For some Nigerian couples battling infertility, the path to having children can mean years of waiting, repeated treatments, pregnancy losses and financial sacrifices, with IVF offering hope that many struggle to afford.
For 13 years, Mr and Mrs Bohan waited.
From 2001, the couple tried to have a child, undergoing different tests and treatments without success. Years passed, but the pregnancy they hoped for did not come.
In 2013, after more than a decade of trying, they sought help at a Nigerian fertility centre, where they underwent assisted reproductive treatment, including egg retrieval and embryo transfer.
The following year, their long wait ended.
On August 14, 2014, the couple welcomed triplets, a boy and two girls.
For the Bohans, parenthood came after 13 years of uncertainty, medical intervention and waiting.
Their experience is one of the many journeys behind Nigeria’s growing fertility treatment industry, where couples who have spent years trying to conceive are increasingly turning to assisted reproductive technology, including in-vitro fertilisation (IVF).
But behind every successful treatment is a less visible story of investigations, repeated attempts, emotional strain, pregnancy losses and, for many families, the difficult question of how to pay for treatment.
A single IVF cycle in Nigeria typically costs between about N1.2 million and more than N4 million, depending on the clinic, medication and treatment plan, according to BusinessDay’s earlier reporting.
For couples who require more than one attempt, the financial burden can quickly run into several millions of naira.
And because fertility treatment is largely paid for directly by patients, the ability to pursue parenthood can depend as much on a family’s finances as on its medical needs.
The World Health Organisation estimates that about one in six people of reproductive age experience infertility during their lifetime, while access to fertility care remains particularly difficult in low- and middle-income countries. WHO says fertility treatment is rarely prioritised in national health financing and can result in significant financial hardship for patients.
For Nigerian couples, the statistics become real when the years of waiting begin to accumulate.
Six years, then twins
For Esther Ibika and her husband, the wait lasted six years.
Both medical professionals, the couple had spent years struggling with infertility before seeking help at Nordica Fertility Centre, according to a testimonial published by the centre.
Ibika described the experience as an emotional, psychological and financial “roller coaster”.
Eventually, treatment resulted in the birth of twins.
Read also: Rising IVF costs put parenthood beyond the reach of many Nigerians
The couple kept their pregnancy test strips as a reminder of the moment they finally saw the positive result, according to the testimonial.
Their story did not end there. The couple later expected another child, which Ibika described as another blessing after years of uncertainty.
For couples like the Ibikas, however, the cost of infertility treatment extends beyond the hospital bill.
There are consultations and investigations before treatment begins. There are medications, procedures and follow-up appointments. For some couples, there are repeated cycles. For others, there are pregnancies that end in miscarriage or premature birth, forcing them to confront the emotional and financial burden all over again.
When IVF success does not mean the end
Mrs Uju’s experience illustrates another dimension of the journey.
After considering IVF options in India, she was introduced to a Nigerian fertility centre through her sister-in-law and began treatment in 2011.
She subsequently welcomed a son, Kamsi, on January 5, 2012.
But her journey to motherhood did not end with her first successful pregnancy.
She later experienced a pregnancy loss and, in 2014, a premature loss involving triplets, according to her testimonial.
She returned for treatment in 2015 and eventually gave birth to twin girls.
Fertility treatment is not always a straightforward journey from procedure to baby, for some women, even after conception, the uncertainty continues.
There can be pregnancy complications, miscarriage, premature birth and the possibility of returning to treatment.
That reality is rarely captured by the simple phrase “IVF success”.
Nigeria’s fertility industry has grown as awareness of infertility and assisted reproductive technology has increased.
Dr Abayomi Ajayi, managing director of Nordica Fertility Centre, told BusinessDay that demand for fertility services has increased over the past five years, driven partly by greater awareness and rising male-factor infertility.
“First and foremost is awareness. The second factor is male infertility, which is increasing globally, and Nigeria is not an exception,” Ajayi said.
He said a study conducted by the centre found that about 12 percent of men who presented there had no sperm at all.
The growing demand, however, is colliding with Nigeria’s wider healthcare financing problem.
World Bank data show that out-of-pocket spending accounted for 71.9 percent of current health expenditure in Nigeria in 2023, underscoring the extent to which households remain responsible for paying directly for healthcare.
IVF is an especially stark example because treatment can cost millions of naira and may require more than one attempt.
For a household already dealing with the rising cost of food, housing, education and other healthcare needs, fertility treatment can become a major financial decision.
A couple may have to choose between using savings, borrowing from family and friends, selling assets or postponing treatment.
And unlike many other medical conditions, infertility comes with a social burden that can make the decision even more difficult.
The woman is often blamed
For many Nigerian women, the difficulty of having a child is not only a private family matter, It can become a public one.
Questions from relatives, pressure from in-laws, comments from friends, suggestions that the woman is responsible, and, in some cases, threats to a marriage.
WHO notes that infertility can cause significant distress, stigma and financial hardship and says women in particular can face social stigma, relationship problems, anxiety and depression. It also stresses that infertility can result from male factors, female factors, a combination of both or unexplained causes.
This makes male involvement in fertility investigations important.
Ajayi’s comments on male infertility are therefore significant because they challenge one of the assumptions that often surrounds childlessness in Nigeria, that the problem automatically lies with the woman.
The fertility journey is a journey for couples, not just women.
The stories of the Bohans, the Ibikas and Uju have something in common.
They all eventually became parents.
But there are thousands of other Nigerian couples whose stories do not have that ending, or whose journey is still ongoing.
Some cannot afford IVF, some stop after one unsuccessful cycle, some continue trying different treatments while others may never reach a fertility clinic at all.
That is why the question around IVF in Nigeria is becoming bigger than whether the technology works.
It is about who can afford access to it.
WHO’s 2025 global infertility guideline calls for fertility care to become safer, fairer and more affordable, noting that in some settings even a single IVF round can cost twice the average annual household income. The guideline also recommends integrating fertility care into national health strategies and financing.
For Nigeria, that raises difficult questions about what role health insurance should play, how fertility care should be regulated and whether couples struggling with infertility should continue to bear almost the entire financial burden themselves.
For every couple celebrating a successful IVF cycle, there are others still waiting… trying for two years, some five, some 10 or more.
Some have experienced miscarriages, some have gone through several IVF cycles, some have spent money they did not have, some have borrowed, some have sold property, some have given up and some are still deciding whether they can afford to try again.
That is why the conversation around infertility in Nigeria needs to move beyond success rates and treatment procedures to the people living through it.
Because behind every IVF bill is a family making a decision about how much it can sacrifice for the possibility of becoming parents.
And behind every statistic is a couple waiting for a phone call, a pregnancy test, a heartbeat, or simply the chance to hear a child call them “Mum” or “Dad”.
