Aaron Nicodemus
Most baby albums begin with a picture of a tiny baby held proudly in the arms of a tired mom. But Pieter and Mandy de Graaf’s pictorial record of their twins starts with fertilised eggs.
The couple are among the few South Africans who can afford to overcome infertility.
Because it is expensive and is not covered by medical aid, treatment of infertility is restricted to a minority. It is also fraught with ethical dilemmas and has low odds for success.
The De Graafs began their search for treatments four years ago, when they learned that Mandy has endometriosis, a disorder which renders her infertile.
Mandy endured hours of medical examinations and proceedures while Pieter had his sperm tested. Mandy was artificially inseminated unsuccessfully with Pieter’s sperm three times.
Then Mandy had an egg fertilised with Pieter’s sperm implanted in her. It was physically painful and, when it failed, emotionally devastating.
The couple went to the Brenthurst Clinic in Parktown and gave in-vitro another try. This time, despite a 70% failure rate, it worked. The De Graafs have their reward: twins, Dale and Kendra. “It’s been a blessing,” said Mandy.
As the couple count their blessings, Pieter tallied the cost. They spent about R55 000 on infertility treatments, here and in the United States.
South Africa’s foray into infertility treatments is relatively new, and is still small scale. Gauteng has six fertility clinics and Cape Town three. There are only four in the rest of the country. There are no statistics on how much money is spent on infertility treatments annually.
At Brenthurst, framed baby pictures hang on the walls. The clinic’s real gallery, however, consists of computer-generated photocopies in the laboratory. The images are of successfully fertilised and implanted eggs, with the names of parents pencilled in.
And when a baby is born, the entire staff rejoices. “We say the baby was made with love,” says Aziza Cassim, a counsellor.
But the ethical dilemmas surrounding infertility treatments are numerous. Since most procedures implant three or more fertilised eggs into the womb, do you “cull” out eggs if more than two are implanted successfully? Or do you run serious health risks to mother and children with multiple births?
Brenthurst, like many fertility clinics, has its own sperm bank. Its donors are mostly university students. According to reproductive technologist Elsie McDonald, mothers can choose the race, education and even eye colour of their prospective sperm donors.
By law, donors cannot receive money for donating bodily fluids, but McDonald says the clinic “pays their expenses”, like transportation. But when pressed, she would not elaborate. The clinic also has an extensive donor list from Denmark.
Sperm banks beg the question: what are the ethical dilemmas of picking out a stranger’s sperm? What are the implications of choosing an egg or sperm based on the desirable characteristics? With ever- sophisticated techniques, can genetic engineering of humans be far away?
Then there is the cost. Artificial insemination is a relatively cheap procedure – costing from R400 to R600 – but its failure rate is about 90%. More complicated procedures, like in- vitro fertilisation, can cost up to R10 000, even if it does not work. Micro- insemination involving lasers can cost up to R12 000.
Medical aids will not cover infertility treatment because it is not considered essential to health. According to Medihelp (a Pretoria-based medical aid) general manager Anton Rijen, “preference is given to health care services which are life-saving or life-sustaining and which benefit the majority of members”.
Yet if you ask the De Graafs if it was worthwhile, you don’t need to listen for their answers. Simply look at the glow on their faces.