IVF restrictions force women abroad

Women with fertility problems could be missing out on the chance to have IVF treatment because of a lack of facilities.

A pregnant woman examines her ultrasound scan at a hospital.

DUBAI // Women with fertility problems could be missing out on the chance to have a baby because of a lack of treatment facilities, experts have warned. Women are increasingly seeking treatment abroad, where they feel better care is offered for less money, and waiting lists are non-existent. In vitro fertilisation (IVF) is available at both public and private clinics in six of the emirates.

But in Dubai, the fertility business is more tightly regulated than in the rest of the country. Private clinics are banned from offering IVF to couples, leaving just one government fertility centre that provides the therapy. And this week, Dubai reiterated its rigid stance when it released a statement advising that any clinics that flouted the rule and offered IVF would be immediately closed down.

"Dubai does not allow treatment in private hospitals and clinics, but I have no idea why they did this," said Aysha al Roomi, from the Health Committee on the Federal National Council. "The law was meant for all of the UAE and the private and public sectors. Dubai will not allow it in the private sector; I don't know why." Doctors say the restriction can interfere with a woman's chance of becoming pregnant.

Dr Michael Fakih, who runs the Fakih Gynaecology and Obstetrics private clinic in Dubai, says the services he can offer to women who are having trouble conceiving are limited to hormonal tablets and certain surgical procedures. For IVF, he refers patients to the Government's clinic. "I've heard that the waiting list can be up to two years. For a woman who's trying to get pregnant, especially if she is over 35, a long wait for treatment could really reduce her chances.

"It's absolutely, absolutely frustrating not to be able to treat them. You are taking the most successful procedure away from them." Fertility rates are dropping in the UAE, mainly due to Polycystic Ovary Syndrome (PCOS), a condition in which the ovaries release eggs less frequently, or not at all. Earlier this year, a senior Ministry of Health (MoH) official said there was an urgent need for more fertility centres to meet the increased demand.

"At present, there is one in Dubai, but that is not enough to meet the requirements of the people in the northern emirates," said Hamad Taryam al Shamsi, the head of the Ajman Medical District. "New centres are being planned by the MoH and the services allowed by Islam will be provided." There are proposals to start an IVF institute in Ajman and to establish a further fertility centre in the emirate.

IVF is a fertility treatment by which a woman's eggs are fertilised by sperm outside of the womb. Many women require several treatments before becoming pregnant. The procedure, often painful and expensive, is usually a last hope for couples wanting children. The Dubai Health Authority (DHA) said it was strictly enforcing its rules for moral and ethical reasons. Dr Odeh Ahmed, the acting head of the facility control unit and quality assurance licensing department with the DHA, said doctors who did not share Islamic values might be tempted to allow a woman to become pregnant by a man other than her husband.

"From an ethical point of view, there are special precautions which could not be easily controlled by private clinics, as the emirates are multinational. The Government needs more control, which is why IVF is still banned in Dubai. A Dubai endocrinologist, who wished to remain anonymous for fear of repercussions from the health establishment, said the tight restrictions were not needed. "I don't see any reason to forbid a medical practice even if one or two doctors have made a wrong decision, otherwise we'll forbid people from driving because one person got into an accident."

He said the law that applied across the UAE was stringent enough to guide doctors in their practices and that the religion or creed of the doctor had no bearing on whether he was willing to follow the rules. Last year, 1,700 couples went to the Dubai Gynaecology and Fertility Centre for treatment and 800 received assisted reproduction therapies, said Dr Mohamed el Kalyoubi, a consultant obstetric gynecologist and IVF expert at the centre.

As for the continued ban on private clinics offering IVF, he said: "Doctors don't do policy. It is not us that requested that we are the only centre in Dubai, it was the decision of the Government in Dubai. They are the people who make the policy." * With additional reporting by Loveday Morris [e-mail]