By Barnabas Thondhlana
An advert calling for sperm donations created much excitement in the streets of Harare resulting in many young, unemployed men rushing for this “gold mine” which came as manna from heaven.
Not only is Zimbabwe going through a debilitating economic crisis, but unemployment hovers at 92 percent. For their troubles, all who donated sperm were rewarded with US$80, a small fortune for the penniless.
The call for sperm donations, which went viral, was from the In-Vitro Fertilisation Zimbabwe team led by Dr Tinovimba Mhlanga, whose clinic, pictured above, is now a hive of activity for childless couples crying out for a baby of their own.
For Penelope Ngandu, Dr Mhlanga is a God-send, an angel of hope and light in a dark tunnel of despair and desperation.
Penelope (not her real name), began the journey to pursue motherhood some 10 years ago. In the 10 years she and her husband Zelekia tried high and low for remedies to address their failure to conceive, to no avail.
The two consulted herbalists and prophets for cure, but all was in vain.
“It was both devastating and hurtful to realise that we were wasting our money seeking remedies which didn’t produce the solution we sought,” explained Penelope.
“And because we desperately wanted to conceive, the herbalists and prophets we consulted capitalised on our desperation.”
In many cultures, childless women suffer discrimination, stigmatisation and ostracism. This forces many infertile women in developing countries to conclude that without children, their lives are without hope.
Most African cultures, Zimbabwe included, demand that for a woman to be socially acceptable, she should have at least one biological child.
“During social gatherings, women talk a lot about their children or being pregnant. Those were the moments I felt extremely isolated,” said Penelope.
“So often, people do not regard you as human. Many-a-time I have overheard other women talking about me being cursed. Luckily for us, both our families understood our situation and reassured us that it wasn’t yet God’s time.”
As fate would have it, Zelekia’s female colleague was facing a similar fertility challenge. Together with her husband, they had undergone a successful in-vitro fertilisation (IVF).
IVF is a process of fertilisation by extracting eggs, retrieving a sperm sample and then manually combining an egg and sperm in a laboratory dish. The embryo is then transferred to the uterus.
“My colleague encouraged us to go through the same process. I discussed with my wife and then sought the necessary medical advice,” said Zelekia.
The couple was referred to Dr Mhlanga, an obstetrician and gynaecologist, who ran several tests, including hysterosalpingography (HSG).
The doctor established that Zelekia had no problems. Instead, Dr Mhlanga said Penelope’s fallopian tubes were blocked.
“Dr Mhlanga explained that there’s no way I was going to conceive normally with blocked fallopian tubes and recommended IVF,” said Penelope.
Although they were not financially prepared to go through the first cycle of IVF, the couple embarked on a quest to raise the required funds.
“We were desperate to have a child and we didn’t have money but it was done,” Tawanda said.
Locally, IVF costs between $3 500 and $4 000.
“We went through the process on August 26, 2018. We were administered a number of medications in preparation for the retrieval of eggs and sperms which was then done on September 24,” explained Chido.
“Then on September 29, implantation of the embryo was done.”
As standard procedure, Chido had to wait for 10 days before being tested for pregnancy.
“The waiting killed me. The 10 days felt like a year. I’m just glad that after my first IVF cycle, I became pregnant,” Chido said.
“I can’t explain the feeling but I thank God that I’m pregnant,” she said.
Between the 1980s and 1990s, a total of 52 babies who are now adults were conceived through IVF in Zimbabwe after it had been pioneered at The Avenues Clinic by Dr Tony Robertson.
Earlier last year, a baby boy was born through IVF at The Avenues Clinic since the procedure was reintroduced last year in the country.
Infertility affects up to 15 percent of reproductive couples worldwide.
Although male infertility has been found to be the cause of a couple’s failure to conceive in about 50 percent of cases, the social burden falls disproportionately on women.
Almost all cultures across Africa put pressure on the woman when a couple fails to conceive.
“For many infertile women, particularly those with problems such as blocked or severely scarred fallopian tubes where surgical tubal repair is either not successful or not advisable, IVF can help,” advised Penelope.
The re-introduction of IVF has been made possible through the efforts of Dr Mhlanga, embryologist Tinei Makurumure and Sister Florence Marechera under the tutelage of Dr Robertson and Mrs Robertson.
The team is receiving help from partners in Australia who run a similar programme in Melbourne. The dominant image of IVF technology is that it is a tool for delivering little bundles of joy to parents who have been unable to conceive naturally.
According to a 2003 research by Health Care Women International on the fertility patterns of women in Zimbabwe, at least one in every four women of childbearing age suffers from some degree of infertility.
Zimbabwe has one of the world’s highest infertility rates along with other southern African countries such as Botswana, Namibia and Lesotho according to a 2010 World Population Prospect survey.
