“My life has dramatically changed thanks to the new medicine and new technologies. I could not have imagined becoming a mother after six years of marriage otherwise,” said Salma Safwat, the mother of a one-year-old daughter called Judy. 

There are many medical technologies out there that can save lives and make lives better, but IVF, or in vitro fertilisation, is an amazing procedure that involves bringing new life into the world when all other attempts have failed.

“It’s God that I am forever grateful to,” said Safwat. She gave birth to her daughter after trying to conceive for six years. The 39-year-old mother then made several attempts with IVF, and she could scarcely believe it when she eventually found out that she was pregnant.

It did not bother Safwat to go through all the IVF procedures, which can include side effects such as mood swings, depression, hot flushes, and the rise and fall of hormones. However, it did bother her spending years not being able to have a baby of her own from her beloved husband. 

When the couple found out that there was a problem with infertility, they approached many doctors and tried many other treatments. At last, they resorted to IVF three times until they were successful.

“We never blamed each other, and we never thought about breaking up or getting separated. We went through the journey standing firmly altogether,” Safwat added, hinting at the psychological stresses that couples may endure for not being able to conceive. 

“Stress, societal pressure, and social anxiety can affect newly married couples who are not able to conceive,” said Nehal Ahmed, a gynaecologist who works in a fertility unit in Alexandria. 

According to a study conducted by US researchers Kristin Rooney and Alice Domar in 2018, it is estimated that one in eight couples have problems getting pregnant or sustaining a pregnancy. What makes matters worse is that the problem can get larger when women do not share their story with family or friends, thus increasing their psychological vulnerability. 

The inability to reproduce naturally can cause feelings of shame, guilt, and low self-esteem, the study concluded.

Anyone who is commencing an IVF journey must prepare themselves mentally, psychologically, and socially. They must know what is coming and what they might feel. 

“Any patient undergoing IVF treatment may have feelings of sadness, anger, despair, frustration, guilt, jealousy, excitement, hope, and/or happiness. It is common for both the male and female partner to experience depression, anxiety, and stress prior to treatment commencing,” said Ahmed who has been working in the field for more than 15 years.

There are many misconceptions around infertility. “Infertility is failing to conceive for a year and a half with regular intercourse. The couple must live together and have regular intercourse but still not be able to conceive. We might also see patients whose husbands are out of the country or who do not see each other for six months. We might also get couples who were not able to conceive in the first three months of getting married,” she added.

“People in Egypt can be in a hurry to get pregnant, and not all cases like those above are cases of infertility,” Ahmed said, adding that some popular proverbs, sadly rooted in society, are not correct, like the saying that you must have another child if there are marriage problems, so that this baby can solve them.

“Married couples should only resort to IVF if there are serious medical issues that have to be solved by intervening medically,” Ahmed said.

“I remember a case of a woman who was very depressed because she had lost her three-year-old daughter. Both parents were very down, and their only solution was to undertake IVF to give birth to another child. I remember how we all sympathised with her and how happy we were for her to conceive again and bring another little daughter into the world,” she added.

IVF certainly gives hope to those who may be hopeless and have serious medical problems. Ahmed also mentioned the importance of egg freezing, saying that it can give hope for women who are over 35 to conceive later.

“Age is a key factor that should be considered when it comes to the quality of the eggs. If a woman married late and is trying to conceive, eggs frozen in the lab could be a good option for her,” she added.

She said that there may be other cases where freezing eggs is a good idea if the patient is undergoing chemotherapy or other therapy for cancer or other diseases. 

Such awareness of the various fertility treatments available nowadays gives hope not only to Egyptians but also to many Arabs who may come to Egypt for treatment as a hub of advanced medicine in many fields.

In comparison to the costs abroad, fertility treatments in Egypt are relatively inexpensive. Medically advanced treatments are very efficient, and the professional expertise available among Egyptian doctors attracts many Arabs, especially Libyans, Saudi Arabians, and Sudanese. 

“I came all the way from Benghazi in Libya to have IVF treatment here in a fertility unit in Alexandria. I come regularly every week to follow up with my gynaecologist, and I receive the best care ever,” said Lobna Fathi, a 41-year-old mother. 

“I have been trying to conceive for ten years, and I approached many clinics in Libya. However, many family members advised me to go to Alexandria to a certain clinic to receive fertility treatment and undergo IVF procedures,” Fathi added.

After a few months, she was overwhelmingly happy at the great news that she will be having her wished-for baby. Now Mohamed is two years old, and Lobna is willing to undergo another round of IVF treatment in Egypt with the same doctor in the hope of having another child.  

“I found a great difference when it comes to the care the doctors and the nurses provide in Egypt in comparison to elsewhere,” she added. She said that she had received systematic care when following up with the IVF procedure as the doctors in Egypt follow up day-to-day care in every step they make.

In many countries worldwide, between three and six per cent of all children are now conceived by IVF. Since 1980, the procedure has spread widely, from UK national Louise Brown, the first person to be born through IVF in 1978, until today.

IVF has significantly changed the lives of many individuals and couples by offering solutions to various fertility issues. These solutions include “expanded family options, genetic screening, and increased awareness as the process has brought more awareness of fertility issues, helping to destigmatise the struggles many face, encouraging open discussions, and promoting support networks,” said Professor Emadeddin Khalifa, professor of obstetrics and gynaecology at Alexandria University.

He added that IVF has opened pathways for alternative family-building options such as egg or sperm donation and surrogacy, giving individuals and couples more choices in how they start their families.

However, he said that there might be emotional and psychological impacts for IVF-using couples. While IVF can be a hopeful option, it can also bring emotional challenges, including stress, anxiety, and financial pressures. Many people seek counselling and support during the process.

After a failed IVF treatment, doctors often experience a deep sense of empathy for their patients. “We recognise the emotional pain and disappointment that comes with unsuccessful treatment,” Khalifa added.

“However, we take failures as learning opportunities. We review the failed cycle with our team, discussing potential changes to medication dosages, embryo selection, or timing to improve future attempts.”

As much as an IVF procedure can be a source of hope, it can have its dark side too. “There are certain risks of ectopic pregnancy, which occurs when an embryo implants outside the womb. There are also risks involving the egg retrieval process, as this involves a minor surgical procedure that carries risks such as infection, bleeding, and damage to surrounding organs,” Khalifa added.

He highlighted the importance of having prepared for IVF treatment by adjusting one’s lifestyle, including through a diet rich in vitamins and minerals and emotionally preparing to maintain a positive outlook.

* A version of this article appears in print in the 5 December, 2024 edition of Al-Ahram Weekly