Childless Kenyan couples spending millions

Kenyan childless couples are going to great lengths and expense to have children. Unable to have children, some couples are taking out huge bank loans, selling property, withdrawing all their savings and investing the millions in baby projects. They will try every artificial method to conceive.

One such woman is Janet and her husband, who spent more than Sh4 million and finally gave birth to Hope, her baby girl who is now 10-months old. The quest to have a child began five years ago, but she was not prepared for the long and arduous journey.

“It never occurred to me that this was going to be a financially and emotionally draining process,” she said. After a series of tests and taking fertility-enhancing drugs for three years, she was still unable to conceive. Further tests established that her husband’s deformed sperm could neither swim well nor fertilise an egg.

Only option

By this time, they had spent more than Sh300,000 searching for a solution. The doctor told them their only option was in vitro fertilisation (IVF), which could be done in South Africa. IVF involves extracting a woman’s eggs and a man’s sperm and conducting fertilisation in the laboratory. The fertilised eggs are left for two to five days to develop into embryos and then inserted into the woman’s uterus.

For Janet and her husband the cost of the treatment, including the air fare and hotel accommodation in South Africa, was about Sh620,000. “That cost shocked us. But we pooled together our savings and decided to give it a try,” she said. Two weeks after the IVF procedure they flew home to await the results from the clinic. But when the news came, it was negative. The embryos had not implanted in the uterus. “My husband and I were so devastated that we spent one week in the house,” Janet recalled.

Six months later, they decided to try again, but this time in London. Medical expenses, accommodation and air fare cost them in excess of Sh800,000. Again, after the procedure, the results were negative. But the London clinic asked them to give it another try, promising to reduce the fee for the repeat procedure. Four months later, after much agony and reflection, they agreed to give it another try.

Negative results

They took a Sh1 million loan from a local bank and spent Sh700,000. But the results again turned out negative. Even with an outstanding bank loan, they decided to give it another shot. And then they read the story of Kenya’s Dr Joshua Noreh in the Daily Nation. He had successfully used IVF to end the agony of childlessness to Kenyan couples.

They decided to try again and paid Sh300,000 for another procedure. Janet conceived on the first attempt but miscarried after a month. “The result hurt me, but it also gave me hope that I could indeed become pregnant,” she said. They tried the procedure again; it failed.

They took some time before deciding to make the sixth attempt in late 2008. Janet conceived and carried the pregnancy to term. And now they have Hope. “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,” said Janet, who feels that nothing is as valuable as a baby, and the cost is not important.

Bringing forth life

Dr Nelly Kitazi, a psychiatrist, says bringing forth life is the essence of a woman and a man, and if they cannot perform this function, then they may consider themselves worthless. Having learnt about the in vitro procedure, many childless couples say they are not concerned about the cost. They will pay anything to have a baby to call their own.

Irene and her husband sold their two cars to finance an IVF procedure. After 10 unsuccessful attempts that cost them about Sh3 million, Irene conceived and gave birth to twins. “You never see it in terms of money. Even after failing to conceive on the first two occasions and spending over Sh800,000, I had this belief that every other try will be successful,” she said.

Another woman who has given birth through IVF, Lilian, says: “The biggest mistake is to lose hope and give up.” Lilian has three children, all conceived through IVF and she estimates she has spent Sh2 million. A friend of hers was lucky and conceived and gave birth on the first attempt, spending only Sh300,000 at Dr Noreh’s clinic.

It is most stressful when a woman fails to get pregnant after investing so much money, time and emotion in the procedure. Fertility experts say dealing with negative results is the hardest obstacle for many couples, especially if it is their first attempt. Women bank on it as their last resort, and when it fails, they find that very hard.

Dr Solomon Wasike of Afya Royal Clinics says 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 do not want to go through it again.

Breakdown

Joy Noreh, a nurse and the administrator at the Nairobi IVF Centre, agrees. She says some women find it difficult to accept a negative result and break down and wail at the clinic, sometimes bringing everything to a standstill. “Women cry and ask if God really exists, questioning why they have to suffer so much unlike others,” said Mrs Noreh, the wife of the clinic’s founder.

“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,” Dr Noreh said. A negative result is emotionally draining, even for him, and he said he always rejoices when the women come back after nine months with babies in their arms.

Studies show that scientists working in IVF clinics across the world are unable to point to the factors that determine the success or failure of egg implants. Dr Noreh said the worst moment in his professional life is when the egg fails to implant after everything has been done correctly. Some clients demand a refund.

He said high emotions are understandable, especially if someone has taken out a loan or used all his savings. But he rules out a refund because, of the Sh300,000 patients pay at his clinic, Sh200,000 goes towards the cost of drugs and laboratory tests.

“Even when we reduce the fee by Sh50,000 in subsequent treatments, this cost is absorbed by the clinic since much of the money goes into inputs, which cannot be varied,” he said. By the end of last month, the Nairobi IVF Centre, which pioneered IVF in the country, had assisted in the conception of more than 250 babies that went to term using the technology.

Worldwide, more than three million babies have been conceived through IVF. In Europe, the success rate in most IVF clinics is between 25 to 60 per cent. Still, IVF presents a better success rate than the natural conception, which stands at 25 per cent for every fertile couple.

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

Studies have shown that young women spend less on the IVF procedure because they have a high probability of conceiving compared to women in their late 30s. Women aged 25-35 years are said to have high chances of embryo implantation, and hence a pregnancy rate of about 40 per cent.

Those in the 35-40 age bracket have a success rate of 20-30 per cent 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 impacts the cost.

For young women, only one embryo may be transferred to the first group, whereas at least two or three are required for the second group of women. In Kenya and most Commonwealth countries, two to three embryos are transferred to maximise the chances of conception.

In the United States, where the success rate is estimated to be near 50 per cent, at least four embryos are transferred to the woman’s uterus. In case all the embryos get implanted, US doctors revert to a controversial 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.

– An AWC Feature