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When IVF Fails, Other Therapies Can Help

Thursday, August 11, 2011

IVF Is It!

Assisted reproductive technology takes root in Nigeria, as many clinics with facilities for such spring up


At over 50 years of age, half of that as a married woman, Fadekemi Williams (not real names) had given up hope of having a child of her own. She had undergone a variety of orthodox and unorthodox conception procedures, all without a positive result. But about five years ago, Williams, who works with one of the General Hospitals in Lagos, told a friend about the problems she was getting from her in-laws on account of her childessness. The friend suggested Assisted Reproductive Technology. She was not overly excited about the idea. But after much persuasion from her friend, she agreed to give the procedure a shot.


Unfortunately, the first round did not go well. The doctor harvested 10 viable eggs, but none of them fertilised. The second visit two years later was fruitful–a set of triplets at the age 53. Williams’ babies were produced from her eggs and her husband’s sperm and were delivered through Caesarean Section at the Lagos State University Teaching Hospital, Ikeja.


Ngozi Nwueze, a staffer of the Lagos State Teaching Service Commission, also experienced childlessness for many years before considering the same procedure, better known as In-Vitro Fertilisation, IVF. Ngozi had been married for eight years. Fertility specialists discovered that she had scarred tubes, endometriosis-a condition that occurs most commonly within the Fallopian Tubes and ovaries that may lead to painful menstruation-and fibroid tumours. Ngozi and her husband could not afford the cost of IVF, so they opted for less expensive treatments.


As a last throw of the dice, they decided to save up money and try IVF at a clinic in Lagos. After three attempts, Ngozi became pregnant and now has a son. “The first three attempts were so heart-rending. Thanks to my husband, who encouraged me to try again. Although the cost was so high and almost affected his business, he told me not to worry. Now, I am a proud mother of a healthy boy,” she told TheNEWS.


IVF appears to have grown in popularity in Nigeria, where there are no fewer than 14 IVF-focused clinics. Most of the clinics were established in the last six months. The latest entrant is the EkoCorp Fertility Centre, an arm of Eko Hospital plc in Lagos. The most prominent are The Bridge Clinic, St. Ives Clinics, Roding Medical Centre, Medical Art Centre, Hope Valley Fertility Clinic, Nordica Fertility Centre and Omni Advanced Fertility Centre, all in Lagos.


Others are M&M Hospital, Aba, Abia State; Nisa Premier Hospital and National Hospital, both in Abuja.


The clinics offer a wide range of services such as Intra-Cytoplasmic Sperm Injection, ICSI, (a procedure in which a single sperm is injected directly into an egg in an attempt to achieve fertilization); intra-uterine insemination (otherwise called artificial insemination.It is the process by which sperm is placed into the female reproductive tract for the purpose of achieving pregnancy), sperm donation, surgical sperm retrieval (a procedure in which sperm is removed from inside a man’s genitals instead of waiting for the sperm to be ejaculated out), surrogacy, egg donor and intra-fallopian transfer (a method in which eggs are removed from a woman’s ovaries and placed in one of the Fallopian tubes, along with the man’s sperm).


However, the cost and wide error margin of the procedure continue to keep many of those who need it away. Chances of success vary widely for each patient, say experts, depending on the cause of individual infertility problem and age. According to experts, the success rate of 25 to 30 per cent of IVF treatment in Nigeria is the same as obtained anywhere in the world.


Chances of success will depend on many factors, including the cause of the fertility problem and age. The older a woman is, the less her chances. Women above 35 years have far slimmer chances. Women under 30 years are said to have a one in four chance of getting pregnant using the procedure. For those over 40 years, it is one in ten. “Usually the success rate of IVF treatment depends on the number of cycles. One attempt of IVF cannot give you more than 30 per cent chance. So, people have to try it several times. We tell people that the more they do it, the brighter their chances. The success rate of nature is about 18 to 20 per cent every month. If IVF can give you 25 per cent, it is a little bit more than what nature can do,” said Dr. Chidozie Egwuatu, consultant gynaecologist and Medical Director, Lifegate Specialist Hospital, Ogba, Lagos. In Nigeria, many of the clinics claim fantastic results on the successful birth rates in their clinics. Some claim as high as 40 per cent success rate.


Dr. Egwuatu revealed that to increase the chances of success, some clinics abroad ask patients to pay for four, five, six attempts at a go, before they start treatment. The thinking is that a woman’s chances of success are higher in multiple IVF treatment.


Dr. Abayomi Ajayi, medical director, Nordica Fetility Centre, Lagos, said what IVF tries to do is a replication of what happens in a woman in a natural cycle. “IVF babies are normal babies and that is because the quality control system in the body is not tampered with in IVF. That is why we have normal babies. People want to increase success rate without decreasing the quality of the baby. So that is usually the balancing act that is being carried out in researches,” Dr. Ajayi informed.


The cost of IVF in Nigeria, said experts, is also reasonable. This is said to have encouraged a number of Nigerians resident overseas to come home and take advantage of the lower cost for some treatment cycles before returning overseas. In the United States, the average cost is between $10,000 and $12,000, while in the United Kingdom, a cycle costs between £4000 and £8,000. This includes fertility testing and consultation fees. In Nigeria, it costs between N300,000 and N1.5 million for a cycle of treatment, depending on the clinic.


The Bridge Clinic in Lagos is reputed to be the first IVF-focused clinic in Nigeria. It opened in 1999 and has been at the forefront of new developments within the field. Recently, the clinic claimed to have achieved success in gestational surrogacy, the first pregnancy in Nigeria attained through Intra- Cytoplasmic Sperm Injection and testicular sperm procedure. Also, the clinic claimed to have treated over 4,500 clients. It recently celebrated the birth of over 1,000 babies to families that had difficulties conceiving.


“We are committed to providing superior IVF services comparable to international standards. We do not create children; only God has the power to do that. But through our assisted conception services, we have been able to bring succour to thousands of couples experiencing fertility challenges all over the country and beyond,” Dr. Richardson Ajayi, Medical Director of the clinic said at the opening of its fourth facility in Kaduna.


Nordica Centre recently introduced an IVF technique that doubles the procreation chances of men with abnormally low sperm count and poor sperm mobility. The new technique is called Intra-Cytosplasmic Morphologically-selected sperm injection, IMSI. This enables the direct selection of good sperms from the man and then injecting them into the woman’s egg to successfully achieve pregnancy.


Ekocorp Centre claimed it had its first batch of IVF patients in December 2009 and till date, 57 patients have so far obtained treatment at the centre. Out of that figure, 27 pregnancies were recorded, a 36 per cent success rate in less than two years of operation, according to Dr. Sonny Kuku, Chairman, EkoCorp plc. “As at now, we have 10 children delivered from treatment received at the fertility centre and 13 ongoing pregnancies. Our results to date are respectable and compare favourably with what obtains in fertility clinics of similar status in the developing world,” Kuku said at the opening of the clinic in February.


St. Ives Clinic, run by Babatunde Okewale, claimed it has successfully delivered close to 200 IVF babies in its less than a decade existence. Just recently, the clinic announced the delivery of a baby girl by the oldest IVF mother in Nigeria, 57-year-old Mrs. Adeyemi Taiwo.


In Nigeria, unlike in other climes, women still shy away from sharing their experiences after successful IVF treatments. Many women would rather attribute their conception and eventual delivery to spiritual intervention.


—Funsho Arogundade


SOURCE: THENEWSAFRICA.COM


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