By Deborah Bamisaye
The room was quiet again. Not the peaceful kind of quiet… The heavy kind. The doctor adjusted his glasses and looked at the couple seated before him.
“We’ve tried medications.” A pause. “We’ve monitored ovulation.” Another pause. “We’ve even helped the sperm reach the egg.” The woman slowly lowered her eyes. “Then why…” her husband asked carefully, “…is nothing still happening?” The doctor leaned back gently.
“Because sometimes,” he said softly, “the problem is not just the journey… but the seed itself.” (Silence)
The couple exchanged a glance they had exchanged too many times before, the look that carried exhaustion, fear, hope, and questions nobody ever prepares you for. Then came the sentence they never imagined hearing.
“There is another path…”
The woman frowned slightly, “What kind of path?” (The doctor opened a file)
“Sometimes,” he explained, “when the sperm cannot fertilize… another sperm may help.
“Sometimes, when the eggs can no longer respond, another egg may be needed.
“And in some situations, both may need help.”
The husband blinked slowly, “You mean… someone else’s?” (No one spoke for a moment)
Because suddenly, this was no longer only medicine. This was identity, Family, Bloodline, Culture, Faith and Emotion.
(A quiet storm began to rise in the room)
The woman’s voice trembled: “If a child grows inside me but doesn’t carry my genes, will I still feel like the mother?”
The husband swallowed hard. “And if the child isn’t biologically mine, will I truly feel like the father?”
The doctor did not answer immediately. Because these are not questions science answers quickly.
Some decisions are made in laboratories. Others are made in the deepest chambers of the heart.
And this… was one of them.
Dear Reader:
“Thank you for following this series and learning one or two things along the way. You see, before any option is considered, doctors must first answer one very important question: What exactly is the root cause of infertility?”
STEP 1: Identify the root cause of infertility
Doctors first determine:
Is it male factor?
Female factor?
Both?
Or unexplained? This usually involves tests and sometimes leads into for a clearer picture.
STEP 2: Match the problem to the right donor option:
A. If the Issue is Mainly the Man → Donor Sperm
When this is chosen:
No sperm (azoospermia)
Very poor sperm quality
Genetic concerns
Why?
a. The woman’s eggs and womb are healthy
b. Only sperm is needed
Outcome:
Mother = genetically related
Father = not genetically related
B. If the Issue is Mainly the Woman → Donor Eggs
When this is chosen:
Low ovarian reserve
Poor egg quality
Early menopause
Repeated IVF failure
Why?
a. The man’s sperm is fine
b. The woman can still carry pregnancy.
Outcome:
Father = genetically related
Mother = carries pregnancy but no genetic link
C. If Both Partners are Affected → Donor Embryos
When this is chosen:
a. Both egg and sperm have serious issues.
b. Multiple failed IVF cycles.
c. Genetic conditions in both partners.
Why?
Neither egg nor sperm is viable
Outcome:
No genetic link to either parent
But full pregnancy experience remains
STEP 3: Consider Emotional Readiness (This is the Biggest Part)
Doctors will ask questions like:
a. Are you comfortable raising a child not genetically related to one or both of you?
b. Will you tell the child in the future?
c. Can your family/culture accept this?
Many clinics recommend counseling before proceeding.
STEP 4: Consider Medical Success Rates
Generally:
a. Donor eggs and donor embryos tend to have higher success rates.
b. Donor sperm success depends largely on the woman’s fertility.
This helps couples balance emotion vs probability of success
STEP 5: Financial and Practical Factors
a. Donor sperm is usually the least expensive.
b. Donor eggs are more complex and costly.
c. Donor embryos can sometimes be more affordable than egg donation.
Availability in Nigeria may also influence the decision.
STEP 6: Cultural, Religious, and Personal Beliefs
This can strongly affect the final choice.
Some couples:
a. Prefer donor sperm over donor eggs
b. Avoid donor embryos entirely or
c. Choose adoption instead
There is no “one right answer, only what aligns with their values.
The Point is:
1. If infertility is mainly from the man, donor sperm is usually considered.
2. If infertility is mainly from the woman, donor eggs are usually considered.
3. If both partners are affected, donor embryos may be the option.
4. If maintaining a genetic link to at least one parent matters, sperm or egg donation is preferred over embryo donation.
5. If the main goal is the highest chance of success, donor eggs or embryos are often chosen.
Very Importantly:
The decision is not just medical; it’s emotional, cultural, and deeply personal.
Doctors guide concerned couples with science, but the final choice depends on:
a. What the couple can accept.
b. What they believe.
c. What future they envision for their family.
You see, some journeys to parenthood stretch beyond biology into places of courage, sacrifice, faith, and difficult choices. Yet for many couples, love still becomes the loudest connection of all.
Next time, we will step deeper into the emotional realities behind donor decisions, family acceptance, and the silent questions many couples rarely say aloud.
With that said, I’ll see you in the next part of this journey.
English