Hoda Sherif
New Lines Magazine / June 8, 2026
One couple’s 10-year quest to conceive reveals the impossible challenges long faced by aspiring parents and medics in the occupied territory, from Israel’s blockade to the depredations of war.
Saeed Abu Raddi was busy sorting through his fertility case notes. The medical records held semen analyses, dozens of doctors’ referrals scribbled in despair, and the ultrasound report from his most recent abortive in vitro procedure. He took a moment to fish out a small Ziploc bag of coffee — his favourite roast from Al-Qishawi in Deir al-Balah. It was to help calm his nerves, he said. “I wanted it with me when I came to Cairo for the surgery. Gaza’s taste, at least.”
Saeed, now 48, and his wife Suha (43) arrived in Egypt in September, 2023, just a few weeks before the Hamas attacks of Oct. 7, 2023, and the Gaza war that ensued. They have remained in Egypt since, in a chronically underserved district just east of Cairo known as Ain Shams. There, decrepit, squalid settlements sprout like huddled weeds, disconnected from many basic living services. The rutted roads are cratered, pockmarked and treacherous — not so much lanes as a series of violent jolts, each one lifting drivers clean out of their seats. The streets are filled with heat and waste. The couple are among hundreds of refugees from Gaza who have found themselves marooned in this humble quarter of Egypt due to the war.
In their overstuffed apartment off Al-Eshrein Street, wedged between honking microbuses and the smell of fried eggplants and cigarettes, Saeed was a man who wore Cairo like a borrowed coat. He felt like a guest who’d long overstayed his visit yet somehow never unpacked, suspended in that absurdly awkward no-man’s-land between intrusion and impermanence. To the couple, Cairo never really stopped feeling like some crappy layover.
I visited them one day, climbing up the five stories to their apartment in a building where the elevator almost never worked, and the hallway smelled of rust and falafel, cigarette ash littering the floor. This was their new life: stateless, unemployed and scavenging through black market favours and mounting debts, with one thing still on their mind. “My heroes wear laboratory coats. You ever heard of that saying?” Saeed grins, faintly rakish. “Maybe it’s a special saying only in Gaza.”
To understand how they arrived here, one must understand the level of courage it takes to have children under siege. After speaking with more than a dozen fertility specialists, including ob-gyns, embryologists and endocrinologists, across several of Gaza’s nine in vitro fertilization (IVF) clinics — Al-Basma, Hala, Helou, the Sarraj Fertility Center and facilities inside the Al-Shifa and Nasser medical complexes — it became clear that decades of siege, aerial bombardment and heavy metal exposure had trained a good number of Palestinian male bodies to recoil against the act of creation, rejecting their biology’s most primal instinct. Male gametes that should swim, I’m told, have lost their bearings and motility, and often collapse mid-journey, confused by inflammation and a bloodstream thick with iron and cortisol.
In Gaza, male infertility is both endemic and systematically suppressed, too ubiquitous to dismiss and too taboo to confront. Since Israel’s assaults have razed much of Gaza’s IVF infrastructure, medical statistics no longer exist. Anecdotal evidence, already rarely heard outside the bedroom, is also in short supply. In 2019, a 2021 cross-sectional study published in the Journal of Reproduction and Infertility, “Depression Among Infertile Men in the Gaza Strip, Palestine: The Neglected Aspect of Fertility Care,” surveyed more than 350 men receiving treatment at three of Gaza’s IVF clinics: Al-Helo, Hindawi and Al-Basma. The results confirmed what many already knew, but few had quantified: Male infertility among Palestinians wasn’t just a source of stigma; it was slowly strangling men’s ability to conceive. Saeed calls it necrosis of the spirit, a festering shame among men that Israel’s occupation and apartheid policies have institutionalized.
“What is the fate of this body when it is denied the capacity to bring forth life, or to ensure protection of a loved one under bombs?” Saeed asked often during the course of our interviews.
After enough time living under the stress of conflict that has defined life in Gaza for decades, the body can no longer produce sperm at all. The clinical term for this is “azoospermia,” a condition in which a man produces no measurable male gametes. It’s what doctors have dubbed the region’s most common male infertility condition. “The majority of cases of male infertility across conflict-afflicted regions circle back to that same, singular failure,” a Cyprus-born leading urologist from the Andrology Institute of America (AIA)-Middle East told me, on condition of anonymity.
The AIA doctor, credentialed through Dubai, Oman, Kuwait and other Gulf states, described how men’s bodies operate as double-edged swords. While designed for physical strain, their biology makes them especially susceptible to the “mutagenic chemicals” generated by explosives, which leave their reproductive organs “ultimately carrying the most formidable scar.”
The United Nations Environment Programme warns that, as of September 2025, nearly 67 million tons of debris — “about as much as 15 Great Pyramids of Giza or 25 Eiffel Towers by volume” — are contaminating Gaza. By May 2025, up to 70% of all structures in Gaza had been destroyed, according to the United Nations Satellite Centre. It’s a dystopian geography of collapse. Where entire urban ecologies have been ground to ash, the land itself acquires a new toxic topography, with rows of streets coated in pyrogenic soot and munitions residues. Sifting through these mountains of rubble, often with their bare hands and often for their own kin, are Gaza’s men.
“Even factory workers,” the AIA physician added, who are “briefly exposed to TNT and uranium dusts from munitions factories during work shifts, then return home to clean air, show measurably high rates of sperm deformities, collapsing motility, and epigenetic alterations.” The threat is multiplied for men in Gaza, where noxious gases fill the air. For more than two years, men like Saeed have had to contend with constant exposure to incendiary smoke, rubble and pyrogenic ash.
Add to these factors poor diet, cheap stimulants, polluted aquifers, compromised soil and crops, and the permanent adrenaline of life under assault and siege, and it’s little wonder that each specialist I interviewed cited a rising trend among Gaza’s men of azoospermia — a condition that appears in scarcely 1% of the male population globally.
The work many men are forced to do, such as ferrying pulverized concrete and dismembered limbs in plastic buckets, also involves appreciable danger, forcing them to inhale crystalline silica (a powder invisible to the eye but catastrophic for the lungs) and bone dust. Such hazardous labor existed before the current war, compounding the incidence of male infertility over time and making it almost banal in its frequency.
Such was Saeed’s fate, too.
Suha and Saeed tied the knot in 2014. The wedding took place at the Salsabil Wedding Hall in Deir al-Balah. The fierce Cairo sun sliced through their dusty, blue-rimmed window, shadowing Suha’s sallow face with thin, angular shapes, she told me, as if recollecting a dream. Padded banquet chairs were dressed in satin roses and romantic hues, red carpets rolled out and ironed. On both sides, carnations of milk-white and mauve lilies stood in vigil.
That’s what we wanted to show in our simple wedding,” Suha said, her honeyed voice barely cutting the thick air. She spoke, always, in whispers that required a sort of rapt concentration to catch.
