The Twin Miracle That Brought Joy to a 70-Year-Old Ugandan Mother

What are the chances that a 70-year-old woman can get pregnant and give birth to a healthy child? While it’s not impossible to become pregnant naturally at 50, it is very rare.  By the time a woman reaches her 40s, her chances of getting pregnant in a single menstrual cycle are only about 5%. Chances decrease even further with age to the extent that natural conception at the age of 70 would be highly unlikely.

These are the odds that Safinah Namukwaya, a 70-year-old Ugandan woman, beat when she gave birth to a set of twins last week. She becomes the second 70-year-old woman to give birth in two years, after India’s Jivunben Rabari who gave birth in 2021 to a baby boy. It was hers and her husband Maldhari’s (55) first baby.

Arthur Matsiko, the spokesman for the Women’s Hospital International Fertility Centre (WHIFC) in Kampala where Namukwaya received in-vitro fertilization (IVF), was quoted by local media as saying both the children and mother were in good health.

“She’s healthy. She’s talking. She’s walking around the hospital,” Matsiko said.

Dr. Edward Tamale Ssali, a fertility specialist at the hospital, said the mother used a donor egg and her partner's sperm for the IVF procedure. The babies were born prematurely at 31 weeks and placed in incubators, it was reported. The birth followed a C-section procedure. Ssali said the mother and babies (a boy and a girl) were still in the care of the hospital but were in good health.

The risks of in-vitro fertilizations

Essentially, IVF is a process in which an egg is fertilized by a sperm outside the body. A woman’s ovulation is first monitored and strengthened, and the eggs are then expelled from the ovaries and treated in a lab with sperm. The egg is then refined for 2–6 days to produce embryos, which are placed inside the intended mother’s uterus to start a pregnancy.

But IVF after menopause is a tricky business and usually is done using a woman’s eggs that had been frozen earlier in life. Unfortunately, there are no records available of the extent to which Ugandan women freeze their eggs, which in some communities might be seen as against traditional culture; or even witchcraft. In Namukwaya’s case, a donor’s eggs were used.

A leading IVF doctor advised that IVF is not suitable for women older than 52.

“There are no rules and regulations yet, but there should not be IVF treatment beyond 52 years of age. If a woman is physically, mentally and medically fit … the chances of getting pregnant is 50 percent if the uterus is fine,” says Dr Kamini Patel, an IVF Specialist in Ahmedabad, India. “The taxing part begins after the procedure because the pregnancy itself risks the heart and other organs as it is an extra burden on the body.”

Namukwaya’s first baby

Namukwaya was first diagnosed with blocked fallopian tubes when she was 25 years, old after a miscarriage and years of painful menstrual cramps. Married off at 15, she only conceived once (which resulted in a miscarriage), and even after she was treated for the blocked fallopian tubes, she never conceived again.

Her first husband got another wife, who bore him children. But he did not send Namukwaya away, and she stayed with him till his death after a short illness. Resigned to never having children of her own, she helped look after and raise her stepchildren.

Sometime after her husband’s death, she met another man who wanted to marry her. She disclosed to him her inability to have children, but he was okay with it, and so they got married.

In 2018 she was told about IVF and subsequently visited the WHIFC. She was started on IVF treatment and in December 2019 fertilized embryos were implanted into her uterus. A subsequent test showed that she had successfully conceived. After 34 weeks she developed complications, and the decision was taken to deliver the child via C-section. So at 36 weeks, she was delivered of a baby girl, Isha Nanteza, who is now 3 years old.

Her second pregnancy

Last year, together with her husband, they decided to try for another baby. She went through the same procedure, with donated eggs, and this time she conceived twins. Talking to the media before delivery, she explained why they decided to have another baby, despite her advanced age.

“I decided to have more children because having one baby is risky, it is like having one stick of matches,” she said. She also said that she did not want to grow old and have no one to look after her.

Whose baby is it?

Ever since the first IVF with a donor egg was done, there have been questions as to whom the baby actually belongs to; is it the donor, whose DNA the baby will have? Is it the birth mother?

According to experts, while the baby will have the egg donor’s DNA, it is the woman in whose womb the baby grows that is considered to be the biological mother. The uterine environment also has a very big factor in what the baby will look like.

“From the pregnant mom’s body, the baby receives the fluids and other compounds for 40 weeks of its development. This is delivered through the mother’s blood via the placenta – and so the mom’s flesh and blood grow the baby’s body. For this reason, regardless of the origin of the egg cell, the pregnant mom is considered the baby’ biological mother. And the baby is her biological child.”

In addition, it is standard practice that the egg donor is anonymous. Neither the recipient nor the donor know each other, unless it is specifically and mutually agreed.

Discrepancies in Namukwaya’s age

Although she says she is 70s years old, there is no real proof of that. Like many children born in pre-colonial times in rural areas, she does not have a birth certificate.

According to the story she told the press, she was married off at 15 years old in 1973, which would mean she was born in 1958. That would put her age at 65 years, not 70.

Cost of IVF in Uganda

In Uganda, prices for IVF vary, with a basic procedure using own eggs costing around US$7,400. IVF with egg donation costs US$8,650, while blocked fallopian tube treatment costs US$4300.   According to Namukwaya, she paid a total of UGX40m (about US$10,000) for her first pregnancy, which she paid in instalments. Costs for her second pregnancy were catered for by the hospital.