The Crippling Financial, Emotional Cost of Infertility in Kenya

I knew having a child would be expensive, but I had no clue how expensive trying to have one would be until my husband and I discovered we needed fertility assistance. One of the most difficult components of the procedure was dealing with the emotional and financial burdens that came with in vitro fertilisation (IVF).

During the four years it took my husband and I to conceive a child, I spent countless hours on the phone with health insurance providers, pharmacists, doctors, and even trying herbal medicine in an effort to first grasp what exactly we were going through and how to achieve what we needed - a child. It's not the most enjoyable experience.

This is part of *Sarah’s (name withheld for privacy reasons) account of her journey with fertility treatment, an all-too-familiar script for many Kenyans who privately have to deal with infertility and the associated costs.  

Millions of child-bearing couples are affected by this globally with the major barrier to modern fertility treatment being the highly prohibitive cost, which is worsened by the limited number of treatment centres.

Any couple that has dealt with infertility understands how costly it can be. Some couples are forced to a never-ending series of sessions, tests, and surgeries, leaving them bankrupt and still unable to conceive.

Infertility is a prevalent reproductive health problem that affects more than 15% of couples during their reproductive years worldwide, according to statistics.

According to the open access journal, Reproductive Biological Endocrinology, infertility impacted 48.5 million couples globally in 2015. A study by the World Health Organisation (WHO) further reveals that one out of every four couples in developing countries suffers from infertility.

Continue reading and let's unwrap this together.

How Much Does Fertility Treatment Really Cost?

Fertility treatment is undeniably costly. To put it in other words, good treatment - including all checkups, as well as counselling from a reproductive specialist – is not cheap.

IVF is one of the two most common fertility treatments. Under this option, eggs are taken from a patient’s ovaries and fertilised by sperm in a lab and when they develop into embryos the doctor puts between two to five embryos into the uterus. 

The other common option is intrauterine insemination where healthy sperm is collected from a partner or donor and directly inserted into the uterus when the patient is ovulating. 

There are many other options including but not limited to the use of donor eggs, surrogacy, egg freezing, medications to induce ovulation and other fertility drugs.

The cost of IVF can vary with estimates ranging from between Ksh200,000 to Ksh800,000. The average cost of standard IVF treatment in Kenya is Ksh400,000.

Don't be lured by the many "cheap IVF" adverts out there. While reduced quoted pricing may appear enticing, it's vital to understand what's included, what services are designated "add-ons," and how much you'll have to pay upfront.

“The consultation comes at a cost. Then there's the fee of determining the woman's hormonal profile, which might vary between Ksh12,000 and Ksh15,000. My husband had to undergo a sperm test as well which was Ksh5,000. I wouldn't use my experience as a case for everyone but, the cost of IVF will vary depending on how many cycles/sessions you will be required to undergo for success. A session might cost you more  than Ksh350,000." Sarah says.

“Before I had IVF, Intrauterine Insemination (IUI), a procedure that costs roughly Ksh70,000 and requires injections, was tried. If you're lucky and it succeeds on the first transfer, you could definitely get through the entire operation without parting with a lot of cash.”

“We weren't so lucky.” She added.

The cost of IVF treatment can vary depending on a number of factors, including:

• Hospital Charges
• Doctor's fees
• Type and quality of implants/consumables used in IVF treatment 
• Medical condition after IVF treatment
• Recommended lab tests following IVF treatment

A Breakdown of Fertility Treatment Costs

A fertility centre will estimate the cost of the IVF procedure, which includes egg harvesting, laboratory fertilisation, and implantation of the fertilised egg into a woman's uterus. 

The medication, which promotes the production of several eggs and, later, assists your body in receiving and accepting a fertilised egg, comes at an additional cost. The medication will cost you between Ksh350,000 and Ksh500,000.

Some patients may also prefer to have the embryos genetically tested to ensure that they are transferring a healthy embryo. Preimplantation Genetic Testing (PGT) is a procedure that may be recommended if you have had a previous miscarriage, or have a complicated past medical history. It might cost between Ksh150,000 and Ksh300,000.