The precise figures of reproductive failure among men, as dozens of fertility specialists working inside Gaza make clear, remain elusive. Despite the obliteration of hospital wards and the permanent loss of patient records, specialists recall that the evidence of widespread infertility was unremitting. Each lab result confirmed what no man wants to hear: His body, not hers, was to blame, broken by spent munitions, nitrates and industrial toxins.
Men’s physiology is the “most biologically porous,” said Mohamed Zedan, a Cairo-born embryologist who has spent more than two decades building and directing IVF laboratories from Giza to Khartoum, Sudan. That makes them more susceptible than women to their ambient surroundings, especially those they encounter in low-wage and hazardous work environments or in regions of sustained military unrest.
Women’s reproductive organs, by contrast, rest behind a wall of flesh. “She is born with all the eggs she will ever have,” Zedan said — between 1 and 2 million at birth. Men, by contrast, begin producing sperm at puberty and, unlike women, continue manufacturing it for most of their lives. That difference makes men, paradoxically, far more fragile. “The male system is continuous, which also means it’s more vulnerable to disruption,” he said. Environmental heat stress, radiation, toxins: All leave their mark faster on sperm than on eggs protected deep inside the female body.
Trained in Spain and Italy, Zedan is certified by both the American Society for Reproductive Medicine and the American Association of Bioanalysts. He is also registered under the national health authorities across Egypt and Saudi Arabia, credentials that have made him a regional arbiter in the science — and politics — of reproduction. His work in Sudan, where he helped establish one of the country’s few functioning assisted reproductive technology (ART) units, remains emblematic of his career: bridging world-class embryological practice with the austere realities of resource-limited medicine in conflict settings.
Across much of the Arab and Muslim world, Zedan explained, infertility is less a medical diagnosis than a cultural blind spot. Few men agree to testing and fewer still to acknowledgment, even in private circles. And in Gaza, infertility has long become the quiet twin of war.
The region, he said, was gripped by a blight of male infertility so routine it had long ceased to astonish him, even after two decades in the field, where he tends to a procession of men in Sudan faced with their own infertility. Most often, such a condition rises less from a single cause than an entanglement: contaminated food ecologies, dehydration, compromised genetics and shrapnel-pocked environments, all conspiring with remarkable efficiency against the male germline.
Unlike the northern hemisphere, vast stretches of North Africa, the Arab world and West Asia are exposed to relentless sun. Add to that a geopolitical arena where war is endemic, and you arrive at the male reproductive nightmare: testes forced to metabolize both extreme heat and the mutagenic afterbirth of constant bombardment.
Gaza’s Health Ministry data, reported through the United Nations Population Fund, recorded just 17,000 births in the first six months of 2025, down from 29,000 over the same period in 2022, a contraction of over 41%. The precipitous fall coincides with a rash of miscarriages, premature deliveries, low-weight infants and neonatal and maternal deaths. While such erosion of natality may be the predictable result of a deteriorating health system devastated by over two years of Israel’s bombardment, the collapse of medical facilities (including neonatal intensive care units and the incubators they house) and 18 years of blockade, the birth deficit cannot be understood through the rubric of clinical collapse alone.
Hundreds of thousands of Palestinians have been herded across the strip by successive displacement orders into overcrowded, ramshackle encampments where domestic privacy has all but vanished; partners have long been wrenched from one another by decades of family separation policies;, and the institutions responsible for documenting and tracking births, foremost among them Gaza’s Health Ministry, have seen their capacity to do so severely degraded by nearly three years of war.
“What devastates them is the grief,” Samah Jabr, the former head of the Mental Health Unit at the Ministry of Health in Ramallah, told me — “the grief for a future they imagined, unborn children they have named in silence, a lineage cut off by the cruel inhalations and ingestions of war’s aftermath. They’re not just mourning fertility. They’re mourning the loss of continuity,” she added.
“A mother doesn’t resent the [unborn] child,” added Jabr, referring to the unborn. “She resents the world that makes their arrival feel like a reopening of every wound it took to get there.”
While more generally, male infertility accounts for about half of all cases in the world, across war-afflicted regions of the Global South, the statistics assume proportions that border on the unthinkable. Between 60% and 90% of all such cases of reproductive impairment are rooted in issues affecting men, according to Marcia Inhorn’s decades-long reproductive research on Palestinian refugees living in Lebanon and, similarly, on Iraqi refugees who now reside in Michigan.
In the course of her fieldwork and research for her book, “America’s Arab Refugees: Vulnerability and Health on the Margins,” Inhorne drew on her 2003 study of southern Lebanon, which gathered reproductive life histories from 220 Lebanese men and a handful of Palestinian refugees living there.
Her research for the 2003 study recorded a range of war-inflicted anomalies sustained by men’s exposure to U.S.-made bombs. “War’s imprint on male fertility, specifically, is staggeringly profound,” Inhorne said. “Exposure to one or more war-related trauma events had been shown to significantly increase their odds of being infertile,” she added. The men most brutalized by violence were the ones most thoroughly affected.
This uptick in infertility, compounded by the relentless toll of death and out-migration among Arab youth, has struck a devastating blow to these countries’ “demographic and generational continuity,” Inhorne told me. Once in care, she said, many of these men submitted themselves willingly to invasive rounds of reproductive testing and treatment: costly semen analyses, genetic screenings, hormone regimens and the often invisible yet deeply scourging procedures of testicular biopsy or testicular sperm aspiration.
They made offerings of their bodies, and empty pockets, in pursuit of futures they may never see. This kind of male reproductive agency — marked by vulnerability, resilience and an unspoken sacrifice— “is frequently omitted from prevailing discourse on Muslim masculinity,” and even more so in global reproductive studies, she added.
Just a week after his first visit to the doctor’s office back in 2014, Saeed found himself on the operating table in Al-Shifa Hospital, where he was told he needed a microsurgical varicocelectomy, two words that felt as daunting and unforgiving as the scalpel that would soon follow. It would mark the beginning of his prolonged journey to start a family.
“You’ll need a laparoscopic varicocelectomy,” Saeed recalled the doctor telling him. (Varicoceles are swollen veins. They either remain hidden beneath the skin or form a tangled mass, usually described as a “bag of worms” within the scrotum.) “The veins — the enlargement is significant. It’s definitely why you’re having trouble conceiving.”
“I stopped believing I was someone worthy of love and joy. Of fatherhood. Of anything, really,” Saeed said.
His first instinct was to glance at Suha, sitting quietly beside him in the doctor’s office, her face pale but calm. She reached for his hand without hesitation. Her eyes held something he couldn’t quite name. Pity? Fear? Resignation? After all, they’d only been married a year and a half. What would stop her from leaving him? He wanted to scream, to argue and to demand a different answer.
“I promised I would pack my own things and even make it easier for her,” Saeed said. All he could think about was the weight of the word “infertile,” how it sat like an accusation.
As the seconds passed, the couple sat silently spellbound. Suha’s voice quavered, but it was certain all the same. “We’re willing to do whatever it takes,” she said. “However much it costs, however many times until we leave with a child. Our child.”