Dr Mhlanga said the sperm they were collecting was to be used for women who did not have sperm donors or husbands.
The potential mother receives treatment to stimulate the formation of follicles, after which Dr Mhlanga extracts eggs in the follicular fluid from the mother through aspiration under ultrasonic guidance in an operating theatre adjacent to the IVF Laboratory at The Avenues Clinic.
They are then passed in a tube through a hatchway between the theatre and the laboratory to embryologist Makurumure.
The eggs and sperm provided are then placed in a fertilisation medium in a dish in the laboratory.
A microscope video camera facility is one of the recent innovations introduced in The Avenues IVF laboratory and theatre.
“Through the microscope video camera facility, the patient is able to see which embryo is picked and we are able to explain why we have chosen one embryo over another.
“They are able to see everything as it happens in the laboratory while they are in the theatre,” Dr Mhlanga said.
Unused embryos are frozen for possible future use.
For Edith Moyo (36), the IVF clinic has given her a reason to live. Edith was kicked out of her Harare home by her husband after she failed to bear a child.
He said he had fallen in love with another woman who already had children, whom he later married.
Edith had lost faith in marriage – convinced that it was impossible without being able to bear children. She was thinking of becoming a nun.
“Being unable to bear children was clearly not my choice. It is unfortunate that our society regards it as a curse,” she said.
“I have forgiven my ex-husband for how he treated me, but there is need for people to change their attitude towards women who are infertile,” she said.
She is now going to be a single mother through IVF, convinced this is the best way for her after her tumultuous marriage.
In 1978, the first “test-tube baby” — Louise Brown — was born in Manchester, United Kingdom. The second successful test tube baby birth occurred 67 days later in India. And since 1981, more than five million babies have been born through IVF.
Since its infancy, IVF has been highly hogged by scrutiny and stirred up plenty of moral controversy and debate.
While IVF allow couples to conceive, this view of IVF has always been only one side of the story.
Not all IVF criticism hangs on bad outcomes. Others consider IVF innately wrong because it is “unnatural”. However, these critics have been silenced over time.
Some critics argue that IVF scientists are attempting to “play God”. In a statement from the Vatican, the Catholic Church states, “(Impregnation) must be carried out according to nature and through reciprocal and responsible love between a man and a woman”.
Others are worried that the so-called test-tube babies can be rejected as social outcasts.
The local IVF centre recently acquired a new version of the Intra Cytoplasmic Sperm Injection (ICSI) microscope which is used when injecting a sperm into an egg in the laboratory.
“This is used in cases where the sperm quality is such that fertilisation couldn’t occur without a direct injection of sperm into the egg,” explained Dr Mhlanga.
IVF pregnancy rate is 40 percent worldwide.
“We are pleased that our pregnancy rate matches the international standard,” he said.
However, Dr Mhlanga added that he feels depressed by the current IVF pregnancy rate.
“My job is gloomy at times when patients fail to conceive in the first cycle. But we encourage couples not to give up,” he said.
Unfortunately for most women in developing countries, infertility services are not widely available and IVF is unaffordable.
Many women without children continue to suffer from social rejection and are made to feel personally inadequate, says Betty Chishava, chairperson and Founder of Chipo Chedu Society, a support organisation for childless women.
For the past 18 years, Chishava has been lobbying for a shift from a negative societal attitude towards childless women through public education campaigns, counselling and empowerment of those affected by infertility.
Women at Chido Chedu Trust for Childless Women show off their wares.
“By virtue of being involuntarily childless, women are disadvantaged and marginalised. I have embarked on projects that seek to address problems arising from childlessness, starting with a change of societal attitude towards this issue as it leads to the breakup of marriages,” she said.
“De-stigmatising childlessness among all groups of people in Zimbabwe through increased awareness and acceptance of the problem has helped reduce the spread of HIV/AIDS. We have staged dramas with follow up discussion sessions all around the country. In rural areas I have tried to educate communities to assist childless couples by integrating them in all activities rather than neglecting them,” she said.
When a pregnancy fails to materialise, women are always blamed, said Chishava, relating the agony she had also been through for 25 years after failing to bear a child.
“I was publicly humiliated and my relatives and friends did not accept me. They even called me names just to remind me that I was a childless woman. But my husband was never provoked,” she said.
While women are easily ejected from marriages, men’s infertility is mostly concealed at all costs, with families sometimes going to the extent of clandestinely agreeing with the man’s brother to impregnate his wife and keeping it a secret.
This exposes partners to sexually transmitted diseases and has resulted in tragedy when the husband discovers what has happened.
“From sharing my experience with women who are barren, I realised that at times the pressure exerted on an infertile women can be too much and this puts some people at the risk of contracting HIV/Aids by having multiple partners in an attempt to fall pregnant,” Chishava said.
Chishava tries to replace the support childless women have lost through their families and community.