Techniques or ART.

“This is the first case I have encountered in Kenya, but there is no way of knowing how many more could be out there,” says Dr J. Wanyoike-Gichuhi.

Dr Wanyoike, a consultant gynaecologist and expert in ART, regretted that Kenya unlike in developed countries has no registry or guidelines for test-tube baby technology.

Such a registry, he says would help follow up and monitor the growing ART services and population in the country and intervene where necessary.

In an interview with the Standard on Wednesday Dr Wanyoike also a lecturer at the University of Nairobi explained how they diagnosed and assisted the 32-year-old woman at a city private hospital.

In the case study, published in the current issue of the East African Medical Journal, Dr Wanyoike, the lead author says the healthy woman had undergone the assisted birth process sometimes last year.

Up to week seven the woman had exhibited a viable pregnancy but at week 13 and four days an abdominal mass was detected prompting the doctors to initiate further investigations.

The investigations revealed gross abnormalities on the fetus and consequently the patient was advised on the necessity to terminate the pregnancy.

On abortion, the report says the fetus was found to have some of the abdominal organs placed outside the body, an unusually large tongue and the body paralyzed on one side.

From these conditions the three doctors, who also included A. M. Achinga of Africa Air Rescue and S. Ndegwa of Foots Steps Fertility Foundation concluded the fetus suffered of what is called Beckwith-Wieldman Syndrome (BWS) reported to be on the increase mainly in ART children.

BWS is describes as an overgrowth disorder usually present at birth, characterized by an increased risk of childhood cancer and certain genetic defects.

However Dr Wanyoike says there is no need to panic because such cases even in assisted birth technologies are extremely rare.

But the trio go ahead to warn against the over handling of embryos and sperms in the ART process to avoid too much exposure to environmental pollutants including light, noise and uncontrolled temperatures.

Natural conception, Dr Wanyoike explained happens in highly specialized body environments, difficulty to replicate even in best of laboratories hence ART manipulation should be kept to a bare minimum.

Citing growing evidence linking ART to an increase of birth defects in ART infants the influential American College of Obstetricians and Gynecologists has recommended stringent frameworks to oversee the practice.

“That is the biggest problem we have in this country, with no regulator, legal framework or even basic guidelines,” says Dr Wanyoike.

The first test-tube babies, two girls to different families, in Kenya were born around 11am on May 8, 2006, at the private Avenue Hospital in Parklands, Nairobi.

The two baby girls were born to two mothers, aged 30 and 35, through Caesarian section with identities of the parents remaining a private matter.

The event elicited strong excitement across the country with Ms Edna Ameyo, then a legal coordinator with Kituo cha Sheria, a legal advice centre in Nairobi calling for the stoppage of the practice until a legal regulatory mechanism was put in place.

But this was ruled out by the then Director of Medical Services Dr James Nyikal saying the practice could go on while he speedily facilitated a regulatory mechanism.

However 11 years later, today, such a mechanism is yet to be put in place nor does anybody know how many test tube babies have since been born in Kenya or even  the quality of facilities offering the services.

The media, working on figures posted on the internet by the Nairobi IVF Centre, which pioneered the technology in Kenya estimate there are about 2,000 test tube children in the country.

But reproductive health experts dispute the figure as highly exaggerated because it is based on confirmed pregnancies but not the take home babies.

Between pregnancy confirmation and delivery, experts say a lot of fetuses are lost and estimate a population of less than a 1,000 test tube children on Kenyan streets today.

The Assisted Reproductive Technology Bill, 2016 currently in the Parliamentary process may cure some of these outstanding problems.

For example the Bill proposes the establishment of the Assisted Reproductive Technology Authority that will keep a register of all people born of the technology and attendant details.

 The Authority, the Bill says  shall keep and maintain a register containing particulars of persons conceived in consequence of assisted reproduction treatment services throughout the country.

It will also inspect and approve the quality of any promises offering such services including facilities and personnel involved in the practice.

The authority will be responsible for regulating all matters relevant to the practice of ART. However drafters of the law may have to reconsider including emerging issues linking the technology to genetic defects.

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