“It was her vow to me. Forget what she promised in our wedding; this is what binds a man to his wife,” Saeed said with a quiet lilt.
In Gaza’s district of Maghazi, nothing stayed secret. The bombshell saga of Saeed’s barrenness travelled quickly. The whispers rippled through weddings, salons and just about every kitchen table gathering. Communal pity followed.
“Many people told Suha to leave me, that after over five years of trying, I had to be broken,” Saeed murmured to me one day during my visit, fidgeting with the strings of his sweatpants. “They told her love was no use where seed could not take root. A growing lineage is all we have in Gaza.”
What defines a man? He turned the question over in his mind, as if shaking it might finally make the answer fall out.
In the years leading up to Oct. 7, Israel’s illegal and comprehensive siege on Gaza left Palestinians without reliable power, a darkness perpetuated by the bombing of Gaza’s only power plant in the early morning hours of June 2006. After this came the methodical disassembly of medical services. Lab and testing equipment aged, with many of the tools no longer meeting operational standards. Some older diagnostic and imaging machines eventually fell out of global health and clinical compliance. Exacerbating the strain, Gaza’s Ministry of Health has long been barred from repairing equipment or replacing expired medications. Fuel trickled in, when it came at all.
The blockade stringently metered everything that entered or left the strip, from construction materials and surgical instruments to oxygen tanks and lab chemicals. For men confronting infertility, the blockade often prevented access to cutting-edge ART, such as intracytoplasmic sperm injection (ICSI). Ever since the first live births using ICSI were reported in 1992 in Belgium, the reproductive technology has become a mainstay in treatment of male infertility, Inhorne said, helping to overcome fertilization failure for couples who have tried conventional in vitro insemination.
In Gaza, though, even if advanced ART tools were available, access to the supporting infrastructure needed to process, freeze, store or monitor embryonic samples was anything but guaranteed. The siege also left patients scavenging for medications abroad, paying highly inflated import fees on routine pharmaceuticals — notably from Jordan, Turkey and Egypt — that were banned by Israeli border patrols.
At the Al-Basma IVF center, Gaza’s largest and most established fertility clinic, Mohammad Ajjour, 38, served as senior chief embryologist for over a decade. Most of the cases he saw came down to male infertility. Between 10% and 20% of cases involved both partners, and another 10%-20% remained unexplained. But no man who sat in that chair ever felt like a statistic. “Not in Gaza,” Ajjour said.
“Our lab received extensive documentation from research bodies that have conducted surveys in border areas near Israel,” Ajjour added. He cited results from near the Beit Hanoun crossing in northern Gaza and the Kerem Shalom crossing in the south, where years of military activity have led to “significantly elevated infertility and subfertility rates among men living there.”
Ajjour said the pronounced levels of environmental pollution, including contaminated soil, air and water, are certain to “disrupt even the most intact sperm,” exposing men to heavy metals, oxidative stress, endocrine disruption, epigenetic changes and systemic inflammation. The pollution is as “critical and decisive a factor” in the high rates of male infertility across the strip as “pesticide-coated” vegetables or expired cans of beans, tuna and other foods sold in local markets. (Israel decides when shipments of canned goods and other items like flour or baby formula may enter Gaza, and goods can expire on inbound trucks or be ruined by the heat as they await clearance.)
Male fecundity is contingent on nutrition. Zinc, selenium, folate and vitamins C and E protect sperm from oxidative stress. Omega-3 fats keep sperm membranes supple; lean proteins and complex carbohydrates stabilize insulin, preserving glucose as fuel for cellular and reproductive function. Energy is the sine qua non of motion, and even a minor shortage of it can disrupt the process that turns a cell into a swimmer.
Yet to speak of “controlling one’s diet” under occupation would almost be farcical, if it weren’t so cruel. While his doctors counselled Saeed on what to eat, he and they both knew that the advice belonged to another reality. “We ate only whatever was available,” Saeed told me, shrugging. “If it wasn’t available, we never tried it.”
A joint analysis by the Integrated Food Security Phase Classification (IPC) partnership confirmed in mid-August 2025 that famine (IPC phase 5) had taken root in Gaza, with over 500,000 people facing catastrophic conditions of starvation, destitution and death. While the precarious U.S-brokered ceasefire has permitted a thin resumption of aid, Gaza’s human-made food crisis remains.
In early 2006, Dov Weisglass, an adviser to then-Prime Minister Ehud Olmert, said that Israel’s policy was “to put the Palestinians on a diet, but not to make them die of hunger.” Since then, when families in Gaza began counting and rationing their calories and protein to stretch the limited food allowance given to them by the Israeli authorities, men’s bodies likely placed reproduction in metabolic abeyance, suspending and sacrificing it in favour of survival. Under these circumstances, sperm, deprived of glucose and oxygen, loses its charge. Its mitochondria begin to sputter. Without the costly assistance of artificial conception, reproduction becomes biologically implausible.
But in Gaza, no IVF or diagnostic laboratory operated in true isolation; each embryonic experiment depended on a network of external contingencies — all within the control of Israel. Culture dishes containing live cells, sperm, embryos or tissue samples must often pass through Israeli checkpoints to get to their final destination. Gaza’s embryologists routinely dispatched samples to partner facilities in the West Bank, including East Jerusalem, and abroad (to Jordan and, sometimes, Egypt) for genetic sequencing, viability testing or pathogen screening. All of these procedures rely on medical instruments forbidden under Israel’s “dual-use” import regime, which prohibits goods that the government claims can be used for military purposes. Among the items that have made it onto Israel’s dual-use list are nonelectric wheelchairs, tarps and sleeping bags, according to Israeli legal nonprofit Gisha.
Fertilization may occur in one territory, freezing in another, the patient waiting in a third. Most laboratory reagents, growth media and sterile containers enter Gaza only through Israeli distributors. And in some cases, even test cultures must be sent to Israel to verify their quality, forcing medical providers to rely on the same occupying forces and suppliers who ration Gaza’s drip-fed diets.
Few medical procedures have proven as onerous under Israel’s military siege as artificial conception. The sophisticated equipment it requires has been delayed by unduly time-consuming inspections and sometimes confiscated at Kerem Shalom, the sole commercial crossing for goods moving between Israel, Egypt and Gaza.
Here, Israeli authorities have made a consistent practice of seizing laser-assisted hatching devices, tools essential to embryo biopsy and other fertility procedures, along with a range of equally indispensable medical equipment, according to Ahmed Sarraj of Al-Shifa’s OB-GYN board.
A veteran reproductive expert, Sarraj described to me the pressure faced by fertility doctors, who are “cornered by both kinds of embargo: the one that actively blocks free movement and medical equipment, and the societal one that blocks male confession.”
Before Al-Shifa Hospital came under fire early in Israel’s assault on Gaza, Sarraj spent more than 11 years overseeing high-risk obstetric cases, leading emergency gynaecologic surgeries, and even training a new generation of OB-GYN residents.
