The million shillings babies

Business

By Dann Okoth

She always wanted a baby, but at one stage in her marriage, she discovered she was infertile. With her husband, she sought advice from a gynaecologist who recommended a test tube baby or In Vitro Fertilisation (IVF).

The IVF is the technique in which a woman’s eggs and a sperm are fertilised in a laboratory and then implanted in her womb.

However, after five attempts and a staggering Sh3.5 million expenditure, no baby was forthcoming. This left her teetering on the edge, overwhelmed by emotional stress amid the huge financial loss.

Eventually Susan (not her real name), at the advanced age of 50 years, delivered twins through IVF after 10 attempts and Sh8 million bill, thereby, underlying an intriguing medical process that continues to baffle those who yearn for babies.

Dr Koigi Kamau, an associate professor in Gynaecology at the University of Nairobi. [PHOTO: DANN OKOTH/STANDARD]

The medical procedure, which was first done successfully locally in 2006, is now being sought by millions of women who cannot conceive conventionally, but for a tidy sum of Sh800, 000 or more per procedure. In some clinics, the operation has become a costly source of pain and happiness for many couples.

Making Babies At The Lab

Making test tube babies, as the procedure is otherwise known, has brought hope for thousands of would be childless women but also shattered dreams, broken hearts and even homes.

The fact that doctors and clinics offering this service are few and far between makes it a preserve of the rich. However, varying success rates have led would be clients approach assisted fertilisation with caution.

There are only about four recognised centres offering the services –– two in Nairobi and the others in Mombasa and Eldoret.

But while the social stigma associated with childlessness continues to drive millions to seek the treatment, the consequences of failure, including emotional trauma, rejection and even divorce continue to pile pressure on women who bear society’s biggest brunt for being childless.

Little wonder that few women, including those who have successfully done the procedure, are willing to talk about their experiences since infertility is treated more like a taboo than a medical condition.

"Through the ten attempts, which stretched over 15 years, I endured a lot of emotional and psychological stress despite counselling and moral support from my husband," says Susan, who didn’t want her real name revealed.

She adds: "Although we are a rich family and could easily afford the doctor’s fee at one point I felt guilty of wasting my family’s resources when every other attempt returned negative."

Suffice to say, the joy and excitement that greets the arrival of a baby for a couple that has waited for decades or even lost hope seemingly overrides everything, including the huge costs incurred.

"When I finally delivered our twins, we were so overwhelmed with joy and everybody seemed to have forgotten the anxiety we had endured for years," says Susan.

"Incredibly, this also marked a turning point in my life as my husband began to appreciate me more — even in-laws who despised me for not being able to have children were more respectful," she says.

Dr Joachim Osur, a reproductive health expert in Nairobi, warns that IVF is a complex medical procedure involving a least five medical experts, including cytologists, embryologists, hormonologists and gynaecologists all working together.

"Ideally, the procedure involves five steps, including ovary stimulation, egg retrieval, fertilisation and incubation and embryo transfer," Osur explains.

He advises couples to seek professional advice before attempting this method of procreation because of the challenges it poses. He says that the procedure is fraught with many ethical issues, adding that people opting for it should be aware of what they are getting into.

"With a success rate ranging between 20-35 per cent, often the processes are a trial and error. When they are successful, doctors can sometimes end up with ten or more fertilised eggs. The question then is do you kill the other nine since the couple only wanted one child?" he poses.

Sticking issues

Indeed, such issues were the sticking point during the constitutional referendum debate with the religious groups raising questions as to when life begins.

The procedures could be physically tasking on the mother. In addition, Osir says, the emotional trauma on a couple could be overwhelming.

"In the African traditional society, a woman was expected to bear children failure to which she was ostracised. This trend seems to have persisted to modern day where such women are still stigmatised," he says.

Osur says childlessness is a personal problem and many couples shy away from seeking help.

"Often infertility is treated like venereal diseases where couples would seek help from the doctor individually without revealing anything to the other partner," he says.

"In Kenya almost 20 per cent of the population— that is two out of 10 people require assistance to conceive. The problem is severe perhaps worse than HIV/Aids," says Dr Koigi Kamau, an associate professor of obstetrics and gynaecology at the University of Nairobi.

He says globally the problem has been ignored, leading to poor quality of life among infertile couples.

Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilised. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods. Ovulation problems are often caused by Polycystic Ovarian Syndrome (PCOS). PCOS is a hormone imbalance problem, which can interfere with normal ovulation.

PCOS is the most common cause of female infertility.

Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman’s ovaries stop working normally before she is 40. POI is not the same as early menopause.

Infertility in men is most often caused by a problem called varicocele –– an abnormal enlargement of the vein that is in the scrotum draining the testicles. This happens when the veins on a man’s testicle(s) are too large. This heats the testicles. The heat can affect the number or shape of the sperm. Sometimes injuries or other damage to the reproductive system block the sperm.

Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men.

But Kamau maintains that people experiencing these problems can get help. "We need to ensure the IVF medical branch which is highly specialised is properly regulated to ensure professionalism, quality and accessibility," he says

The doctor says cost is important and this aspect would form the basis of future regulatory and policy framework.

But with only a few outlets offering this service and with the service non-existent in major health facilities like Kenyatta National Hospital and other provincial hospitals, IVF remains a pipe dream for the majority poor who seek the service.

 

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