Rising IVF costs put parenthood beyond the reach of many Nigerians

As fertility treatment becomes increasingly sought after in Nigeria, rising costs and limited health insurance coverage are putting parenthood beyond the reach of many couples. With public health spending among the lowest globally and households financing most medical expenses out of pocket, fertility care has become one of the clearest examples of how healthcare financing shapes access to essential medical services.

Nigeria’s fertility industry is expanding as delayed childbearing, changing lifestyles, rising infertility awareness and advances in assisted reproductive technology drive demand for fertility services.

A single cycle of IVF typically costs between about N1.2 million and over N4 million, depending on the clinic, medications and treatment plan.

Dr. Abayomi Ajayi, Managing Director of Nordica Fertility Centre, said the country’s fertility clinics have witnessed growing demand for assisted reproductive services over the past five years, driven largely by increased public awareness and a rise in male-factor infertility.

“First and foremost is awareness,” Ajayi told BusinessDay. “The second factor is male infertility, which is increasing globally, and Nigeria is not an exception. We conducted our own study, which showed that about 12 percent of men who came to us had no sperm at all. That means, regardless of what they do, they may not be able to impregnate their partners.”

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He added that Nigerian fertility clinics are also seeing an increase in Nigerians living abroad returning home for IVF treatment.

The trend suggests that while medical tourism has traditionally flowed out of Nigeria, some fertility patients are increasingly returning home for treatment, which shows growing confidence among some Nigerians in locally available assisted reproductive services despite persistent affordability challenges.

The financial burden comes against the backdrop of a growing global infertility challenge. According to the World Health Organization (WHO), around one in six adults worldwide experience infertility during their reproductive years, making it one of the world’s most common reproductive health conditions. Yet fertility care remains largely absent from universal health coverage packages in many countries, particularly low- and middle-income economies.

WHO also notes that infertility affects men and women almost equally, challenging the long-held perception that childlessness is primarily a woman’s issue. The organisation says male factors, female factors or a combination of both may contribute to infertility, while some cases remain unexplained.

“The report reveals an important truth: infertility does not discriminate. The sheer proportion of people affected shows the need to widen access to fertility care and ensure this issue is no longer sidelined in health research and policy, so that safe, effective, and affordable ways to attain parenthood are available for those who seek it,” WHO Director-General Tedros Adhanom Ghebreyesus said while unveiling the organisation’s global infertility estimates.

For many Nigerian couples, the biggest obstacle to fertility treatment is not medical eligibility but affordability. Unlike many essential health services, fertility treatments are generally financed through out-of-pocket payments because they are rarely covered by health insurance. According to the World Bank, Nigeria remains heavily dependent on direct household spending to finance healthcare, exposing families to significant financial hardship when specialised care is required.

Fertility specialists also say the sharp depreciation of the naira has significantly increased the cost of treatment because many fertility drugs, laboratory consumables and specialised equipment are imported.

“There is the exchange-rate issue,” Ajayi said. “The exchange rate was around N400 to one US dollar and it is now over N1,000, prices are bound to go up. In reality, clinics could have increased prices threefold, but that has not happened. Nevertheless, treatment costs have risen.”

The World Bank’s Nigeria Public Expenditure and Institutional Review estimates that public health expenditure accounts for only about 0.5 percent of the country’s Gross Domestic Product (GDP), while out-of-pocket payments account for roughly 77 percent of total health expenditure. The report also estimates that healthcare expenses push more than one million Nigerians into poverty annually, with approximately one in four Nigerians experiencing catastrophic health spending.

For households pursuing fertility treatment, these financing gaps can translate into years of delayed care, repeated treatment cycles funded from personal savings, loans or family support, and difficult decisions between pursuing parenthood and maintaining financial stability. WHO has described infertility as not only a health issue but also an equity challenge. “Infertility is one of the most overlooked public health challenges of our time and a major equity issue globally. Millions face this journey alone, priced out of care, pushed toward cheaper but unproven treatments, or forced to choose between their hopes of having children and their financial security,” Tedros said.

Ajayi said public perception of infertility continues to place disproportionate attention on women despite growing evidence that male infertility contributes significantly to many cases.

WHO notes that infertility may result from male factors, female factors, a combination of both or unexplained causes. Male infertility may arise from low sperm count, poor sperm quality or reproductive tract disorders, while female infertility may be linked to blocked fallopian tubes, endometriosis, uterine abnormalities, polycystic ovary syndrome or hormonal disorders. Despite this, women continue to bear a disproportionate share of the social stigma, emotional distress and marital pressure associated with childlessness.

Ajayi believes government intervention should focus less on subsidising individual treatments and more on strengthening regulation and improving overall healthcare financing.

Ajayi said that Nigeria continues to underinvest in healthcare compared with many African countries, making it difficult to expand access to specialised services such as fertility treatment. “If we are being realistic, funding remains the biggest challenge. Nigeria’s health sector still receives less than five percent of government budget allocation, which is lower than many African countries,”.

According to him, infertility is often viewed by policymakers as a personal rather than a public health issue, making it less likely to attract government funding compared with communicable diseases such as tuberculosis.

“The best the government can do is to regulate the sector and ensure that only qualified providers offer fertility treatment,” he added.

WHO recommends that governments integrate fertility care into national health policies, strengthen prevention and early diagnosis, improve public awareness, and expand access to affordable reproductive healthcare. The organisation also advocates stronger investment in fertility services through universal health coverage to reduce financial barriers and ensure equitable access to treatment.

Nigeria’s fertility market is growing, the debate has moved from medical innovation to healthcare financing, insurance coverage and public policy. For many families, the question now is whether they can afford effective fertility treatments.