“In many sessions, I found myself not just a doctor, but a psychotherapist,” he said. “I’ve seen men who are very successful at work, but so very broken inside. … Many would come with their wife, but it was mostly the wife who did the talking, and he kept quiet.”
He added, “Sometimes, I’d request a moment alone with him, his wife may leave the room, and then the walls would come down, and he’d finally feel safe enough to speak.”
He recalled one case in particular that still haunts him today, of a 32-year-old husband who tried for eight years to conceive with his wife, but to no avail. “He had a complete absence of sperm. This is the condition we see most,” he recalled. After attempting testicular sperm extraction three times, a miracle happened when just a few gametes were found. They moved quickly to ICSI. Within just a few short months, his wife was pregnant.
“Unfortunately, she miscarried in the second month,” Sarraj recalled. “But that’s not the worst part.” When the husband returned to the clinic, “he was completely devastated. He looked at me and said, ‘Doctor, I don’t consider myself a man.’ That sentence is engraved in my heart. I can still hear his voice.”
Cryogenic materials and the sensitive media that preserve them depend on uninterrupted, time-critical transit to be sustained in a “womb-like fluid.” The thermally regulated conditions that culture dishes require while on the move are impossible to maintain under Israel’s siege and capricious inspections at Kerem Shalom. “The biological samples often die,” Sarraj explained.
Rudimentary lab materials arrived in damaged boxes, if they arrived at all, shaken or splintered during the erratic, often humiliating inspections at the crossing. A shipment might vanish for days or be held up until it expires. Sarraj saw critical culture dishes arrive just days, or even hours, before their expiration date.
He broke down the process. “Such culture media can be thought of as the embryo’s life-support broth in a lab setting. Without it, the entire procedure has a zero percent success rate.” In this engineered bath, the embryo drifts in simulation, buoyed by a chemistry of care: pH, nutrients, hormones, oxygen and heat calibrated to the decimal. It floats in this tempered solution, manicured to mimic the womb’s caretaking intelligence. For weeks, sometimes months, the embryo survives in imitation, waiting to be restored to the body.
“The media we use to preserve eggs, sperm and embryos has a very short shelf life,” Ajjour said. “Due to the intentional delays at the crossings, in many cases, we had to cancel egg retrievals because the media did not arrive, or they arrived corrupted. Imagine relaying that news to a waiting couple.”
Like the majority of northern Gaza, Al-Shifa Hospital, once the largest and most important medical complex for referrals in the territory, was devastated in April of 2024 after a large-scale raid by Israeli forces. Not long after, Sarraj would have capped a decade on the OB-GYN board. Now, his patients are either missing, mourning or dead, he lamented.
The science of ART and incubation is exact. The work of keeping embryos alive depends upon electrical continuity measured not in days but in seconds; every outage, fluctuation or exhausted battery threatens to undo what months of treatment made possible. Sarraj said that doctors’ ability to treat patients is dictated by forces far beyond the lab’s control. Daily blackouts threaten the controlled environments in which fragile embryos are kept.
His father’s clinic, Al-Sarraj Fertility Center, located in the northern Rimal neighbourhood in Gaza City, relied heavily on solar energy, but this is a brittle fix. Because solar generation alone cannot guarantee the uninterrupted, meticulously regulated electricity required by an IVF laboratory in a territory subject to repeated military assault and supply chain restrictions, solar could only ever be a stopgap. The supply of electricity remains dependent on batteries, backup power, maintenance and replacement parts, all of which were vulnerable under Israel’s restrictions. When the power fails, batteries exhaust their charge, or fuel shortages affecting backup systems become acute. So, too, does the integrity of incubator conditions and monitors, jeopardizing months of painstaking fertility treatment that may unravel in a matter of hours.
“Solar energy isn’t always available, especially during wars or border closures which happened arbitrarily,” Sarraj said. As a result, his father’s IVF center reeled from huge financial losses.
Now, Dr. Sarraj tells me, “After Israel’s ongoing carnage, the Sarraj center has been obliterated and all the medical progress we made … it is all ransacked, as if our breakthroughs never occurred. But they did. Amid a great deal of sorrow, they did. And by God, we never surrendered our commitment to our patients.”
For Saeed, who had already endured two failed IVF rounds and was mired in debt, the cold chain was non-negotiable. The timing of the daily electricity cuts was always different, each cycle stealing something essential: a charged computer to study for an exam; Suha’s sister Hala’s oxygen ventilator, needed to help her breathe through her neuroblastoma cancer; or a refrigerated specimen zipped in a biohazard bag and waiting to become an embryo.
“Keep in mind,” a disheartened Saeed told me one spring morning, “it was us who were naive to believe it would ever work. We would never even make it far enough to do a fresh embryo transfer in Gaza. Just like the lab results of my definitive diagnosis would never come back right.” He continued: “Maybe you’re thinking, how dumb of me, right? But I was young. I had just gotten married. It had only been a few years, and each doctor spoke with so much love, it was hard not to trust their medical advice.”
“Israel only allows us to have six hours of electricity per day. How can an embryo that must be held frozen at -197 Celsius stay viable when there are 12- to 16-hour daily power cuts? The labs and exams they use to diagnose my reproductive issue are all outdated. We’re under siege, as God is my witness! Still, we had no other option. Could we afford to cross the border to travel for the full round of IVF treatment in Egypt?” he added.
In the end, Saeed thought, swinging between self-blame and rage at the occupation that forced these terms of life, it wouldn’t be a bullet or a soldier that would undo him. The final betrayal would be by his own body.
None of this is to say that there weren’t moments charged with a kind of miraculous, improbable optimism. Gaza’s fertility specialists improvised whenever they could, making use of over 2,000 underground tunnels along the Philadelphi Route, which connected Egypt’s Sinai with the besieged strip, most of which were largely destroyed following the ouster of Egypt’s former President Mohammed Morsi in 2013.
Underground tunnels were dug to connect southern Gaza’s Rafah with the Sinai. While they were built to circumvent the Israel-imposed blockade of the strip, they weren’t just used for the transit of weapons for Hamas. They were for sustaining life: food, fuel, medicine, livestock, even the transport of brides from Egypt into Gaza to complete marriages stalled by the blockade.
Sometimes the magic came smuggled in through crates, ferried by thick rope: medical imaging parts, precision laser tools long forbidden, small portable incubators, preparation kits and even small X-ray components. Every so often, the tunnels even made possible the reunion of separated Palestinian families, making them whole again.
According to one embryologist from Al-Basma’s IVF center, who has asked to remain anonymous for security reasons, 2010 was the year that saw the most smuggling into the facility.
“A lot of it was also public,” he said. “During 2010, the movement of goods between us through the underground tunnels was not necessarily considered smuggling. Things were a bit more relaxed on the Egyptian side back then. But with Egypt’s regime change, and once Israel got wind of it, it became much harder.”
“On very rare occasions, we desperately smuggled in the modern tools we couldn’t work without, because there was no other way,” he added. “If providing an occupied population of millions with the essential needs for procreation, a God-given right, is my biggest crime, then so be it.”
