英国新闻听力 在发展中国家设立的新的生育治疗项目（在线收听）

New Program of Fertility Treatment for Developing Countries

CLAUDIA HAMMOND: When you think of fertility problems, African might not be the first continent to spring to mind. In many conutries there, large families at the norm and the average couple has six children. But this doesn't mean it's easy for every one. In Sub-Sahare Africa, a third of women are experiencing fertility problems. But the European Society of Human Reproduction and Embryology is about to announce that it's setting up a new program of fertility treatment for developing countries. As Michael Hawking reports from Arusha in Tanzania.

MICHAEL HAWKING: As most African governments are concerned with managing population growth, helping infertile couples to conceive is not seen by many as a big priority. But infertility is a problem that can cause real misery and hardship for those affected. Of the 17 years of trying and failing to have a child, Rita Sembuya, founder of the Joyce Fertility Support Centre in Uganda, to help further infertile women.

RITA SEMBUYA: When you have infertility in Uganda, it's very very devastating. Socially Rolutat, is a person who should never have existed. In the African society a marriage can only be completed after the birth of the child. In the medical side, we find very very many problems because the technologies over treating this infertility inadequate. You find yourself going into infertility for ten years, moving from one doctor to another until you give up, and at this time you have gone through so many operations, so many medications. In the end, you end up with no success at all.

MICHAEL HAWKING: But help may now be on its way. A group of Europe's top fertility experts have set up a special task force to try make fertility treatment much cheaper and more widely available. There are currently only about 25 fertility clinics in Sub-Sahara Africa. The aim is to open many more. In Europe and the USA, in-vitro fertilization, or IVF, is widely available but treatment is very expensive. Each attempt or cycle can cause thousands of dollars because of the hormone injections and other drugs involved. Ian Cook, a member of the new task force says that one suggestion is for African clinics to use these drugs more sparingly, giving a lower success rate, but making the treatment much cheaper.

IAN COOK: Our in-house calculations at that moment are about 120-year old for a cycle of this low cost IVF. In a sense, that's an isolated figure and does not include staff costs. And so we'll have to be more realistic in that and it may will be that there has to be a margin put on top of that to make it economically viable for the institution to run such a program. The next phase will be to be trial offer depending on the cost for two or three cycles to an individual so the key milady pregnancy rate can begin to be respectable numbers.

MICHAEL HAWKING: Ian Cook is already running a pilot study in two clinics in Sudan and South Africa. By recruiting couples who have never had fertility treatment before, he hopes to work out exactly what can be achieved

IAN COOK: We want to take patients that have not previously being offered the infertility management at all because we think that's the only way we can assess the population to which we will be offering this. Now a number of those, hopefully quite a number will be able to be offered technique shot of enriching fertilization. But that will allow us to define the population for whom IVF is appropriate and indeed the population for whom IVF is not appropriate.

MICHAEL HAWING: Last December the task force met in Arusha, Tanzania, to discuss the range of services that might be offered. Besides IVF there are several other treatments as well as many techniques for diagnosing fertility problems. One possible solution is to set up a fertility clinic in each major city but give local doctors the tools to diagnose patients closer to their homes. Such is the hope for the millions of women like Rita Sembuya who longs for an end to the stigma of childlessness.

RITA SEMBUYA: It's a dream which we are all looking forward to. Because in our country in-vitro fertilization is only for the rich people. All the members of the Joyce Fertility Support Centre and the African fertility allies are looking up to the outcome of this meeting as something that is going to cause a transformational change in the lives of people with infertility.

CLAUDIA HAMMOND: Michael Hawking reporting from Tanzania.

在发展中国家设立的新的生育治疗项目

克劳迪娅·哈蒙德：当你一提到生育方面的问题，非洲可能不是第一个涌入脑海的地方。在那里的许多国家，大家庭是很普遍的，平均每对夫妇都有六个孩子。但是对于这样一个大家庭，生活并不容易。在撒哈拉以南的非洲，三分之一的妇女都有生育方面的问题。而欧洲人类生殖及胚胎学会即将公布它要为发展中国家设立一个关于生育治疗的新项目。这是麦可·霍金来自坦桑尼亚州阿鲁沙的报道。

麦可·霍金：由于大多数非洲政府都在控制人口的增长，所以很多人都没有把帮助不孕夫妇受孕视作重要的优先项目。但是对于那些不孕的妇女来说，不孕是可能导致她们不幸和痛苦的重大问题。经过17年的努力仍没有孩子的丽塔·西姆巴亚是乌干达乔伊斯生育支援中心的创始人，她进一步帮助了这些不孕妇女。

丽塔·西姆巴亚：在乌干达如果你不能生育，这是非常非常严重的。索希利·罗鲁塔特是一个本应该不会存在的人。在非洲社会里，婚姻关系只有在子女出生后才算成立。在医疗方面，因为治疗不孕的技术还欠缺，我们发现了非常多的问题。你发现自己不孕有十年，看了一个医生又一个医生，而在这期间，你经历了很多的手术和吃了很多的药，直到你最终放弃为止。但是最后，你还是没有成功。

麦可·霍金：但帮助现在正在进行中。一些欧洲的顶尖生育专家已经成立了一个特别专责小组，设法使生育治疗更便宜，并能够更广泛地推广使用。目前在撒哈拉以南的非洲仅有约25个生育诊所。这次的目标是要开办更多家诊所。在欧洲和美国，试管授精（也可称为IVF）被广泛运用，但治疗费用很高。由于激素注射和其他相关的药物的使用，每次尝试或每个周期的治疗都可能花费数千美元。伊恩·库克是新专责小组的一员，他说有一种建议是让非洲的诊所更节约地使用这些药物，虽然这样降低了成功率，但是却可以使治疗更加便宜。

伊恩·库克：根据我们的内部计算，目前大概120岁为一个低成本的试管受精周期。在某种意义上，这是一个孤立的数字，并且还不包括人事费。所以在这方面我们要更切合实际，而且在它的基础上要有一定的差额，这样会使执行此种项目的机构经济可行。下一阶段的提供依赖于两个或三个周期的成本，这要针对个体，这样主要的怀孕率才能开始提高。

麦可·霍金：伊恩·库克已经在苏丹和南非的两间诊所做了一项初步研究。这项研究是通过招收一些从未有过生育治疗的夫妻来展开的。他希望可以准确地计算出什么是成功的要素。

伊恩·库克：我们想招收一些从没有接受过不孕症治疗的病人，因为我们认为这是我们能够对那些接受我们所提供的治疗的人们进行人口数额评估的唯一方法。现在有很多人希望能够提供多样的生育技术治疗。但是，这将使我们很难确定合适试管受精的人口和不适合试管受精的人口。

麦可·霍金：去年12月，专责小组在坦桑尼亚的阿鲁沙会面，讨论一系列可能提供的服务。此外，还讨论了有关试管婴儿的几个其他治疗方法以及许多诊断生育力问题的技术。一个可行的办法是在各个主要城市成立一个生育诊所，但是要把工具给当地医生来诊断其附近的病人。这是像丽塔·西姆巴亚一样，渴望结束不能孕育儿女这种烙印的数百万妇女的希望。

伊恩·库克：这是我们一直在追寻的梦想。因为在我们国家，试管受精只适用于有钱人。乔伊斯生育支援中心和非洲生育联盟的所有成员都在关注这次会议的结果，把它看作是改变不孕人们生活的重大变革。

克劳迪娅·哈蒙德：这是麦可·霍金来自坦桑尼亚的报道。