Advancing assisted reproductive technology in Africa: a narrative review on the promising role of molecular biology and molecular techniques.

Assisted Reproductive Technology (ART) has significantly improved fertility outcomes globally, yet its full potential remains underutilized. In Africa, persistent barriers including high costs, limited access, inadequate infrastructure, lack of awareness, and sociocultural and ethical concerns impedes its utility. This review explores the promising role of molecular biology and advanced molecular techniques in overcoming these challenges and advancing ART on the continent. Techniques such as preimplantation genetic testing (PGT), non-invasive prenatal testing (NIPT), CRISPR/Cas9 gene editing, mitochondrial replacement therapy (MRT), and single-cell RNA sequencing offer opportunities to enhance embryo selection, minimize genetic and epigenetic risks, and improve pregnancy success rates. Furthermore, innovations like biomarker discovery, liquid biopsy, and genomic screening can personalize treatment strategies and improve reproductive outcomes. We also provide a narrative on the progress made in expanding ART services, improving affordability through low-cost protocols, and building local expertise through training and collaborations. While challenges persist, especially in regulation and access to ART, the integration of molecular innovations in a phased manner has the potential to transform ART if implemented within appropriate infrastructural, ethical, and policy frameworks. This review underscores the need for sustained investment, policy reform, and interdisciplinary collaboration to bridge existing gaps and ensure that ART technologies are accessible, safe, and effective for all individuals and couples affected by infertility in the region.