In 2010, his medical team risked everything to smuggle in a contemporary laser device from Egypt — “life-changing,” he called it — for extracting microscopic samples from embryos. “After we received it, I couldn’t believe how we made do without it all this time. But this is only one very rare example of successful medical smuggling. It was far harder than one can even imagine.”
The device is standard-issue for high-stakes genetic testing in hospitals worldwide, yet blacklisted by Israeli border patrols. “That was the last time I recall smuggling successfully through the tunnels to our Basma center. It is not an easy process by any means and there is a lot at risk if we get caught. But it was a medical breakthrough. A moment our entire team will never forget.”
The microscopic precision the micromanipulation laser offers can be the difference between conception and embryonic collapse, making it absolutely essential for enhancing implantation outcomes.
But under Israel’s notoriously opaque and frequently changing dual-use regulations governing Gaza, “sensors and lasers” have been consistently listed among the most surveilled categories for medical goods entering the Strip. The list, which classifies a wide range of optical and laser instruments as dual-use, even extends to “equipment and tools of physical and chemical analysis,” enabling Israel to bar what are universally considered quotidian instruments of medical and scientific research.
(The dual-use argument is often absurd. Dates, dense with sugar, could have been a lifeline to starving Palestinians in Gaza, but have long been blacklisted because, as officials told CNN, Israeli security deemed the seeds “suspicious” on X-ray scans. Sleeping bags met a similar fate. They were green, a humanitarian worker explained, “and green means military, and military is dual-use.”)
“Male infertility treatment was frequently hampered for reasons beyond our control,” Ajjour of Al-Basma said. He cited DNA fragmentation testing, which measures the integrity of genetic material in sperm, as an impossible “medical dream,” as the equipment needed to carry it out is also blacklisted under “dual-use” rules.
Israel has long insisted that advanced lab technologies, such as centrifuges, DNA sequencers and chemical reagents — common elsewhere — pose a national security risk, as they could be diverted to “developing biological or chemical weapons.”
“Usually, this meant working with primitive biopsies without the latest development — essentially [using] outdated equipment. What good is that?” Ajjour asked. Decisions about what is prohibited are not open to negotiation or appeal. “Entirely forbidden,” he said.
Among the Israeli-designated “dual-use” items were critical laser devices, microcentrifuges, certain microsurgical instruments and gases used in the freezing process. “Many supplies were available,” Ajjour said. “But also, lots of indispensable supplies were not. These are essential. Honestly, if you asked any specialist treating male infertility whether they could manage without these basic tools, tools that are standard worldwide in the fragile treatment of embryos, they would simply laugh. It’s just near impossible.”
“Unfortunately, even some simple chemicals or solutions were delayed for months, and every delay meant the death of a couple’s dream,” Ajjour said. “IVF and ICSI are among the most time-sensitive procedures in the world. Israel knows this.”
In 2010, Gaza’s underground tunnels had ferried an improbable cargo: the blacklisted laser-hatching device for Al-Basma. Every passage through the tunnels flirted with disaster, but this one punctured the blockade with something rarer than joy. It was a medical victory, however slender.
The tool is a vital part of early screening, and without it a doctor’s ability to prevent inherited disorders or assist families with known genetic conditions is severely compromised. “We waited for years for it to enter,” Ajjour said. “When it finally did come in through the tunnels, I can’t tell you what that device meant to us. It cost us a lot. Unfortunately, it was used for less than a year, and then the [2012] war began.”
In 2009, Egypt had begun erecting an underground steel wall to stop the digging. In 2011, it briefly eased the border restrictions. But by 2015, the Egyptian military had shut many hundreds of tunnels — sealing off Gaza’s last opening to the world outside.
The first andrologist in Gaza who accompanied Saeed into the operating room for the laparoscopic varicocelectomy in 2017 wasn’t at all cruel, Saeed made sure to note. He meant well, he even spoke lyrically, but he was just as helpless as the next doctor working under a ruthless medical siege.
“I was in Egypt,” Saeed said, “when I first learned from the Egyptian doctor that my veins were never enlarged at all. You can’t imagine my shock.”
Saeed relayed what the doctor had told him: that the surgery he had had in Gaza didn’t address the root of the problem. The blockage was never in the testes but in the seminal duct, which was cinched shut. The surgery was “the wrong solution to a misread problem.”
Saeed was suffering from an obstruction of the ejaculatory duct, causing a blockage in the vas deferens, the slender channels through which male reproductive cells ordinarily travel.
Saeed still recalls the shock — the way the doctor, with such surgical detachment, glanced at the high-resolution ultrasound and, within what seemed like milliseconds, diagnosed the issue. Nothing about the scanning equipment was unique; they met the global norm for clinical-grade devices. Still, they were modern, and mostly inaccessible in Gaza. Had they been available, they would have offered Saeed critical diagnostic clarity years earlier. “The imaging and X-ray machines I saw at Dr. Ahmed’s office in Egypt … I’ve never seen ones like them before; they aren’t allowed to exist in Gaza,” Saeed told me, looking down. “The doctor looked at the scan for less than five seconds, I swear, and he spoke like it had all been obvious from the start.”
Gaza’s healthcare architecture, subjected to exhaustive oversight under Israeli diktat, hadn’t just failed Saeed. It had worsened what might have long ago been salvageable. To this day, the father-in-waiting carries no grudge for the misdiagnosis that cost him thousands of dollars and so many gray hairs.
For Palestinian fertility specialists, attending international conferences and exchanging the latest case studies and knowledge has been out of reach for almost 20 years, as Alaa Mourtaja, a former IVF specialist at Al-Basma, told me. He currently serves as a senior embryologist at Dr. Khalid Idriss Hospital in Jeddah, Saudi Arabia. No medical conferences or professional dialogue with peers abroad were admissible beyond Gaza’s borders. This enforced intellectual quarantine has kept Gaza’s doctors condemned to a permanent medical silo. That medical practice survived there at all under such isolation owes to the determination of Palestinians, who have been perpetually compelled to invent, and then reinvent, the impossible.
That need to adapt has sometimes forced families to pay steep costs. “All the gold jewellery we sold to get to Egypt was from Suha’s dying sister Hala, who has been paraplegic since the age of 6,” Saeed said. “Her other sister Haya even gave up her wedding ring! We gave and gave all the money that my family now in Gaza needs. Now they will die because of us. We can’t pay to evacuate them.”
Saeed had just heard the news that his brother’s pregnant wife was killed in an Israeli strike, while searching for flour among stalls that had nothing left to sell.
She was only two months away from giving birth.
It was a sultry Cairo day in July 2024. Saeed was describing a doctor in Gaza whose demeanour could ease the pain of his patients. “Their patience is legendary,” he said. “Unfortunately, I’ve only ever been treated that way by fellow Palestinians inside Gaza.”
In December 2023, Israel bombed Al-Basma, Gaza’s primary and most comprehensive IVF lab, obliterating the cryogenic tanks that housed nearly 4,000 embryos, thousands of sperm samples and countless unfertilized eggs. With that strike, a generation’s potential was incinerated in liquid nitrogen.
