Assisted reproduction — Cameroon

The legal framework

There is no Cameroonian legislation devoted to assisted reproduction. The activity is carried on within the framework of general medical law, under authorisation from the Ministère de la Santé publique. The first children conceived in Cameroon by FIV (fécondation in vitro, IVF) were born in the 2000s, and the offer has since developed in a few private facilities in Douala and Yaoundé, which perform IVF and ICSI (intracytoplasmic sperm injection, in which a single sperm is injected into the egg). The couple's work-up (bilan) is available in the university hospitals (CHU, centres hospitaliers universitaires) and in private laboratories in the large cities. Gamete donation (don de gamètes) is not legally organised: the parentage (filiation) of a child born from a donation rests on no text and can be challenged. There is no cover by any scheme, and private insurers generally exclude IVF from their policies. The private offer is aimed at married couples of a man and a woman. Those who need techniques that are not available locally — above all donation — go to Morocco, Tunisia, South Africa or Europe.

In Cameroon the critical point is the embryologist: an IVF laboratory is only as good as the person who handles the eggs and sperm, and several facilities work with embryologists who come on occasional missions. Ask who will actually carry out the fertilisation and the embryo culture, and on what date. Among women, the after-effects of sexually transmitted infections are the leading cause of infertility, which ties the prevention of infections directly to fertility; among men, severe sperm abnormalities are frequent and call for ICSI. Family pressure leads many couples to consult late, after years of traditional treatments — yet time is the one factor nothing can make up: at 40, the chances of IVF with one's own eggs are low, however good the centre. Since the centres are in Douala and Yaoundé, couples from the English-speaking North-West and South-West regions, like British nationals working elsewhere in the country, have to plan their stays around the monitoring, which requires several ultrasound scans a few days apart.

For Cameroonians in the UK — many of them from the English-speaking regions — and for British-Cameroonian couples, the choice is often between treatment in Cameroon and treatment in the UK. In the UK, NHS funding for IVF is decided locally, on criteria such as the woman's age, and differs between England, Scotland, Wales and Northern Ireland; people living in the UK on a visa who have paid the immigration health surcharge use the NHS much as residents do, but must still pay for assisted conception; and the NHS pays nothing for treatment abroad. UK fertility clinics, private as well as NHS, are licensed by the HFEA (Human Fertilisation and Embryology Authority), which has no powers overseas: it cannot deal with a complaint about a clinic in Douala, and its donor register covers only UK clinics — a person conceived with a donation made in a UK clinic since April 2005 can learn the donor's identity at 18, whereas nothing organises donation in Cameroon. For British citizenship and a UK passport, who is a parent is decided by UK law: the woman who gives birth is the mother, and her husband is the father if he consented to the treatment — which is why the copie intégrale (full certified copy) of a marriage recorded in the état civil (civil status registry) matters, while a customary marriage that was never recorded proves nothing. Surrogacy is lawful in the UK only on a non-commercial basis, and the parental order that transfers parenthood from the surrogate is available only to intended parents living in or domiciled in the UK; Cameroon, which has no law on assisted reproduction, provides no framework for it either.

Key points

In practice

• See a gynaecologist and have both partners assessed from the start, with a semen analysis (spermogramme) every time — in a CHU or a private laboratory in Douala or Yaoundé. If you move between the UK and Cameroon, keep copies of all results so that they can be used in both countries.
• Look for and treat curable causes first, in particular genital infections and their after-effects.
• Check the centre's authorisation and that it has an embryology laboratory on site; ask who will carry out fertilisation and embryo culture, and when — a centre that works through missions must be able to give the date.
• Obtain a written quote covering the whole cycle, medication included, before you start.
• Plan the journeys that monitoring requires — several ultrasound scans close together: for couples from Bamenda, Buea or the UK, a question of leave and accommodation.
• Couples living in the UK should ask their GP about NHS referral and the local criteria before paying privately, and check that any UK clinic is licensed by the HFEA; a married couple proves the marriage with the copie intégrale of the Cameroonian certificate and a certified English translation if it is in French.
• If the child is born in Cameroon to a British parent, declare the birth at the centre d'état civil (civil status centre) within the legal time limits, then apply to HM Passport Office for the first British passport with the birth certificate and a certified translation; whether the child is British depends on the British parent's own status — a parent who is British by descent does not automatically pass citizenship on to a child born abroad.

Cost and coverage

A cycle of IVF or ICSI costs 2 to 4 million CFA francs in Cameroon — about 3,050 to 6,100 euros at the fixed rate (655.957 CFA francs to the euro), a little less in pounds — and the couple's work-up 150,000 to 400,000 CFA francs, about 230 to 610 euros. There is no cover, and private insurers generally exclude IVF; add travel and stays for the monitoring and, for treatment in Morocco, Tunisia or South Africa, flights and accommodation. The NHS pays nothing for treatment abroad. In the UK, NHS-funded IVF depends on local criteria, visa holders pay for assisted conception even after the immigration health surcharge, and private clinics set their own prices — ask whether medication is included.

Where to go

• Private reproductive medicine centres in Douala and Yaoundé.
• Obstetrics and gynaecology departments of the Hôpital Général de Douala and the Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé.
• Centre Pasteur du Cameroun and approved laboratories, for the tests; Ministère de la Santé publique, for the authorisation of facilities; Cameroonian learned societies of obstetrics and gynaecology.
• HFEA: guidance on treatment abroad and licensed UK clinics; GPs for NHS referral; HM Passport Office for a child's first British passport; British High Commission in Yaoundé (consular assistance); Irish citizens: Department of Foreign Affairs.

Frequently asked questions

Official sources and links

• Services du Premier ministre — official government website — laws and regulations of Cameroon (French version)
• HFEA — fertility treatment abroad — UK regulator's guidance: what to check, donor identity, surrogacy and parental orders
• British High Commission Yaoundé — consular assistance for British nationals in Cameroon