Infertility poses a profound public health and social challenge in Sub-Saharan Africa, disproportionately impacting women who bear the social stigma, marital instability, and economic marginalization associated with childlessness. Assisted reproductive technologies (ART), particularly in vitro fertilization (IVF), hold transformative promise to restore reproductive autonomy and fulfill the fundamental human right to parenthood. Yet, despite this potential, access to IVF services remains alarmingly limited and inequitable across the region. This disparity is driven by intersecting structural impediments including steep economic costs, weak or uneven legal and policy frameworks, entrenched sociocultural stigma, and under resourced healthcare systems. This article undertakes a rigorous comparative and doctrinal legal analysis grounded in international and regional human rights instruments such as the International Covenant on Economic, Social and Cultural Rights (ICESCR), the African Charter on Human and Peoples' Rights, and the Protocol to the African Charter on the Rights of Women in Africa (Maputo Protocol). It explores how these normative frameworks interact with national laws, policies, and institutional capacities in four strategically selected countries: South Africa, Kenya, Nigeria, and Cameroon. South Africa exemplifies a more progressive and comprehensive ART governance model characterized by constitutional protections for reproductive autonomy, judicial reinforcement of non-discriminatory access, and formal legislative instruments regulating clinic operations and parentage rights. Kenya and Nigeria showcase evolving but fragmented regulatory landscapes challenged by regulatory inertia, limited statutory authority, and heavy reliance on private sector fertility services. Cameroon reflects earlier-stage ART governance constrained by healthcare resource shortages and potent cultural norms shaping reproductive health priorities. Beyond legal frameworks,