•Most women reported struggling with the little-studied infertility-related depression or anxiety.
•You see couples posting pictures of their babies on social media and wonder when you will ever participate in this way of life.
For women struggling with infertility, one of the greatest cruelties is the uncertainty of whether one will ever become a mother.
Your friends and relatives seem to conceive without effort and have children. You see couples posting pictures of their babies on social media and wonder when you will ever participate in this life of motherhood.
Kenyan women going through fertility treatment have described the process as torturous, with accompanying psychological suffering.
“I feel like I am passing through a desert. There is no water and something to eat, only scorching sun, which burns. That's how I feel, my heart is breaking and I am in escorting pain,” a 35-year-old with with no child said.
She is one of the 33 women whose experiences are documented in the BMC Women’s Health journal in an article by Julius Njogu and Albanus Mutisya of Jomo Kenyatta University of Agriculture and Technology; and Anne Njogu and Yang Luo, both of Central South University in Changsha, China.
The authors spoke to women attending fertility clinics at Kenyatta National Hospital, Thika Level 5 Hospital, and Kiambu Level 5 Hospital between October last year and January.
Most women reported struggling with the little-studied infertility-related depression or anxiety.
“It was found that women described infertility treatment as emotionally distressing, physically painful, and financially constraining,” the authors said.
Their study is titled, "Experiences of infertile women pursuing treatment in Kenya: a qualitative study."
“The findings offer insights into the plight of women seeking fertility treatment and the need for incorporating psychosocial interventions or counseling into the fertility treatment routine to help these women get through treatment challenges,” they concluded.
A 34-year-old woman with no child said she felt useless.
“I was driving from the hospital after my appointment. Then a thought came to my mind, you useless woman, you may try to get the best care for your inability to have a baby, but no matter what, you will never have a baby. You are better off dead than alive because you have no value to the society, family and husband,” she said.
Some of the women were scared of reaching pre-menopausal age without having a child and were desperate for any help.
“I am worried that I am ageing and will be a pre-menopausal woman soon. I heard that a woman's fertility declines with age, so I came to the hospital to get help before it is too late, ” a 36-year-old, who had one child, said.
Other women reported profound sadness and frustration during their menstruation, which came as a reminder they are incapable of having children.
The study, which was qualitative, shows women who experienced miscarriages during infertility treatment experienced intense emotional pain.
“Having a fertility issue is a problem on its own, and losing the baby you have worked so hard for, you feel like you are bleeding inside. I lost my IVF baby (embryo) at eight weeks,” said a 40-year-old study participant who had one child.
They also described their infertility treatment experience as lonely and isolating because they lacked communication with their husbands and lost most of their friends.
“My husband does not want to talk about infertility or treatment; he keeps quiet or changes the topic when I try. I also lost most of my friends, and I had nobody to talk to except God,” said a 32-year-old participant with no child.
Kenya Fertility Society says two in every 10 couples suffer from infertility. Their data also estimates that at least 4.2 million Kenyans require medical assistance to conceive.
A third of infertility cases in Kenya arise from male factors, mostly due to abnormal sperm, low sperm count and erectile dysfunction.
Most studies done locally show the commonest cause of female infertility is tubal factor, with 83.6 per cent having bilaterally blocked tubes.
Head of Family Health Department in the Health Ministry Dr Isaac Bashir said the ministry is already carrying out a major survey to identify the causes, geographic distribution and drivers of infertility in Kenya.
"The study will also determine the link between long-term contraception use and infertility as well as Kenyans' perception and stigma associated with infertility," he said.
The strategy of the study is contained in the National Reproductive Health Priority Research and Learning agenda 2022 – 2027 which was launched in August.
The JKUAT study shows there were six ways women tried to cope with the fertility treatment burden, ranging from religious practices and personal faith, giving in to feelings, shifting focus, taking a break, staying with their relatives’ children, and receiving support from others.
“When I started infertility treatment, I decided to pursue higher education; I have done bachelor’s degree, last year I graduated with master’s degree. Schoolwork has kept me busy, making me forget temporarily about my treatment problems,” said a 42-year-old with no child.
Human genetics specialist Grace Njoroge says fertility treatment in Kenya is expensive and this adds to the stress.
They are also not covered by health insurance.
"IVF treatment costs typically range from Sh200,000 to Sh800,000 depending on the facility selected, the number of cycles, and the number of sessions required, without accounting for the emotional toll of the procedure.," she told the Star.
"The high cost of IVF, which is typically the last option for those who hope to conceive, may leave those who cannot afford it with no hope."
IVF success rates depend on many factors, such as age and the reasons for infertility.
Overall, first-time IVF success rates often fall between 25-30 per cent for most intended parents. However, this probability tends to increase after multiple IVF cycles.
This means that almost half the people who undergo IVF do not get pregnant and, unfortunately, their doctor will not always be able to tell the reasons for the failure of IVF.
Counselling psychologist Grace Ngare told the Star nearly all fertility clinics in Nairobi offer their clients proper counselling.
"But what should be done is now to extend the counselling to their husbands. When infertility in a marriage is due to a female factor, the women are normally left alone and when the treatment fails, they are blamed. They are told I spent a lot of money on you, and you are not getting pregnant," she said.
Ngare said the family of the man should also get counselling because men often face a lot of pressure from their families. "They are told, look at your agemates that you got married together, they already have children and you have none. This leads to desperation and frustration."
Ngare added that the society needs education on issues of children because human beings do not have full control.
"Sometimes women also get very negative. When treatment fails they get anxious about future sessions and think they will also fail. They blame themselves and also blame God asking why do you let me go through this. Counselling will help deal with this," she said.
Edited by Henry Makori