For many couples, the excitement of choosing baby names, imagining tiny clothes and dreaming about midnight feedings comes naturally.
Parenthood is not just expected, it’s deeply desired. But for some, the journey to that dream becomes a quiet struggle marked by uncertainty, loss and waiting.
When pregnancy doesn’t come, or worse, when it comes and ends in miscarriage, it can leave couples with a grief that is hard to explain and even harder to carry.
For women, especially, it begins to challenge identity, confidence and sometimes, the very foundation of a marriage.
For Rebecca, 26, this reality has become painfully familiar. She and her partner Peter, 29, have been trying to have a baby for the past three years.
But instead of celebrating new life, they have suffered three consecutive miscarriages: one in 2023, another last year and again this year. Each time, the loss has cut deeper.
After the third miscarriage, Rebecca underwent a hysterosalpingogram, a special X-ray that looks at the uterus and fallopian tubes.
It was during this test that doctors discovered she has bilateral hydrosalpinx, a condition where both fallopian tubes are filled with toxic or infected fluid.
“The doctors told us that this fluid can leak back into the uterus and make it nearly impossible for an embryo to implant and grow,” Rebecca said.
“That’s likely what’s been happening all along, the embryos never had a chance.”
To increase her chances of carrying a pregnancy to term, doctors advised that Rebecca undergo a procedure to block the tubes from the uterus.
It’s a minimally invasive surgery, either hysteroscopic or laparoscopic, but with one major consequence: Once the tubes are sealed, natural conception is no longer possible.
The plan also includes cleaning the uterus to clear any infection or inflammation caused by the miscarriages.
Doctors will use PRP (Platelet-Rich Plasma) made from Rebecca’s own blood, and inject it into her uterine lining to help strengthen it and improve the chances of embryo implantation.
“After they seal the tubes and prepare the uterus, we’ll start IVF. That means I’ll begin hormone injections on the second day of my cycle to stimulate my ovaries, then go for ultrasounds every few days to monitor the egg development.” Rebecca said.
Once the eggs are mature, doctors will collect them through a procedure done under sedation, and Peter’s sperm will be collected the same day.
The fertilisation takes place in the lab, and the resulting embryos are grown in an incubator for several days before being frozen. In a future cycle, Rebecca’s body will be prepared for the embryo transfer.
“If we get several good embryos, we’ll freeze the extras. That’s a relief because it means we don’t have to go through the whole process again if we want more children later,” she said.
HOPE AFTER DESPAIR
While Rebecca’s journey is just beginning, Mary Nyokabi’s has come full circle, but not without years of pain.
Now 42, Mary got married at 26 with the hope of quickly starting a family. But month after month turned into year after year with no pregnancy. For 15 years, she faced the agony of unexplained infertility.
“You start to question your womanhood. The silence, the looks, the questions... they say nothing, but they say everything. You begin to doubt yourself,” she said.
After many tests and disappointments, Mary was diagnosed with blocked fallopian tubes, a condition that made natural conception almost impossible.
She and her husband tried everything from hormonal therapy to traditional remedies, but nothing worked. The emotional toll was immense, and the fear of losing her marriage became very real.
“I’d be lying if I said I wasn’t scared he might give up,” she admitted.
“There’s this unspoken pressure. You feel like you’re the problem. But he stood by me.”
Four years ago, after exhausting every other option, Mary and her husband turned to IVF. It was a difficult decision, especially financially, but one they were ready to try.
“It was expensive. It was emotionally exhausting. But we had to try,” she said.
The procedure worked. Mary became pregnant, and today, their son is three years old.
For Priscilla Muendo and her husband William Muendo, the journey to parenthood was long, uncertain and emotionally taxing.
But today, sitting side by side with smiles lighting up their faces, the couple shares a testimony filled with hope, one that’s now doubled with the anticipation of their second baby, conceived through In Vitro Fertilisation (IVF).
Married for six years, the couple from Kasarani had faced a deeply painful struggle with infertility. Just like Mary, Priscilla was diagnosed with blocked fallopian tubes, a condition that makes natural conception nearly impossible.
“I thought I would never conceive. It was heartbreaking. But we sat down, talked about it and decided to go for a consultation,” she said
Their journey led them to a fertility clinic where, after a series of consultations and medical tests, IVF was recommended.
On November 18, 2022, Priscilla underwent her first embryo transfer. Nine days later, too anxious to wait, she took a pregnancy test at home and it was positive.
“We couldn’t believe it at first,” William said.
“It didn’t feel real. But when we went to the hospital and the results were confirmed, we were overwhelmed with joy. It actually worked.”
Priscilla’s first pregnancy through IVF was carefully monitored by Dr Sarita, who supported the couple from conception through delivery. Today, their first IVF baby is a healthy two-year-old and now, they are expecting their second.
