When an Israeli projectile hit Gaza’s largest fertility clinic in December, the explosion blew off the lids of five liquid nitrogen tanks stored in a corner of the embryology unit.
As the ultra-cold liquid evaporated, the temperature inside the tanks rose, destroying more than 4,000 embryos plus 1,000 more samples of unfertilized sperm and eggs stored at Gaza City’s Al Basma IVF center.
The impact of that single explosion was far-reaching: an example of the invisible toll that Israel’s six-and-a-half-month attack has had on Gaza’s 2.3 million people.
The embryos contained in those tanks were the last hope for hundreds of Palestinian couples facing infertility.
“We know deeply what these 5,000 lives, or potential lives, meant to parents, whether for the future or the past,” said Bahaeldeen Ghalayini, 73, a Cambridge-trained obstetrician and gynecologist who founded the clinic in 1997.
At least half of couples – those who can no longer produce sperm or eggs to create viable embryos – will not have another chance to get pregnant, he said.
“My heart is broken into a million pieces,” he said.
When asked by Reuters on Wednesday about the incident, the Israeli military’s press desk said it was investigating the reports. Israel denies intentionally attacking civilian infrastructure and has accused Hamas fighters of operating from medical facilities, which Hamas denies.
Three years of fertility treatment were a psychological rollercoaster for Seba Jaafarawi. Removing her eggs from her ovaries was painful, the hormone injections had strong side effects, and her sadness when two pregnancy attempts failed seemed unbearable.
Jaafarawi, 32, and her husband were unable to get pregnant naturally and turned to in vitro fertilization (IVF), which is widely available in Gaza.
Large families are common in the enclave, where almost half the population is under 18 and the fertility rate is high, 3.38 births per woman, according to the Palestinian Bureau of Statistics. Britain’s fertility rate is 1.63 births per woman.
Despite Gaza’s poverty, couples facing infertility turn to IVF and some sell televisions and jewelry to pay the costs, Al Ghalayini said.
There’s no time to celebrate
At least nine clinics in Gaza perform IVF, where eggs are removed from a woman’s ovaries and fertilized with sperm in a laboratory. Fertilized eggs, called embryos, are often frozen until the optimal time for transfer to the woman’s uterus. Most of the frozen embryos in Gaza were stored at the Al Basma center.
In September, Jaafarawi became pregnant, in her first successful attempt at IVF.
“I didn’t even have time to celebrate the news,” he said.
Two days before his first scheduled ultrasound, Hamas launched the October 7 attack on Israel, killing 1,200 people and taking 253 hostages, according to Israeli counts.
Israel vowed to destroy Hamas and launched an all-out attack that has since killed more than 33,000 Palestinians, according to Gaza health authorities.
Jaafarawi worried: “How could I complete my pregnancy? What would happen to me and what would happen to those inside my womb?”
Her ultrasound was never performed and Ghalayini closed her clinic, where five more of Jaafarawi’s embryos were stored.
As the Israeli attacks intensified, Mohammed Ajjour, chief embryologist at Al Basma, became concerned about the levels of liquid nitrogen in the five sample tanks. Refills were necessary approximately every month to maintain the temperature below -180°C in each tank, which operates independently of electricity.
After the war began, Ajjour managed to secure a supply of liquid nitrogen, but Israel cut off electricity and fuel to Gaza, and most suppliers closed.
In late October, Israeli tanks entered Gaza and soldiers closed the streets around the IVF center. It became too dangerous for Ajjour to control the tanks.
Jaafarawi knew she had to rest to keep her fragile pregnancy safe, but dangers were everywhere: she climbed six flights of stairs to her apartment because the elevator stopped working; A bomb leveled the building next door and shattered the windows of his apartment; Food and water became scarce.
Instead of resting, he worried.
“I was very scared and there were signs that I was going to lose (the pregnancy),” she said.
Jaafarawi bled a little after she and her husband left their home and moved south to Khan Younis. The bleeding subsided, but her fear did not.
‘Five thousand lives in a shell’
They crossed into Egypt on November 12 and in Cairo, her first ultrasound showed that she was pregnant with twins and that they were alive.
But after a few days, she experienced painful cramps, bleeding, and a sudden change in her abdomen. She arrived at the hospital, but the abortion had already begun.
“The sounds of my screams and cries in the hospital still ring in my ears,” he said.
The pain of loss has not ceased.
“No matter what you imagine or tell you about how difficult the IVF journey is, only those who have been through it know what it’s really like,” she said.
Jaafarawi wanted to return to the war zone, retrieve her frozen embryos and try IVF again.
But soon it was too late.
Ghalayini said a single Israeli projectile hit the center corner, blowing up the embryology lab on the ground floor. He doesn’t know if the attack specifically targeted the lab or not.
“All of these lives were killed or taken: 5,000 lives in a single projectile,” he said.
In April, the embryology lab was still littered with broken masonry, blown-up lab supplies and, among the rubble, liquid nitrogen tanks, according to a journalist hired by Reuters who visited the site.
The lids were open and, still visible at the bottom of one of the tanks, a basket was filled with tiny, color-coded straws containing the ruined microscopic embryos.
(Reporting by Andrew Mills, Imad Creidi and Saleh Salem in Doha, additional reporting by Dawoud Abu Alkas in GazaWriting by Andrew MillsEditing by Peter Graff)