African Woman and Child Feature Service

Kenyan women and men are taking huge bank loans, selling their properties, withdrawing all their savings and then investing the millions of shillings into baby projects. Those in this desperate search for a baby are infertile couples who will do anything to conceive.

One of them is Janet (not her real name) who has used in excess of Sh 4 million before giving birth to her 10 month old baby girl. For her, it all started five years ago when she and her husband walked into a clinic to solve one of the basic problems: infertility.

When she opened the doctor’s door, she was convinced that her problem had been solved. “It never occurred to me that this was going to be a financially and emotionally draining process,” she says.

After going through a series of tests and taking fertility enhancing medications for three years, she was unable to conceive. Further investigation established her husband had a serious fertility problem-his deformed sperms could neither swim well nor fertilize an egg. By this time, they had spent over Sh 300,000 searching for a cure.

The doctor told them the only option was In Vitro Fertilization (IVF), which could be done in South Africa. The cost of the treatment including the airfare and hotel accommodation totalled to about Sh 620,000.

“That cost shocked us. But we pooled together our savings and decided to give it a try,” says Janet. They travelled south for the treatment.

Two weeks after the IVF procedure had been performed and they were back in Kenya, the clinic called to deliver the results. They were negative: the embryos had not implanted in the uterus.

“My husband and I were so devastated that we spend one week in the house,” Janet recalls. Six months down the line, they decided to try again: but this time around in London. They had read on the internet that the IVF success rate there was good.

Medical expenses, accommodation and airfare cost them in excess of Sh 800,000. Again, after the treatment, the results were negative. The London clinic asked them to give it another try, promising to mark down the fee for a repeat treatment.

Four months later, after much agony and reflection, they agreed to go through the second IVF procedure in this clinic. They took a one million loan from a local bank to settle the cost of this treatment.

This third attempt cost them Sh 700,000. But after two weeks of waiting, they got disappointing feedback: the results were again negative. With a loan pending in the bank, the couple decided they were not going to give it a shot again.

But in 2007, after reading in the Nation an inspiring story about Dr Joshua Noreh and the number of babies he had successfully delivered locally using IVF, they decided to attempt again.

Here, they paid Sh 300,000 to go through the procedure. Janet’s first attempt at this clinic saw her conceive, but she miscarried after one month.

“The result hurt me, but it also gave me hope that I could indeed get pregnant. I resolved to go for another treatment,” she says.

This attempt was not successful either. Together with her husband, they agreed to rest for sometime before deciding on the next course of action.

Late 2008, they went back to Dr Noreh, and in their sixth attempt since they started IVF treatment in South Africa, Janet finally conceived and carried the pregnancy to term. Now they have a bundle of joy, a 10 month old baby girl, Hope.

But by the time she was delivering Hope, they had spent over Sh 4 million on this baby project.

“It reached a point I was so obsessed with having my own biological child that it never mattered to me how much it was going to cost. Even now we are still paying some loans,” Janet says with a broad smile, at least she can see the fruits of this investment.

Some people would find such amount of money enough to build a new house or educate about 10 people at the university or pay fees for 150 students in secondary school. But Janet argues nothing is as important as a baby.

Psychiatrist Dr Nelly Kitazi says bringing forward life is the essence of a woman or a man and if they cannot perform this basic function, then they start considering themselves as worthless.

This is more difficult for a man, who the society considers as prolific, with any form of infertility considered as a woman’s problem. Hence the fear and obsession to have a baby at all costs.

Indeed, Janet’s fixation for a baby is not an isolated case. Infertile couples are going to greater lengths and depths in search of children. Some are selling their properties, using all their savings or taking huge bank loans to finance their baby projects.

Irene and her husband sold their two cars to finance the IVF treatment. After 10 unsuccessful attempts that cost them about Sh 3 million, she conceived and now they have twins.

“You never see it in terms of money. Even after failing to conceive on the first two occasions and spending over Sh 800,000, I had this believe that every other try will be successful,” says Irene.

“The biggest mistake with IVF is to lose hope and give up,” adds Lillian, who has three children, all through IVF. She estimates the total investment in this treatment to about Sh 2 million.

Her friend was so lucky she conceived and gave birth with the first attempt, spending only Sh 300,000.

But the most stressful time is when the woman fails to get pregnant after investing so much money, time and emotions in this treatment.

