World-class fertility treatments at KHAMH

Jul 24, 2024 11:01 AM

In vitro fertilisation (IVF) has transformed the landscape of reproductive health in Bahrain, offering hope to couples who previously struggled with infertility. The kingdom joins the rest of the world to celebrate World IVF Day tomorrow to recognise the advances made in reproductive medicine since the first successful birth resulting from IVF in 1978, writes Jayne Houghton.

King Hamad American Mission Hospital (KHAMH) in A’ali, started offering fertility treatments last November employing the most modern ART technologies using artificial intelligence and digital machinery run by experts in this field.

The services are managed by the IVF/ART pioneer Dr Maryam Dashti and the clinical services are offered by IVF experts, Dr Hafsa Ali Al Buarki, Dr Sabah Amal Baig, Dr Khulood Ahmad Alderazi and Dr Hamad Elheloo.

The IVF journey, which started in Bahrain in 1990, has witnessed a lot of progress in the field of assisted reproduction, specifically in lab applications, logistics, medications and medical treatments. The advancement was achieved by IVF visionaries showing a lot of dedication and perseverance and in collaboration with the National Health Regulatory Authority (NHRA) in the kingdom.

KHAMH ART-IVF Centre director Dr Dashti has played an instrumental role in establishing and advancing IVF in the country, and her expertise now directs the state-of-the-art centre at KHAMH.

Beginning with her return to Bahrain after completing her PhD in technology-based clinical immunology in the UK, she embarked on establishing Bahrain’s first IVF centre in 1988. This endeavour required further hands-on training in London, at The Lister Hospital and King’s College London, followed by the arduous task of setting up the first IVF centre in Bahrain with the limited resources made available then.

However, with unwavering support from the hospital’s administration, the centre flourished. Dr Dashti recalls: “We had a good pregnancy success rate in comparison to the international values then.”

This success culminated in the birth of the first IVF baby in Bahrain, a baby girl born on March 16, 1990, a testament to the dedication and expertise of Dr Dashti and the late Dr Nabil Riskallah who was the first fertility gynaecologist in Bahrain.

Male infertility is on the rise now, probably due to environmental factors and to a lesser extent genetic factors. Intracytoplasmic sperm injection (ICSI), is a technique of injecting a single sperm into the egg to achieve fertilisation, which may not happen with the classical IVF method. This technology was introduced globally in 1992 for treatment of couples with compromised semen. The first baby born by ICSI in Bahrain was in 1996, after acquiring the right equipment and technology.

Also, the techniques of freezing semen, eggs and embryos for married couples added a lot of reward and assurance to the pregnancy success rates; currently semen can be kept frozen for 10 years, while eggs and embryos are kept for five years. Endeavours to extend the time of cryopreservation have been initiated to give the opportunity to freeze eggs for unmarried women who have to wait due to social reasons or need to protect their gametes (an organism’s reproductive cells) for a medical reason.

Reflecting on the early days of IVF in Bahrain, Dr Dashti emphasises the importance of the embryology lab, stating: “The embryology lab is the core of any IVF centre and must be governed by a very strict quality control programme.”

In the early days, fertility treatment was not easily accepted by the community and most of the time the female was blamed for it. Luckily, awareness of the public increased with continuous education and communication through the media. Dr Dashti’s advice to patients facing fertility issues is clear: “Do not wait... the earlier you seek help, the better.”

She also encourages other IVF centres to ‘invest in the best technology available’ and prioritise the embryology lab.

Dr Dashti emphasises that collaboration with other international centres plays a vital role in the improvement of services: “It is essential to keep close proximity with advances in the field through research and publications, international meetings and upgrading skills with continuous education.”

The ART-IVF centre adheres to international standards and best practices, ensuring that every aspect of the IVF process, from the handling of gametes and embryos to the culture media and equipment used, is subject to rigorous scrutiny.

‘High quality technology ... and very strict quality control measures’, as emphasised by Dr Dashti, are the foundation upon which successful outcomes are built. These measures include continuous monitoring of environmental conditions, regular equipment calibration, and comprehensive staff training to minimise any potential risks and maximise the chances of a successful pregnancy.

“The centre’s state-of-the-art laboratory, with its cutting-edge technology and adherence to stringent quality control protocols, showcases the American Mission Hospital’s unwavering commitment to providing the highest quality of care to its patients,” Dr Dashti added.

Senior IVF consultant, Dr Al Buarki, with more than 20 years’ experience in fertility treatment, expresses her concern for patients who need pre-implantation genetic testing (PGT) and diagnosis.

“In Bahrain, some haemoglobinopathies (inherited blood disorders) are more common in certain families due to consanguineal (related by blood) marriages. PGT for detecting beta thalassemia and sickle cell anaemia can help and ensure these families achieve healthy pregnancies.”

Dr Al Buarki adds that this method can also ensure avoiding pregnancies with babies having chromosomal abnormalities, which in turn reduces the incidence of frequent miscarriages for some women and will increase healthy pregnancy outcomes.

IVF consultant and a fellow pioneer in the field, Dr Baig, reflects on her own journey: “I was trained at The Lister Hospital in London by the best IVF practitioners and joined the IVF team to offer my expertise in fertility treatment.”

Dr Baig underscores that ‘IVF is not just a medical problem, it’s a social issue, involving psychological, emotional, and financial factors’.

Over the past 30 years, Dr Baig has witnessed the transformation of IVF from a taboo subject to a widely accepted practice, thanks to education, social media, counselling and improved communication.

Today, IVF is more accessible and sophisticated than ever before. “It’s become much more affordable, much safer, more streamlined, and more individualised,” explains Dr Baig.

Advancements in reproductive technologies, protocols and research have led to significant improvements in success rates. However, age remains a crucial factor, with younger women experiencing higher chances of success. Recognising this, Dr Baig and Dr Dashti both emphasised the importance of egg preservation for women who may wish to delay childbearing, noting that while this isn’t yet allowed in Bahrain, it’s a growing trend globally.

The development of intracytoplasmic sperm injection (ICSI) has been a game-changer in the field of IVF. Dr Baig explains: “This is where the sperm is actually injected into the egg ... it ensures fertilisation of the egg.”

Other advancements, such as genetic testing and sperm retrieval, have further enhanced the effectiveness of IVF.

Dr Baig’s advice to couples struggling with infertility is to ‘investigate if there’s a problem ... and then consider IVF’, especially before the age of 35.

She stresses the importance of trust and open communication between doctor and patient, emphasising that ‘emotional intelligence and empathy ... are very important in this field’.

The inauguration of the ART-IVF Centre at KHAMH marked a new chapter in the technological advancements of IVF, promising to provide state-of-the-art care and support to couples seeking to fulfil their dreams of parenthood.