Fertility treatment keeps changing, and hospital brochures are full of new names and add-ons. Some of these make a real difference for the right couple. Others add cost without much proof that they help. Here is a plain guide, with the questions to ask before you pay.
Genetic testing of embryos (PGT)
Preimplantation genetic testing checks embryos before they are placed in the womb. It has special meaning in Ghana because of sickle cell disease.
When both partners carry the sickle cell trait (AS), or one carries S and the other C, each pregnancy has a one in four chance of a child with sickle cell disease. About 2 percent of babies born in Ghana have the disease. With IVF and PGT-M, embryos can be tested and only those free of the disease are transferred. Dr Edem Hiadzi, one of the experts we work with, pioneered Ghana's first pre-implantation genetic exclusion of sickle cell disease in 2020.
- PGT-M: tests for a specific inherited condition, such as sickle cell disease
- PGT-A: checks embryos for the wrong number of chromosomes, sometimes offered to older women or after repeated miscarriage
- PGT-SR: for couples where one partner carries a chromosome rearrangement
PGT adds cost and is not right for everyone. PGT-M is clearly useful when a known condition runs in the family. The benefit of PGT-A for every patient is still debated, so ask why it is being recommended for you.
If you and your partner do not know your genotypes, a simple blood test will tell you. It is worth knowing before you start.
ICSI
Instead of leaving the sperm to find the egg in a dish, the embryologist injects one sperm directly into each egg. It is the standard answer to a low sperm count or poor movement, and it means many men with sperm problems can still father their own children.
Freezing eggs and embryos
Modern ultra-fast freezing, called vitrification, means most frozen embryos survive thawing. Couples can freeze extra embryos from one cycle and use them later without repeating the whole stimulation. Women can also freeze eggs, for example before cancer treatment or to delay pregnancy. Success depends heavily on age at freezing, so earlier is better.
Freezing also helps families abroad: embryos created elsewhere can be shipped to Accra, which can save a trip.
Time-lapse embryo imaging
A special incubator photographs the embryos every few minutes, so the embryologist can watch them grow without taking them out. It may help in choosing the best embryo, but the evidence that it improves the chance of a baby is mixed. Treat it as a possible extra, not a must.
Artificial intelligence in embryo selection
Computer programmes that study embryo images and predict which one is most likely to implant. It is promising but still new. Be careful of any claim that AI will guarantee a result.
Endometrial receptivity testing (ERA)
A small sample of the womb lining is tested to find the best day for transfer. It is mainly discussed for women who have had several good embryos fail to implant. Studies have not shown a clear benefit for most patients, so it should not be routine.
Tests and treatments for men
- Semen analysis: the first and most important test
- Sperm DNA fragmentation: looks at the quality of the sperm's genetic material, sometimes useful after repeated failure or miscarriage
- Surgical sperm retrieval: for men with no sperm in the semen, sperm can sometimes be taken directly from the testes and used with ICSI
Still in the laboratory
Making eggs and sperm from stem cells, and editing embryo genes to prevent disease, are research topics only. No hospital anywhere can offer them safely today, and anyone selling them is not being honest with you.
Questions to ask before paying for any extra
- Why are you recommending this for me, specifically?
- What is the evidence that it improves the chance of a baby, not just a better-looking embryo?
- How much does it cost, and what happens if I say no?
- Does it carry any extra risk?
The best technology is the one that suits your situation, not the newest one on the flyer. Because we are not a hospital, we have nothing to sell you. We help you weigh what the doctor recommends, and we will tell you when an extra is worth it and when it is not.
This article is general information, not medical advice. Your own situation needs a proper assessment by a qualified doctor, which we arrange at our partner hospitals in Accra.
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