“We managed to rescue some equipment and devices from the site, and to this day, I remain in contact with everyone I worked with, though many have left the strip,” Ajjour said.
Prior to the latest Gaza war, only nine clinics in Gaza performed IVF. But the bulk of Gaza’s frozen embryos had been stored at Al-Basma. The explosion blasted the lids off five liquid nitrogen tanks located in a corner of the embryology unit. As the freezing fluid vanished, the temperature climbed dramatically. Over 4,000 frozen embryos and 1,000 active vials housing specimens of sperm, including Saeed’s, and unfertilized eggs were all left to perish. It marked yet another nail in the coffin of Gaza’s crumbling neonatal system.
Following his second passage to Egypt in 2022 in pursuit of preparatory fertility care, Saeed, already facing debt of more than $25,000, was to head back home to Deir al-Balah, where he and Suha still resided. He said a final goodbye to the curtained cubicle, the paper gowns, the Egyptian doctor who ran his own private clinic specializing in ICSI and who had declared him ready for the surgery, unaware that Saeed had little more than a skeletal stash of funds, enough to stave off hunger for a few days at best.
Saeed’s readiness came with a price tag he could never afford. The doctor had estimated a whopping $7,500 for the ICSI operation on Egyptian soil. Border crossings and aftercare, of course, were not included. And so, with his most recent test results folded into a manila envelope in one hand, and the pharmaceuticals prescribed by the doctor in another, he boarded a bus back toward the Rafah crossing. He was to return to his hometown of Deir al-Balah, where IVF might be marginally more affordable, but existed only in theory.
When the couple first began trying, Saeed was 29. He was working part-time as an assistant at Suha’s father’s butcher shop. He held a diploma in advertising and marketing from Palestine Technical College in Deir al-Balah, but in Gaza, paper means little, he said. Without a “wasta” (connection), someone to vouch for you, a certificate alone cannot open doors. And Saeed knew no one.
So, naturally, he worked as the next best thing he could find: an electrician, a handyperson of sorts, or even a gardener. He became whatever, whenever it was needed. No task was beneath him and no labour too menial. He rewired homes, scrubbed stairwells, trimmed hedges and installed entire lighting systems for a plethora of venues. Saeed became the guy people called, trusted and dependable. Each year during Eid, he even helped butcher cows, goats, sheep and camels for his neighbourhood in Maghazi. Every penny counted in the quest for his yet-to-be-conceived baby.
“Whatever it took to make money, I did. I worked day and night, I had to. But I also had much more energy those days,” Saeed recalled to me from his Cairo apartment.
Every job, no matter how slight or strange — hauling concrete up three flights of stairs, fixing the singed socket of a cousin’s rented flat — all of it was contributing to a future he was trying to build, brick by brick, for his wife and future children. He had learned from the best, after all: his own father, Mahmoud.
Saeed clung to memories of his cherished time with his father, the moments when Mahmoud was the person he should have been — and could have been, had it not been for the duress of life under occupation.
“Now he’s dying a slow death. And there’s nothing I can do from across the border to save him,” Saeded lamented.
Saeed imagined his father, now diabetic and living with uncontrolled hypertension, laughing and relaxed, as he used to be, after having just trimmed the fig trees and swept the twigs from the tiled yard in their home in Deir al-Balah.
“He asks me if I want an airplane ride and of course I say yes, what kid doesn’t?” Saeed, smiling, described one childhood memory to me. He remembers his father holding him by his right wrist and ankle and spinning him like a shot putter, never letting go. The garden turns into a green blur, and Saeed is flying — flying until he can spin no more. The memory has textures, smells, even the feel of the weather, a lack of rain and hints of orange peel. He recalled the garden in fine detail: the rhododendron bush, the olive trees, the weeds in the flower beds. But the finest detail was reserved for the look on his own face, creased with love and unbridled joy — not only for the ride but for being with him, for being with his dad.
Suha remembered the night before Saeed’s second border crossing from Gaza for his solo, pre-treatment evaluation in Egypt, how she wept into the folds of her sister’s black abaya, her hands clasped in Haya’s. The antique necklaces and bracelets once warmed by their grandmother’s skin were now charms in a last-ditch effort to coax life from the world’s most neglected ground. Even Haya’s wedding ring had been deftly slid off and placed right into Suha’s palm as capital.
“Don’t thank me. I will have none of that,” Haya told her that night. “Just tell us the good news upon his arrival, my dear.”
Suha felt open. To the endless possibilities that could come out of Saeed’s time in Egypt. To the advanced testing and the abundance of medicine that didn’t arrive in short, erratic bursts. To another medical opinion (they had stopped counting after the first seven doctors) unmarred by operational scarcity. Perhaps this was all they needed after all. She’d miss him for those six months, the first time the couple would have ever been apart for that long, but she’d have to make do. He was a man on a mission. And she would be waiting for his calls by the hour.
She remembered sitting in Haya’s room that October night, the air swollen and heavy inside her rib cage, because even if the good news should arrive, they knew their sister Hala’s days, marked by cellular decay from the advanced neuroblastoma, were as numbered as they were dreadful. Hala always pushed the hardest for Suha’s kids. Suha said it was because she believed in building a family that could outlast all the sorrow they had lived through, a generation of children who might one day live to see the freedom they did not.
“Let Hammoudy grow up with a cousin,” Suha recalled Haya whispering, in reference to her own son. “Encourage Saeed on this trip. Don’t stop encouraging him to finally become the father he’s always dreamed of being.”
“Let us fill the empty spaces that might come for us any day,” Suha recalled Haya saying in a soft voice, “so that these kids can each take care of each other, the way we tried to do for our sick Hala all these years. A large family, Suha, that’s all we have.”
With the clock on his 90-day visa ticking, Saeed would have to overstay his permitted time in Egypt, which would mean a $200 fine, even more money the electrician did not have. By then, the couple had tried just about everything: medication from Jordan and Turkey, treatment in Egypt that had already cost them an arm and a leg, hormone therapy, even dietary folklore passed down from a cousin in Khan Younis.
Unable to pay, Saeed returned to Gaza with a small suitcase, his treatment plan folded between two shirts that still smelled of Cairo’s chalky air. But Saeed didn’t come back to rest. The treatment still ticked inside him, like a watch in a drawer. Three months had passed since his initial treatment phase. He had another three months to go before he could give IVF another try.
He unpacked the medication first. The hormones were packed in a clear Ziploc bag with an ice pack that had long since melted. There was no proper fridge to store them anywhere in Gaza, not one with reliable power anyway, so he kept them in Hala’s house. They had a small backup generator for her oxygen ventilator, though it was flimsy at best. Between the infertile man clutching at his dreams and the cancer patient chasing borrowed time, they juggled medical appointments.
Back at the hospital in Gaza, Saeed felt like his waiting was finally about to mean something. Really, he felt it in his bones, he said. This time, he wasn’t relying on hope. He knew better.