“Every case is different. You have to take that first step. Go for consultation,” Priscilla advised other couples facing similar challenges.
“You’ll be tested, diagnosed and from there, you can find the right treatment. Whether it’s IVF or something else, there’s always a way forward.”
COMMON BUT STIGMATISED
In Kenya, infertility is more common than many realise and far more stigmatised.
Dr Sarita Sukhija, a fertility specialist at Myra Fertility Centre, says recent statistics indicate that one in five couples struggles with infertility, and about 4.2 million Kenyans require medical intervention to conceive.
Despite the scale of the problem, infertility remains a topic rarely spoken about openly. Many affected individuals suffer in silence, burdened by societal pressure, cultural expectations and misinformation.
This silence has allowed infertility to grow into a hidden epidemic, where judgment and stigma often replace support and understanding.
Rather than turning to qualified medical professionals, many couples resort to religious or traditional healers.
Cultural beliefs and fear of being ostracised discourage them from seeking proper diagnosis and treatment. The absence of open conversations around fertility challenges leaves those affected feeling isolated, ashamed or broken.
Yet infertility is a medical condition, not a curse, failure or secret to be hidden.
“Infertility is defined as the inability to conceive after 12 months of regular, unprotected intercourse,” Dr Sukhija said.
She emphasised that infertility can affect both men and women, and the causes are wide-ranging.
In women, issues may stem from blocked fallopian tubes, uterine abnormalities such as fibroids or polyps, cervical conditions like stenosis or polyps, or ovarian disorders that interfere with ovulation.
In men, infertility may result from sperm production or motility problems, hormonal imbalances, infections or anatomical defects.
Age is also a factor for both sexes, and shared environmental exposures, such as toxins, substance use and lifestyle habits, can contribute significantly.
“It’s imperative that both partners undergo a thorough fertility evaluation,” Dr Sarita emphasised.
“Infertility is not a 'woman's issue'; it's a shared concern that requires a joint approach.”
The good news, she said, is that infertility is often treatable, thanks to advancements in reproductive medicine.
Options Dr Sukhija cited include Assisted Reproductive Technologies (ART), such as In Vitro Fertilisation (IVF) and Intrauterine Insemination (IUI).
Others are treatment of infections, surgical procedures, such as tubal repairs, ovulation induction therapies.
Also doable are lifestyle changes, including improved nutrition, stress management and cessation of substance use.
“With timely and appropriate interventions, many couples can go on to achieve their dream of parenthood,” Dr Sukhija said.
Despite these medical options, social narratives around fertility still place overwhelming pressure on women in particular.
One of the most enduring and misleading concepts is the so-called “biological clock”.
Dr Sukhija says the idea of a biological clock is scientifically incomplete and socially loaded.
She said fertility decline is not abrupt but gradual, and varies greatly from one individual to another.
“The word ‘clock’ can be misleading as it implies a ticking time bomb when, in reality, fertility decline is more like a dimmer switch than an on/off button,” she said.
Biologically, the components of the so-called clock are egg quantity (ovarian reserve), egg quality and timeline of reproductive health.
It’s true that fertility tends to decline from the mid-30s onward, but that doesn’t mean it vanishes overnight.
At Myra IVF Centre, for example, eggs can be preserved for up to 12 years, offering women more control over their reproductive timelines.
UNSOLICITED ADVICE
Societal pressure often masquerades as biological advice, pushing women to have children at “the right time” regardless of their personal or medical readiness.
While age does play a role in fertility, the fear-based narrative surrounding it lacks nuance and compassion.
Dr Sukhija said this misrepresentation contributes to a range of myths.
“Many people believe, incorrectly, that fertility ends suddenly at 35, or that women who are not pregnant by 30 have missed their chance,” she said.
“It's time we stop using biological clock as a warning bell and start having informed, respectful and supportive conversations about women’s reproductive health. Science is evolving, and so should our narratives.”
She indicated that infertility does not always stem from external or age-related causes. For many women, it is the result of complex medical conditions, such as Polycystic Ovarian Syndrome (PCOS).
While PCOS is commonly associated with irregular periods and the presence of ovarian cysts, it is, in fact, a much deeper endocrine disorder that affects various aspects of a woman’s physical and emotional health.
A study conducted at Kenyatta National Hospital found that 37.4 per cent of women presenting with irregular cycles were diagnosed with PCOS.
Globally, the World Health Organisation estimates that 6-13 per cent of women of reproductive age are affected by the condition. Yet, PCOS remains poorly understood and frequently underdiagnosed.
“PCOS is a hormonal imbalance that disrupts the natural ovulation process. As a result, ovulation may rarely or never occur, leading to irregular cycles and difficulty in conceiving.” Dr Sukhija said.
