Thulani gazes at his new-born daughter with a mixture of elation and wonder. His phone rings and he answers: “I can’t talk now. Khanyi has just given birth to a baby girl!”
He sounds like any proud first-time father. But Thulani and Khanyi* are no ordinary couple. Their journey to parenthood has been fraught with risk. It has also cost them dearly — both financially and emotionally.
Thulani discovered he was HIV-positive in 2007. He could not believe it. He and Khanyi were about to start a family, but suddenly it seemed as if their dream was shattered. Khanyi was HIV-negative: How could she become pregnant without risking exposure to the virus?
The couple kept “praying to God” for help. Finally, in 2008, an internet search led them to the Vitalab Fertility Clinic in Morningside, Johannesburg. The clinic’s website looked promising: it seemed that couples like them could become parents after all safely.
Doctors warned Thulani and Khanyi that the treatment would not be cheap and it wasn’t. “We took money from our savings, we took loans. We did all we could. The only thing we wanted in the world was a child,” says Thulani.
There was also the fear factor: Thulani recalls his concern when he learned he would have to start taking ARVs before he and Khanyi could have a child. “It looked scary.” Eventually, in 2010, the couple was ready to try for a baby. Their first two attempts — which involved washing Thulani’s sperm and then injecting it into Khanyi’s ovaries — were unsuccessful and the Vitalab medical team decided to try plan B.
They used a laboratory process called intracytoplasmic sperm injection, during which Thulani’s sperm was injected into eggs from Khanyi’s ovaries.
It worked but the process cost them R50 000 — no small sum for a couple living on a teacher’s salary.
“With faith anything is possible,” says Khanyi. “Today I am holding my baby girl. I can’t even put her down. I am so happy to be a mother.” Vitalab spokesperson Dr Merwyn Jacobson says treatment for HIV-positive couples can cost between R28 000 and R60 000, depending on how many attempts are needed.
He says that attitudes towards HIV have changed for the better: “HIV-positive people can lead a long and happy existence with an average life expectancy,” he says. “There is no reason why their lives cannot include the joy of raising a family.”
Professor Augusto Semprini pioneered fertility treatment for HIV-positive couples in Italy in the late 1980s. But it was only in 2008 that the Cape Fertility Clinic in Claremont, Cape Town, opened the first dedicated laboratory in South Africa. A handful of other clinics, including Vitalab followed.
The demand grew so dramatically that, in April this year, Vitalab opened its own special laboratory, dedicated to helping couples with viral diseases such as HIV and hepatitis B and C. The laboratory is the first of its kind in Gauteng.
Vitalab’s approach is holistic and involves specialists, counsellors and embryologists. Couples are screened before they are accepted in the programme and are counselled at every stage. This, Jacobson says, ensures maximum protection for potential parents and their unborn child. But most South Africans cannot afford the services of such clinics.
Caroline Nenguke, media officer for the Treatment Action Campaign, believes reproductive care is a basic human right. “If some state hospitals can provide IVF [in vitro fertilisation] to people who are HIV-negative, I don’t see why these hospitals cannot also provide the same service for couples who are HIV-positive,” she says.
Nenguke’s view is shared by a number of HIV/Aids activists but some feel it is unrealistic to expect the state to cover such costs while there are so many other competing health needs.
In 2009 researchers from Wits University and the Human Sciences Research Council sparked debate at the Southern African Aids Conference in Durban when they presented the results of a study of “HIV-discordant” couples in South Africa, Tanzania and Ukraine. The term refers to couples where one partner is HIV-positive and the other is not. The study found that 74% of these couples without children wanted them, whereas 36% of those who were already parents wanted more children.
“The high proportion of HIV-positive individuals and discordant couples who desire children reveals a need for explicit HIV policies recognising the reproductive rights of people living with HIV, and respect for the choice of individuals and couples who desire children,” the study recommended. Thulani and Khanyi have started saving again. They want to try for another child.
*Names have been changed for the sake of confidentiality