Rachel, a Ghanaian woman, waited four years for a miracle after struggling with recurrent fibroids that led to the surgical removal of her womb. Despite the setback, she and her husband turned to surrogacy, a poorly understood option in Ghana. At a fertility centre in Accra, her husband's sperm was transferred into another woman who agreed to carry the pregnancy on their behalf. Today, they have a child they had long hoped and prayed for. Rachel's story highlights the lesser-known faces of infertility in Ghana.
In Ghana, surrogacy is an arrangement where a woman carries and gives birth to a child on behalf of another person or couple, known as the "intended parents". The country's Registration of Births and Deaths Act, 2020 (Act 1027), provides for surrogacy and assisted reproductive births, including the legal process for determining parentage. There are two types of surrogacy: traditional and gestational. In traditional surrogacy, the surrogate's own egg is used, while in gestational surrogacy, the surrogate carries a pregnancy created through in-vitro fertilisation (IVF) using an embryo from the intended parents or donors.
According to the World Health Organisation (WHO), about one in six people of reproductive age experience infertility during their lifetime globally. In Ghana, studies show that the incidence of infertility is estimated to be 11.8 per cent for women and 15.8 per cent for men. Roughly two per cent of women in their reproductive age suffer primary infertility, while 14 per cent suffer secondary infertility. These statistics highlight the need for awareness and access to fertility treatments, including surrogacy.
Professor Promise Emmanuel Sefogah, Vice President of the Fertility Society of Ghana (FERSOG), emphasises that infertility should be viewed as a "medical disorder" that can be treated or managed like any other medical condition. He notes that uterine fibroids, advanced age, some cancers, and uterine agenesis are among the medical reasons that can make carrying a pregnancy difficult or unsafe. Sefogah stresses that nobody chooses to be childless, and those suffering from infertility need help, which can come in the form of assisted reproductive technologies, including surrogacy.
However, the cost of accessing fertility treatment in Ghana, including surrogacy, remains a significant barrier. Published estimates suggest that a surrogacy procedure in Ghana can cost between $30,000 and $100,000, depending on the type of surrogacy and service provider. Prof. Sefogah expresses concern that fertility treatment is largely paid for out-of-pocket in Ghana, compounding the difficulties faced by people struggling with infertility. He calls for financing mechanisms, such as the National Health Insurance Scheme (NHIS), to support childless couples.
Dr Nana Yaw Osei, a Fertility Specialist and CEO of the Walking Egg Fertility Centre, reiterates the need for infertility to be seen as a health issue rather than a moral failure or religious "curse". He recalls a recent case where a 30-year-old surrogate delivered quadruplets through IUI after the intended mother had lost her uterus. Osei's experience underscores the importance of raising awareness about surrogacy and other assisted reproductive technologies in Ghana.
To address the challenges in the fertility sector, Prof. Sefogah calls for a comprehensive framework to regulate assisted reproductive technologies (ART) in Ghana, reducing abuses and exploitation. He notes that work is ongoing to lay a bill before Parliament to ensure standardisation in the sector. Ultimately, increasing access to fertility treatments, including surrogacy, and addressing the stigma surrounding childlessness can help more people in Ghana build their families.
Key points
- - In Ghana, surrogacy offers a pathway to parenthood for women who have lost their womb or struggle with infertility. - The country's Registration of Births and Deaths Act, 2020 (Act 1027), provides for surrogacy and assisted reproductive births. - The cost of surrogacy in Ghana can range from $30,000 to $100,000, making it inaccessible to many due to out-of-pocket payments.