He sat cross-legged on the exam chair, his posture revealing the detachment of a man who had memorized the stages of disappointment. Suha was right beside him, her hand locked around his.
The signs were all there. He could mouth the sentence before it even left the doctor’s lips. The dipped tone that always preceded clinical defeat, the clipped inhale, the fingers pressed together, the uncomfortable pivot of the office chair — a doctor’s body bracing to deliver the word “unfortunately.” The way doctors tried to reduce the gravity of lost virility into bullet points on a clipboard never made sense to him.
Clinically, the numbers had barely moved at all in months. The results, his doctor admitted gently, pointed to a continuing shortfall or deficiency in his gametes. The count had not changed. It was still zero, Saeed was told. There was nothing in the doctor’s manner to suggest a next step. “My most heartfelt apologies to you both,” he said, adding: “God does not judge us by outcomes, and He knows the measure of this trial.”
Saeed was back at another doctor’s office against his will, conscripted into yet another round of debasing screenings. This doctor was loquacious, his speech peppered with humour, though never inappropriate for the occasion, and Saeed never doubted for a moment that he wasn’t taking their issue seriously.
He liked the way this doctor called him boss, even though he clearly wasn’t the one running the show. “What do you call the sorrow of being the last branch of the family tree?” Saeed asked me. That day, he had thought, even just for a day, he’d answer to “boss.”
A few months after that visit, Saeed’s sperm count remained at zero. “We were stuck in a deadlock; nothing we did changed the circumstances. I was doomed,” he said. “Medical resources in Gaza are just too weak.” And the injections hurt. “They tired me out. I took them for months. But after the revised medication period finished in Egypt, the few [sperm] I did have at the very start of my journey dropped to zero. And that never changed,” Saeed told me, shaking his head now. “I was even worse off than when I started.”
“But after everything we’d been through, failure wasn’t an option. We spent too much, financially. We were too invested. We spent every penny a newlywed couple needs, for ourselves, for a home, all the savings I’d built over years, completely gone. We had to make it work.”
Six months later, he visited a doctor named Fayyad, who requested to withhold his last name. It was he who prescribed the supposed breakthrough, the plan that would finally summon sperm. This time, it was medicines and injections ranging from zinc supplements, Tamoxifen, Nolvadex and other testosterone-stimulating vitamins.
“I had a small amount [of sperm] before I started the accursed ‘Testoviron’ treatment years ago. I followed everything my doctors said religiously,” Saeed told me, nearly choking on his coffee. “I wonder sometimes, if I’d lived somewhere free, how much of my life I could’ve kept.”
After months of semen analyses, the doctor informed Saeed that the couple should prepare to undergo their third attempt at IVF. They had over 20 healthy eggs, retrieved from Suha’s ovaries in an outpatient procedure that was performed under general anaesthesia, and even — yes — the sperm. It looked “ready.”
It was to be now or never, the doctor told them. Six months had passed, and the next round of semen analyses had come back promising, motile, properly shaped, viable. Words that sounded holy to the emotionally broken ears hearing them.
The procedure was done at Kamal Adwan Hospital, the last operating major public medical facility in northern Gaza, since levelled by Israeli bombing in December 2024.
Saeed recalled how the chair was uneven on one leg, as if designed to remind one that comfort was never part of the treatment plan. It had a rigid plastic back that was “too tall, too straight,” pushing him upright like a guilty man awaiting sentencing. His hands were clenched so tightly they left half-moons in his palms.
That morning, the nurse had handed him a thin plastic vial. It was time to see which of his swimmers could outrun this place of misery and finally make it to the light. His fingers flexed and unflexed like they were trapped, searching for a release that never seemed to come.
When he emerged, he didn’t even trust his own hands to cradle the tube back down the hall to meet the nurse. He passed it back as fast as he could.
The lab results shattered the long spell of emptiness. In a small vial, a surge of hope came to life. Saeed had not one, but two ghostly white specks, drifting with no direction. Under the microscope, the medical verdict came in. One speck was abnormal, the other unmistakably alive.
Will it implant? Will it stay? Can a future miraculously sprout from all this desolation? No one could yet say for sure. But the best that science could offer under siege, it did — through in vitro fertilization beneath the rattle of explosions.
Not even a week had passed before Suha began her period.
“The baby couldn’t hold for longer than that. That’s how weak my cells are,” Saeed said, his chin sinking into his chest.
Without his wife’s knowledge, Saeed had been scraping together just enough to return to Cairo for one final, desperate pilgrimage. It was September 2023, just before the Oct. 7 attacks. This time, they sought not just treatment, but the full IVF cycle. It was an all-in gamble with a cost much steeper than their already accumulating loans. Everything they could spare was set aside for this.
“It should work. It will work,” he told himself the night before the trip, pacing in his bedroom.
For weeks, their only dialogue was the sound of things not being said. No one dared. He almost blurted it once, while Suha was brushing her teeth: that maybe this had to be the last time they tried, that he couldn’t afford any more. Affording ceased to be a question of cash. It was the fatigue setting in deep in the man’s body, as the sterile days turned into years. Ten of them, to be exact. And in his head, where thoughts crowded only in agonizing loops: failing cell counts, endless dollar signs, her disenchanted face, a choir of rejection from all the doctors he’d visited. There’s a certain level of fatigue that can give rise to insanity. Saeed was far past that. His head hadn’t been quiet in nearly a decade.
But he banished the thought. He was scared she’d hear it as surrender, scared she’d see him, not just as a man who couldn’t give her a child, but as one who had given up, too. And so he just watched the water run while she brushed her teeth. Let her rinse, spit and walk right past him.
On his family’s land, olives would soon pepper the earth beneath their trees, and Saeed — who had never missed a harvest season with his father and in-laws, their knees pitted deep in the dirt — felt a sharpness in the timing.
“I don’t know. To this day, I still get sad that our land goes on … with or without any of us,” Saeed said. “I get jealous and protective over Gaza’s soil. The way of nature, it is remarkable. It’s going to outlive us all, yet the soldiers treat the earth so horribly with bombs and white phosphorus chemicals.” Saeed gestured to his suitcase. “The wheels off that thing still smell like our concrete.”
He was busy filling another crumpled pouch with little snacks — date cookies, sunflower seeds, a few chocolate wafers. “For the road,” he anxiously murmured, after his wife joked whether all that sugar would help their chances of getting pregnant. He felt the weight of the journey might be softened with sweet things from home.
What was non-negotiable for Saeed, what mattered more than square footage or natural light, was the elevator. There had to be an elevator in their temporary home in Cairo. Not because Saeed was tired or picky, but because this time, it would be different. This time, they’d both be undergoing the highly taxing IVF procedure for the first time on Egyptian soil, and, as he had learned, it meant waves of irritating injections, hormone storms, surgeries, bed rest, days of delicate movements and strict instructions. There would be a wife — perhaps a new mother — in recovery.
Just two weeks after the pair crossed the border, the war on Gaza commenced. Suha would never see her sister Hala again. Saeed would never see his mother again.
