Kenyans who are unable to bear children naturally are increasingly turning to modern scientific methods to help them reproduce in what some experts are referring to as “record numbers”.
The positive outcomes reported from the clinics undertaking the procedures appear to be the driving force behind this huge interest in assisted reproduction.
As one walks into the Nairobi IVF Clinic, the number of people in the waiting room is intimidating: men and women sit pensively waiting for their turn to consult the doctor, and possibly get a solution to their fertility problem.
This year, more than 400 babies have been delivered through In Vitro Fertilisation (IVF), bringing the total number of infants born through this method to more than 1,900 since 2006 when Dr Joshua Noreh delivered the first test tube babies in Kenya.
IVF refers to fertilisation that takes place outside the body to assist couples with conditions that lead to barrenness.
Some of the women have given birth to twins while a few have had triplets.
The numbers represent only what is happening at the Nairobi IVF clinic.
Interestingly, it took British gynaecologist Dr Patrick Steptoe, the pioneer IVF doctor behind the first test tube baby, Louise Brown, nine years to deliver 1,000 babies.
The increase in the number of test tube babies comes at a time when Parliament is racing against time to create laws to guide, among other things, the science around IVF and how it should be applied in Kenya.
However, the Reproductive Health Care Bill 2014 seems to focus more on surrogacy, where a woman carries the pregnancy on behalf of a couple.
A law dealing specifically with IVF or assisted reproduction is yet to be put in place.
But lack of specific laws has not stopped couples from seeking help from the experts.
At the clinci, there are those who are consulting for the first time after failing to conceive naturally.
Others are waiting to go through the embryo transfer procedure; another group is waiting to have their eggs retrieved; while another lot is going in for artificial insemination since their husbands’ sperms are either too weak or inadequate to fertilise an egg.
On a typical day, Dr Noreh, a director at the clinic, says they perform between eight and 12 of such procedures; sometimes the number goes up to 16.
On average, the clinic does embryo transfers to four clients in a day or even 10 on a busy day.
What this means is if the embryo implantation is successful, four to 10 women are likely to be declared pregnant after two weeks.
Embryo transfer which is the last step in IVF process, involves the placement, in the woman’s uterus, of the formed embryo which was realised after the egg was fertilised with the sperm at the laboratory.
The clinic performs two artificial inseminations daily.
Insemination is mostly used when the man has sub-fertility problems; weak sperms which die before fertilising the egg or a low sperm count.
The many procedures done daily demonstrate two things: the high number of infertility cases and the success rate of the IVF technique.
In the past 11 months, the Nairobi IVF Clinic has handled about 1,000 IVF cases. Of these, 700 were new IVF clients while 300 were coming back for their frozen embryos.
The clinic’s success rate now stands at about 45 per cent.
Many IVF clinics in Europe and US have a success rate of between 40 per cent and 70 per cent.
It is this success rate that has seen even foreigners from UK, Germany, Canada, US, Nigeria, Uganda, Tanzania, Ethiopia, Ghana, Mali, Botswana, Somali, Rwanda and Burundi come to Kenya for infertility treatment at the clinic.
Foreigners may also prefer coming to Kenya for privacy.
In Kenya, one single IVF treatment costs Sh300,000 if the egg and sperm are from a couple. Those who utilise donated eggs or sperm pay Sh390,000 for single treatment. Repeat treatment for failed attempts costs the same amount.
This means the service is out of reach for many Kenyan.
Some of the clients who spoke to the Sunday Nation said they have had to save for many years or had to take a loan to finance the treatment.
“I took three loans totalling to Sh1.1 million before I successfully conceived. I think it is worth the sacrifice,” said a client who cannot be identified for privacy reasons.
Dr Noreh says the increase in numbers requiring assisted reproduction may be due to increased awareness.
“While these problems have been there, the increased awareness on IVF treatment has made many people realise that there is a solution to their problem. Doctors too are aware of what can be done, and are referring patients here,” he said, adding that many of the cases are referrals from other doctors.
“In recent years, I have been seeing men coming to me saying that their wives are unable to conceive, and would like to know if they are the source of the problem. Others are accompanied by their wives,” says Dr Noreh.
This, he says was not the case a few years ago. Men resisted their fertility to be put to test. For a long time, and even now, misconception that infertility is a woman’s problem has made many men live in denial about their contribution to the problem.
But in recent times, men have come to accept, though painfully, that they too can be an obstacle to getting a baby.
Mr David Chweya, a psychotherapist who counsels couples with fertility problems, says while it is easier to convince men who have low sperms quality or count to seek assistance, it is sometimes difficult for men without sperms at all.
They go into deep shock and denial when such news is disclosed to them.
Men without sperms usually have three options: to adopt a child, remain childless, or use a donated sperm to fertilise their wife’s eggs. The latter is the most difficult solution, and requires a lot of counselling and patience.
“Many men cannot reconcile with the fact that another man is donating sperm to help them have a baby. For a man, this is the lowest point in their lives. They are brought up knowing they will be fertile over their lifetime,” says Mr Chweya.
Society, he says, prepares a woman for infertility by constantly reminding her that such eventualities might happen. It does not do the same to the man, hence the shock and denial.
Mr Chweya says that some men only accept their problem after undergoing fertility tests at different clinics.
A LAST RESORT
Similar resistance, but of low intensity, is witnessed when the woman has to use donated eggs. Dr Noreh recalls incidents where some men resist their wives or both spouses refuse to use donated eggs.
“This issue of egg or sperm donation is very sensitive and emotional because it tells the couple they have to be assisted by other people to have a child.”
The IVF treatment is used as the last resort when other infertility treatments have failed or are not possible.
On average, statistics show that 70 per cent of the fertility problems can be traced to the woman, while 30 per cent are male related factors.
Dr Noreh says about 50 per cent of the causes of infertility among women seeking treatment at the clinic is due to blocked tubes.
The rest, he says, is due to either advanced age, or Polycystic Ovary Syndrome — a condition in which a woman has an imbalance of female sex hormones that may result in menstrual cycle changes or cysts in the ovaries.
Among men, the main causes of infertility are low sperm count, lack of sperm or poor sperm motility.
But once the couple agrees to the options available, the next challenge is what is to be done with the frozen embryos.
Kenya does not have laws to guide assisted reproduction. As such, most local clinics have been relying on the Commonwealth guidelines on IVF.
During the embryo transfer, the practice is to transfer two or three embryos into the woman’s uterus for pregnancy to take place.
The excess embryos are frozen and only thawed when the woman comes back to have another baby.
Dr Noreh says the couple has to sign an agreement that if after 10 years they will not have used the embryos, the clinic is free to donate them to other couples.
“We never destroy embryos and this is the solution to dealing with embryos that are not used,” he says, adding that many couples are reluctant to sign such an agreement.
However, none of the first IVF cases in the country have frozen embryos that are 10 years old — the oldest is about six years.
For now, it is all bliss as the IVF technique churns out babies and puts smiles on the faces of couples who would otherwise remain childless.