When looking for an affordable IVF facility, ask if any of these expenses are included, and if so, how much they cost;

• Ask if the price they quoted includes key processes such as a baseline blood test and an ultrasound to start your cycle.
• Whether you can schedule as many in-cycle monitoring appointments as your cycle requires as possible.
• Enquire about every single laboratory procedure that will be required.
  

Because navigating all this alone might be challenging, it is critical to meet with a fertility service provider to evaluate the data and acquire actual answers that you may need.

The Emotional Cost of Infertility

Infertility and its complications, such as miscarriages, can have a detrimental effect on a person's overall health and quality of life. Many couples who want to start have a child but are unable to do so will experience psychological and interpersonal distress.

One of the most common reasons for a couple's separation is infertility according to a 2020 study that was published in the International Journal of Reproductive Biomedicine.

According to the peer-reviewed journal, Clinical Therapeutics, up to 60% of patients struggling with infertility have experienced psychiatric symptoms, with significantly higher levels of worry and despair than those who aren't. Research published in the BMC Women's Health journal also found that depression affects approximately 41% of women with fertility issues. 

“We felt as if we were alone in the entire world going through this since we had no one to talk to because it was such a strange issue that most people had never heard of then.

Because we were at the age where people expected us to have children, questions from friends and family became heavy and many.”

“Although some of them were genuinely concerned for us, the more they asked, the more it was increasingly difficult to bear. Especially  because we were doing everything we could, to make it happen.” 

“We faced the pain alone most especially due to the taboo surrounding infertility,” recalls Sarah.

For Sarah and her husband, their journey to beating infertility and getting a child cost them close to Ksh1 million in total. 

However, although the costs really impacted their finances, according to her, the process was a moment in life where the emotional costs outweighed the financial ones.

How Can You Navigate These Costs?

1. Contact your insurance company before going to a fertility treatment centre

The first thing you should know before going to a fertility clinic is whether your insurance covers fertility and, if so, what kind of coverage they give.

Barbara Collura, president, and CEO of Resolve advises, "Speak with the insurance providers and find out exactly what is covered from your health insurance if you have health insurance or via your or your partner's insurance." 

Ask your insurance agent the following questions if your fertility treatment is included in your coverage:

• Is the cost of initial consultations covered, and, if so, how many? (This may help you determine whether you'll be able to visit several hospitals before deciding on one.)
• Is insurance going to pay for diagnostic testing? While I.U.I. and I.V.F. procedures may not be covered, blood tests and ultrasound monitoring may be.
• Is medication covered, and if so, does it have to be obtained from a particular pharmacy?
• What types of procedures are covered? Is in vitro fertilisation (IVF) and intrauterine insemination (IUI) covered?
• Is there a waiting period before being eligible for I.V.F.?
• Is it necessary to begin with specialised treatments, such as I.U.I.? (Some insurance companies require a few months of attempting to conceive or a specific quantity of I.U.I.s. before beginning I.V.F.)
  

If you do not have health insurance, consider getting one or start saving up. The costs might add up very quickly.

2. Make a financial strategy after you've gathered expense information

After contacting your health insurance provider, you're weighing your financial options. 

It's critical to know the exact cost of your IVF treatment and other reproductive procedures so you know where your money is going and how much you'll have to spend out of pocket.

Setting financial and medical goals with your partner and doctor at some point during the process is a smart idea. Consider how many I.U.I.s you may try before proceeding to I.V.F., as well as how many I.V.F. cycles you will go through.

Most people will require more than one round of therapy, but it is difficult to predict how many cycles you will require. Some studies suggest that most women can get by with three, while others suggest that the number should be closer to six.

3. Recognize that you may require rest.

Medical specialists recommend frequent breaks. Breaks are taken in between treatments for a variety of reasons, including economical, physical, and emotional ones.

WRAPPING UP

Infertility, or the inability to conceive or carry a baby to term, is a painful experience for many people, financially, mentally, and physically.

"At long last, we had our son. The entire journey of attempting to become parents was dark and difficult, but today I can look at my baby and feel so much joy and peace.” Sarah remarks

Don't give up! There is a glimmer of hope at the end of the tunnel.