In “They Make Death, and I’m the Labor of Life,” Layal Ftouni, a scholar and assistant professor of gender studies and critical theory at Utrecht University, writes of how Palestinian life asserts itself not in spite of, but within, the machinery of incessant death and destruction wrought by the Israeli occupation. She writes of a love for life so inextinguishable it smuggles itself through the aperture of steel bars in prison cells, often during family visits. From the depths of arbitrary confinement, where tens of thousands of Palestinians are held by Israel, the act of “sperm smuggling,” a Palestinian invention of only the last two decades, circumvents settler-colonial efforts to curtail the reproduction of Palestinian life.
Palestinians’ tireless insistence on life-making contrasts with their colonizers’ monopoly on life-ending — “born,” as Ftouni writes, “from within conditions of woundedness and out of Palestinian fortitude, simultaneously.”
“In our lives, we blame the occupation for everything,” Saeed chuckled. “The bravery of our doctors makes every other man appear as if he were a two-dimensional paper drawing.”
I asked Ajjour, of Al-Basma, about the surreptitious transfer of sperm from Palestinian prisoners held hostage inside Israeli detention centers, an act that bypasses walls, wires and entire systems designed to make the future seem impossible.
At the beginning, he told me, the process was chaotic. There was no protocol, no real structure. But “the most crucial factor was ensuring the sample reached the freezing lab alive.” For a long time, it didn’t. The journey was too long, the handling too abrasive. Most early attempts arrived at the lab lifeless, often past the viability window, and were rendered unusable.
But over time, medical professionals, prisoners and equipment all adapted. “Once we started giving clear instructions to those involved,” he said, “the samples arrived viable and, slowly, the cases began to succeed.” Just a courier and a container, holding what the team came to refer to as “a hope suspended between life and death,” he said.
When I asked him what the effort meant to him, not as a lab director, but as a human being, he said: “It’s a human right, for every Palestinian behind bars, for every family — despite the most unfair challenges you can ever imagine, Palestinian life has a right to continue, and it always will.”
And in many of these cases, it did: life, smuggled from behind concrete walls, across impossible distances, hoisted even through crawlspaces and hidden in dates, into a vial of liquid nitrogen. Fathers who will never touch their own children, born of divine intervention as they were. Babies who came into the world knowing them only through cherished relics, village hearsay and creased photographs. Still, they arrived as heirs to a proud lineage maintained by the brave men who dared resist. An embryologist from Al-Basma attests to Ajjour’s account, on condition of anonymity, adding: “There were some moments where we felt not as if we were in a medical center, but actually, that we were in a resistance arena, where every tube held so much symbolism for all of us, and every sperm cell carried a deeply historic message. When pregnancy did occur, the joy was indescribable, proof that prison isn’t the end of manhood.”
Saeed is not sure if anyone who treated him back in Gaza is still alive. If they are, he’d want them to know how much their care healed the parts of him that were never sick. He’d want his future child to know what it meant to be loved like that, with the kind of kindness that lit up even the darkest room. To be treated like something so precious, even in a place where everything was always at risk of breaking. “I promise you, it is not us who are unsophisticated. It’s the rest of the world,” he told me, “these doctors are much more than healers.”
Beyond the draconian limits imposed on their profession, Gaza’s ART specialists embraced a much higher calling; they became the most compassionate custodians, not just of biology and cells, but of a people starved of care. To Saeed, they would always be above blame. None of his doctors from Gaza have been reachable. Still, he’ll always remember them this way.
Right before crossing, he felt his feet come to the path as if they were magnets to iron. “I didn’t want to leave. Really, I didn’t want to come here. I wanted to have a child on my soil. On my terms. I wanted agency. I wanted to be surrounded by my family during what would surely be another round of painful surgeries.
I wanted my mother to meet my future child. And to reencounter her own son, unshackled from this ceaseless affliction. My mother is dead now.”
The moment had finally arrived. There, up on the windowsill where Suha kept her toothbrush and a moribund basil plant, was the test, lying face-up. She was sitting on the ledge of the cracked enamel-coated tub next to a balled-up lime microfiber towel and the mug she uses for rinsing. The sink was speckled with dried toothpaste, and the whole bathroom smelled insistently like damp stone. Somehow, Suha thought the fall evening breeze — part heat wave, part Cairo rot — could whip the pregnancy results right out of the plastic. And so she left it up there while the minutes passed.
They’d stockpiled the little hotel sachets — shampoo, conditioner and some multiuse body wash that smelled of dusted rose — for the weeks to come. Anything to save up where they could. It had been two weeks since the embryo transfer. The days passed, bloodless and hopeful. Her body was a ticking, traitorous thing, she thought.
Suha paced back and forth on the grey and brown checkered bathroom floor, wearing rubber wash slippers with wilted flower prints that made a nervous pitter-patter against the ceramic tiles. The chipped walls and the floor she was treading were dull with age. She wondered if women are born to be haunted, or if the haunting is something they ought to be grateful for.
Outside, a neighbour watered the streets with a hose, an absurdity no local can explain. Dogs were howling like wildcats. In the window’s reflection, the half-drawn November moon wavered. It was maddening, this street they’d settled upon in Ain Shams — its after-hours, high-decibel life roared all through the night. Still, she angled her head and perked her ear up to the window to listen. The hullabaloo felt oddly calming, as if it were proof of life beyond her own walls — a home, perhaps, that would soon be barren no more.
A negative result would end their chances at parenthood — thousands more dollars they did not have. They had already poured upward of $35,000 into the trip — more than enough to relocate their families out of the lion’s den.
The bathroom door was tobacco-dark, poorly painted, its hinges loose. It didn’t reach the floor. Doors rarely did in this city. Saeed studied the scars in the paintwork while he waited, wondering how many men before him had occupied this mortifying space of male impairment. Through that uneven slice of light underneath the door, he watched as his wife’s shadow moved — pacing in short, clipped strides. Saeed knocked on the door.
“Suha, ya galbi [my heart]?” he tried. No answer.
His ear moved closer to the wood. He heard rustling, and his insides began squirming, an instinctive recoil. A gasp, a wail. More inaudible sounds floating. Then nothing. Was this joy, afraid to speak its name? Or grief?
“What is it?” he asked again. “What happened?!”
Still no answer. He pressed his ears to the door until the rusty, powdery smell shot right up his nostrils.
He could feel his pulse in his palms. There was a spill of sound. Guffaws bordering on hysteria. Or perhaps sobs of despair. She made no sound of thanks. None of her usual prayers braided with hope, no soft recitation to carry meaning through the door. She would never invoke the name of God in a bathroom. And so the silence left him stranded, aghast, a prisoner of circumstance.
Suddenly, the lock clicked. A chink of light parted the door’s grain. Pinned in place by his wife’s face, Saeed was momentarily deaf. He was oblivious to everything but the flood of light — and the lambent woman before him, cupping the soft rise of her belly, now carrying 10 years’ worth of belated fortune.
Hoda Sherif is an Iranian-Egyptian investigative conflict reporter and writer based in Cairo
