Why more Kenyans are embracing IVF

Forty-nine-year-old Nancy* (not her real name) had been struggling for the last 12 years to get pregnant. After fruitless tries, she decided to seek out assisted reproductive therapy.

Visiting Mediheal Diagnostic and Fertility Centre in Nairobi, one of the six IVF clinics in the country, the doctors were sceptical about her ability to carry a pregnancy to term.

“We examined her and found that she had fibroids that made her chances of conceiving almost nil,” says Dr S. R. Mishra, chairman of the Mediheal Group of Hospitals.

The fibroids eliminated her as a viable candidate for IVF due to the fact that her uterus was not a suitable environment for a test-tube baby.

“We referred her to a doctor at Aga Khan University Hospital where she had an operation to get rid of the fibroids, came back six months later to try again. She got pregnant and had her baby at 50,” says Dr Mishra.

Nancy’s bundle of joy is just but one of the success stories of IVF treatment in the country following the success of the first test tube babies born in Kenya in 2006. For the Mediheal Group, she is the oldest patient they have had to date.

Vision

With fertility experts like Dr Joshua Noreh pioneering the IVF in the country, the success rate of the procedure has been seen as in the top margin at between 40 and 45 per cent.

As a young man in university in India in the 90s, Mishra had a vision of setting up a fertility clinic, a dream he achieved in 2004 when Mediheal began its journey towards successful fertility treatments in Kenya.

Initially, the group was handling about 20 cases every year, a number that has been growing steadily. Now, annually, Dr Mishra and his team are handling 40 to 50 treatments in the four to five cycles they handle annually.

“We do the cycles at particular times because of bringing in the equipment and also the experts for our partner, the Dr Pai Group from Mumbai,” he says.

The increased number in the patients seeking the treatment has not only been seen by the Mediheal group. Across the road from their Nairobi clinic is Dr Praful Patel’s clinic at the Aga Khan Doctors Plaza.

Being among the pioneers of IVF in the country, the Dr Patel has a passion for his line of work.

The BDLife team caught up with him when he was winding up a cycle of IVF treatments. Annually, he and his team do five cycles with each cycle handling 30 patients.

Harvesting eggs

The treatments are usually done in cycles to lower the cost by harvesting the eggs in batches. According to Dr Mishra, the equipment and some of the experts for the treatments are brought in from abroad therefore making this a more cost efficient option.

IVF - in vitro fertilisation is basically the process where the fusing of the female egg and male sperm is done outside the body – in a test tube, hence the name test tube babies. The embryos are produced in the laboratory and then placed in the woman’s womb.

In African society, infertility has always been considered a taboo yet, according to Dr Patel , nearly a third of the population have difficulty having children for one reason or the other. The main issue he has seen over the years is convincing the men to have their fertility levels tested.

In men, the reasons according to Dr Patel that would lower their ability to father a child would be poor quality sperm, low count and poor motility.

“In these cases, the sperm will not fertilise the woman’s eggs,” he explains.

There are cases where men cannot ejaculate because of medicines they are taking, even paralysis or if the sperm ducts are blocked due to infection. In such cases, the sperm is extracted directly from the testicles for the test tube procedure.

For women, infection, tubal ligation, ectopic pregnancy, cases of ovulation problems or if a woman has no uterus but has eggs are some of the reasons they would seek assisted reproductive technology.

In such cases, the eggs are extracted and fertilised outside then implanted into the woman or a surrogate where the mother has no uterus.

No ovaries

In cases where woman has a uterus but no ovaries because of cancer, endometriosis or age, then the doctors will use compatible donor egg and fertilise this with sperm from the partner or from a donor and then allow the women to carry her own baby.

According to Dr Patel, donors remain anonymous unless a relative wants to donate eggs for the mother- to-be. In such cases, then the donor and the recipient are advised to draw up a legal contract stating that the egg donor has no claim to the child at a later date in life. This is also the reason why egg donors and recipients remain anonymous.

You give the profile of ideal man or woman for sperm or egg donor, and the doctors match the profile to their donors.

Surrogacy or gestational carriers are used in cases where the embryo is implanted in another woman’s uterus to carry the baby to term. Some of the specialists provide surrogates, some go for family members.

According to Dr Mishra, most go for the sister to the mother-to-be. However, the legislation in Kenya dictates that the birth (gestational) mother is the legal parent, and therefore the couple must take care of the legal aspect of it all.

“We have people coming in from Australia and Germany for surrogacy because there are regulations against surrogacy in those countries,” says Dr Mishra.

A new trend when it comes to fertility is the fact that more and more women are having their eggs harvested and stored for future use.

“We harvest 10 to 15 eggs in storage. This is because women are now putting off having children until they are well in their thirties,” explains Dr Patel.

With IVF, most births tend to be multiple. The local practice is to implant a total of three embryos into the woman’s uterus.

If all these are fertilised then the woman ends up with twins and triplets. In case the treatment does not take, the couple will have to wait at least six months before they can try the treatment again.

After three unsuccessful attempts at the treatment then the couple is then advised to look into alternatives like adoption.