Dealing with a negative result, fertility experts argue, is the hardest thing for many women and men, especially if it is their first IVF treatment.

The reason being after investing dearly in the procedure, the couple has very high hopes and expectations. Women bank on it as their last resort and when it fails, they find it very hard to cope with the news.

Dr Solomon Wasike of Afya Royal Clinics explains that the process of egg retrieval and the collection of the sperm from the man either through masturbation or injection, are so emotionally draining that some men would not want to go through them again.

Joy Noreh, a nurse and the administrator at the Nairobi IVF Centre, agree. She says some women find it difficult to accept a negative result and breakdown and wail in their clinic, sometimes bringing everything to a standstill.

“Women cry and ask if God really exists, questioning why they have to suffer so much unlike other women.”

At times, the doctor has to stop all procedures to attend to such women or couples. This is worsened when the couple realizes some of those who they were with in the same treatment cycle have conceived.

“When I start treatment, the objective is to get a positive result. And hence when you get a negative one, many questions arise as to what went wrong,” says Dr Noreh.

He says a negative result is emotionally draining even to him, and always rejoices when the women come back after nine months with babies in their arms.

“You look at the money these women have invested in this procedure, and feel for them when the pregnancy is not successful.”

Studies show that scientists working in IVF clinics across the world are unable to point to the factors that make the egg implant without problems in some women and fail to do so in others, resulting in no pregnancy.

Dr Noreh’s worst moment in his professional life is when the egg fails to implant after everything has been done right. Some clients demand for the refund of the money.

According to him, such motions are understandable especially if someone has taken a loan or used his savings to invest in treatment that gives a negative result.

He however adds that refund is very difficult in any IVF clinic in Kenya or in a foreign country because a huge fraction of the money is used for buying drugs and laboratory procedures.

Of the Sh 300,000 patients pay in his clinic, Sh 200,000 goes into buying drugs and conducting laboratory investigations.

“Even when we reduce the fee by Sh 50,000 in subsequent treatments, this cost is absorbed by the clinic since much of the money goes into inputs, which cannot be varied,” says Noreh, a father of three.

His clinic, The Nairobi IVF Centre, has now employed a professional counsellor to talk to the couples before and after the treatment. The counselling session is to taper the high expectations the couple has, which he attributes to the violent reactions when the procedure is not successful.

During the counselling, the women are psychologically prepared for both a positive and negative results. In the developed world, they too have elaborate systems to help women or couples cope with a negative IVF result.

At the Nairobi IVF Centre, the success rate is about 45 percent, meaning 55 percent of the women will not conceive after embryo transfer.

By the end of last month, the clinic, which pioneered IVF in the country, had delivered over 250 babies using the technology. Worldwide, over three million babies have so far been born using this technology.

In Europe, success rate in majority of the IVF clinics is between 25 and 60 percent. Here too, the failure rates are high. Still, IVF present a better success rate than the natural conception, which stands at 25 percent for every fertile couple.

Scientists think some of the failures the women experience in IVF treatment can be attributed to the quality of the eggs, the sperm and embryo; age of the woman; quality of her uterus; her living and working environment, the support she gets from the husband, and failure to follow the doctor’s instructions.

However in other instances, doctors are unable to tell why some women get pregnant on the first attempt with IVF and others have to try several times.

Studies have shown that young women spend little on IVF procedure because they have a high probability of conceiving compared to women who are in their late 30s.

Women aged between 25 and 35 years are said to have high chances of embryo implantation, and hence high pregnancy rates of about 40 percent. Those in the age bracket 35 to 40 years have a success rate of between 20 and 30 percent and are likely to spend more money on repeat treatments before conceiving.

The age of the woman further defines the number of embryos to be transferred, which has a future implication on the cost. For young women, only one embryo may be transferred to the first group, when at least two or three are required for the second group of women.

In Kenya and most of the commonwealth countries, two to three embryos are transferred to maximize the chances of conception.

In the United States, where the success rate is estimated to near the 50 percent mark, at least four embryos are transferred back to the woman’s uterus.

In case all the embryos get implanted, US doctors revert to a controversial a process known as reduction, where the unwanted embryos are injected with a chemical that stops them from growing. Such process is not supported in Kenya, Europe and many other African countries. Only three out of the many IVF clinics in Britain resort to the reduction technique.

AWC-Feature