Dr Marienus Trouw, a gynaecologist sub-specialist in reproductive medicine, who practises at Netcare Pretoria East Hospital, checking on a newborn baby in the neonatal ICU at the hospital.

In a remarkable tale of human fortitude supported by advanced fertility treatment, one lucky couple was finally blessed with a baby after trying for 20 years to conceive. 

The joy was “indescribable” for Alex Dandadzi and Eleanor Mukura, when Eleanor at the age of 52 gave birth to a healthy baby girl at Netcare Pretoria East Hospital, after undergoing a number of fertility treatments at the Pretoria Fertility Centre based at the hospital. The decades long ‘journey’ to this incredible moment however had been nothing short of a rough ride at every possible turn.

“I first became aware of my fertility problems when it was discovered that I have fibroids, or growths in my uterus that were preventing me from falling pregnant. Twice I had them removed and twice they grew back. I was on the verge of making a final decision to have my uterus removed when one Sunday morning I received an unexpected phone call from an old childhood friend who had had a similar experience of fibroids removal treatment at Netcare Park Lane Hospital in Johannesburg,” says Eleanor. 

Hailing from Harare in Zimbabwe, the couple travelled to South Africa where the next chapters of their story began to unfold. Filled with renewed optimism, Eleanor for the third time underwent a lengthy operation to remove the fibroids that had grown back, after which she began her journey with in vitro fertilisation (IVF). 

Dr Marienus Trouw, a gynaecologist sub-specialist in reproductive medicine, who practises at Netcare Pretoria East Hospital explains that IVF involves hormonal injections to encourage the woman to produce more than one egg – these eggs are then retrieved from the uterus and fertilised in a laboratory to create embryos. They are then allowed to grow for around five days before being placed back into the uterus. 

“The first procedure was unsuccessful and the doctor who treated me passed away before we could try again. After some time we were referred to Dr Trouw, however by this stage the fibroids had once more grown back, so I then had to undergo my fourth fibroid removal before we could continue with IVF treatment,” says Eleanor. 

“This time it was a success and we were filled with an incredible sense of hope. However, no sooner had I reached the end of the first trimester when devastatingly, I had a miscarriage. We had come so far and decided to keep on trying. The following two attempts resulted in failure. It was only some years later, on our fifth and final IVF attempt that I finally fell pregnant with our baby girl who is now here with us.” 

All told, Eleanor and Alex’s 20 year journey to this point involved four fibroid removal operations for Eleanor, five rounds of IVF and one miscarriage, not to mention the many emotional ups and downs along the way. But every single step has been worth it, confirms Eleanor. 

“The result is our beautiful baby who we have called Esther, a biblical name which carries the meaning of a star and a woman of courage. Her Shona name is Nyashadzashe, which means grace from God. We had almost given up on having a baby of our own but by God's grace, when we least expected it at our older age, it happened,” she says. 

According to Dr Trouw, this particular case in fertility treatment is an exceptional one. “There are many factors that can influence fertility and the outcomes of fertility treatment. Age of the mother is one of the key determiners in the rate of success. When it comes to IVF there is an average success rate of about 50%, and while this can be higher, up to 65% for women younger than 35, it can also drop to as low as 10% after the age of 42,” he explains. 

“Physiological factors in the female, such as fibroids, can be the initial cause for difficulty in conceiving. This can also include ovulation problems, blocked fallopian tubes and endometriosis – when the tissue that normally only grows on the inside of the uterus also grows on the outside and attaches to other parts of the body, which can cause scarring that makes it difficult to conceive.

“We also see physiological problems in the male, such as poor sperm motility, low sperm count and in some cases no sperm at all. Around a third of cases involve a combination of factors within the female, the male or both, while about 10% of cases cannot be explained, as we simply do not have all the knowledge yet,” he notes. 

While the complexity of fertility issues can seem overwhelming for individuals trying to conceive, Dr Trouw points out that there are a number of solutions available to those who are struggling, as well as steps that can be taken to avoid problems worsening over time. 

“Firstly, for people who have diagnosed difficulties with fertility, there are multiple treatments available and it could be as simple as stimulating ovulation with tablets or injections. For women suffering from endometriosis, fibroids or blocked fallopian tubes, surgery may be the answer. Sometimes we might do insemination with an intracytoplasmic sperm injection (ICSI), where the sperm is injected into the egg in cases where it cannot naturally penetrate the outer layer for whatever reason,” says Dr Trouw. 

“Secondly, thinking and planning ahead can be hugely helpful for people who know they would like to have children but who are not yet at that stage in their life. We live in a time where many people are choosing to start a family later than has traditionally been the case. It is important for them to be mindful of the impact that age can have on fertility, particularly in women where older eggs are generally not only fewer in quantity but also lower in quality, which can lead to complications such as miscarriage or chromosomal abnormalities in the foetus. 

“If one is able to do so, freezing eggs before or around the age of 35 can be a good option in case fertility problems are diagnosed later down the line when the time does come when a couple would like to start a family. It is also important for both men and women to consider their own state of health, as lifestyle factors such as obesity and smoking can negatively impact fertility in both sexes. 

“If you do find you are struggling to conceive, your general gynaecologist will be able to refer you accordingly. However, it is important to be aware that the fertility treatment journey is different for everyone. It can therefore help to have a step-wise plan in place, created in conjunction with your treating doctor, so that you know what to expect, as timelines can become quite drawn out and there are often high costs involved, particularly when it comes to more advanced technologies,” Dr Trouw suggests. 

For Eleanor and Alex, the road to finally bringing their little bundle of joy home was far longer and more arduous than they could ever have expected. “Even once I had successfully fallen pregnant the second time, it was not a smooth ride – I had elevated blood pressure and had to go on maternity leave six weeks before the estimated delivery date. This involved me travelling to South Africa from Zimbabwe, where I live and work. I also developed kidney complications that meant I had to remain hospitalised after the birth for much longer than would usually be the case. 

“I would never wish for anyone to have to endure such hardship and I would advise couples not to leave family planning too late, as you never know what complications may arise. Thanks to the support of Dr Trouw, Sr Lizette White and the rest of the amazing team at Netcare Pretoria East Hospital, our greatest wish came true. Our message to anyone out there who is struggling to conceive is to keep your hope alive – miracles do happen.” 

Pieter Louw, general manager of Netcare Pretoria East Hospital, says that the facility and its staff are honoured to have played a part in this extraordinary success story. “Each and every couple and individual who visits the fertility centre at our hospital for treatment has a different story to tell. It is our privilege to support them, alongside the world class specialists who practise here, as they navigate what can be a very challenging experience and to share in their joy when treatment results in special moments such as the birth of baby Esther,” he concludes.