How fertility centres are helping couples to get babies

Five years after her wedding, Aaira Nantambi could not conceive. No matter how much she badly wanted a baby, her husband was understanding and patient.
“My husband and I kept praying together. We believed that one day, we would be blessed with a baby. There are moments when I would be depressed, but he was stronger than I was. He kept encouraging me to wait on the Lord,” Nantambi narrates.
Nantambi’s sisters-in-law, however, made her life more miserable, by demanding that she produces a baby or she leaves their brother’s home.
“A childless marriage is the worst thing that can ever happen to any woman. Relatives, friends and in-laws exert unnecessary pressure on a woman to have a baby. Some begin to think that you carried out several abortions. Others think you have no uterus and others are not ashamed to call you barren. The worst thing about it is that everyone casts a blame on the woman, she adds.”

Herbal medicine
In their search for a baby, Nantambi and her husband tried several herbal medicine as advised by friends and relatives and visited different gynaecologists. She took the medication religiously, in vain.
“I tried many options. My sister referred me to a herbalist, who prescribed a 10 litre jerrycan of herbs, that I had to finish in three days. Sometimes, I did not have my periods. The herbalist became my god. Whenever I told him I had not had my menses, he would gave me more herbs and I bled heavily,” she adds.
Fertility centre
After years of trying and losing money to unscrupulous people, Nantambi lost hope in all herbalists. While the couple was praying for a baby, their family friend wondered whether they had visited a fertility centre, particularly, the Women’s Hospital International and Fertility Centre.
When the couple went to visit the hospital, tests were done and the doctor’s report indicated that one of her fallopian tubes was blocked.
Nantambi says: “The doctor said that there was a possibility for me to conceive naturally, but chances were very minimal. He advised us to opt for an in vitro fertilisation (IVF), but it was very expensive.”
The procedure, according to Nantambi, required Shs10m, which the couple could not afford. At this point, the couple lost hope of having a baby. Even two subsequent years of trying to conceive naturally did not yield any results.

Baby at last
In 2012, the Women’s Hospital International and Fertility Centre ran a promotion for couples who had fertility challenges. The advert required couples to share a video, highlighting their fertility challenges and the hospital would offer medical treatment at subsidised prices to the couples.
“We recorded the video and fortunately, we won a free IVF treatment. Several months after the procedure, we received our first baby. This was a miracle,” Nantambi recalls.

What exactly is IVF?
IVF is a procedure of having a baby that takes place outside a woman’s body (in a test tube) and no sex is involved.
There are numerous tests that a couple must undergo before the IVF treatment is administered. These include semen analysis, ovarian reserve tests, infection screening, genetic screening for sickle cells, other hereditary diseases test and a pelvic scan.
Nantambi recalls a time when her ovaries were stimulated using tablets and injections, a procedure at producing eggs for about two weeks.
According to Dr Joseph Nsengiyumva, a gynaecologist at Bethany Women’s Hospital, the eggs of a woman are removed from the ovaries and the sperms are taken from the man, using the Intra Cytoplasmic Sperm Injection. The injection is part of an IVF treatment cycle, where sperms are injected into each egg in a test tube to assist fertilisation, using very fine micro-manipulation equipment.
After a period of three to five days, Dr Nsengiyumva says an embryo is formed and transferred through a catheter in the cervix, using an ultrasound for accuracy into the womb.
“After the process, the woman is given progesterone vaginal pessaries in form of capsules for the luteal phase support, so that the lining of the uterus becomes thicker to prepare for the pregnancy,” he says.

Cautions
At this point, the expectant mother is cautioned against infections, heavy work, strenuous exercises, intercourse, sauna and must take medication as prescribed.
After the transfer of the embryos, Nantambi could not work because she was cautioned against using boda boda, travelling for long distances, standing for too long, bending or sitting, exercise, intercourse or sleeping on her stomach.
Dr Edward Tamale Ssali, a senior obstetrician or gynaecologist at Women’s Hospital International and Fertility Centre, says precautions are meant to reduce the risks of miscarriages. “Two weeks after the process, the woman should be able to test positive for pregnancy. “After conceiving, there is no specialised treatment and care for women who conceived by IVF because they are like any other pregnancies,” Dr Ssali says.
Women are encouraged to take folic acid like those that conceive naturally, except that they may need to take a few hormonal treatments.

More than one baby
Also, a couple may ask for two or more fertilised eggs to be inserted, but this can only be done after an assessment to show that the womb can accommodate them without any difficulty.
“We can do more than one baby. But some foetuses shrank from the womb and a few may remain. In medical school, we are taught that you can reduce the number of foetuses to reduce the chances of the mother miscarrying. If the uterus becomes overloaded, the cervix opens and the mother is at risk of losing the babies,” Dr Ssali explains.
Two of Nantambi’s embryos shrank and she remained with only two. Today, she is a mother of two beautiful baby girls, aged two.

Costs involved
According to Dr Ssali, the cost of undertaking IVF depends on a number of factors including the causes of failed conception, the processes involved, treatment and the age.
“There may not be a fixed cost but the whole process may cost you about $ 5,000, approximately Shs18.5m. A couple may pay less or more, depending on the complexity of cases,” Ssali says.

Causes of failed conception
About 15 per cent of the women fail to conceive naturally, because of several defects suffered by both males and females.
Dr Ssali says: “Defects that lead to failed conception can be polycystic ovary syndrome (PCOS) and blocked fallopian tubes in women, due to infections. These contribute about 60 per cent of failed conceptions.”
Fifteen per cent of women that suffer miscarriages, develop blocked tubes, according to Dr Ssali. This contributes to 50 per cent of infertility rates among women in Uganda.
He adds that infections after termination of pregnancies can also lead to failure to conceive among most women. Some fibroid operations instead cause tubal blockage. Low sperm count in men contributes 30 per cent of impotence.
He also mentions a case of a girl who underwent premature menopause as early as 19 years. Such abnormalities are another cause of infertility in women.
Polycystic syndrome (PCOS), a problem with hormones that affects women during their childbearing years, also causes blocked tubes. Reports reveal that many women suffer this infection unknowingly, but its causes are also unknown.

Other Assisted Reproductive Techniques
The IVF is the commonest treatment for treating infertility in women with blocked tubes or men with low sperm count.
Hormonal treatment, one of the assisted reproductive techniques is recommended for women who have irregular periods and have ovulation challenges.
Dr Ssali recommends Intra Uterine Insemination (IUI) for cases of men that suffer from erectile dysfunction. “It is also an option for men who want to continue having children even when they are away on long-term missions such as military duties. In such cases, a sample of the man’s sperms is drawn, kept safe and inseminated into the partner’s uterus, after the agreed spacing.”
Also men that suffer from scrotal cancer, leukaemia and cancer of the pancreas but want to give birth usually have their sperms drawn before they undergo treatment and are kept for future use.
This is because radiations which are involved in the treatment of these cancers affect the quality of sperms.