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When IVF Fails, Other Therapies Can Help

Monday, October 1, 2012

30,000 babies born through IVF in Nigeria

IVF technique records 40% increase in pregnancy rate
NEW advances in technology, facilities, drugs and expertise have led to a 40 per cent increase in In Vitro Fertilisation (IVF)/ first test tube baby pregnancy success rate in 34 years, with an estimated 30,000 babies in Nigeria and five million globally.

The first IVF baby, Luis Brown, was born in England 34 years ago, while the first in black Africa was on March 17, 1989, at the Lagos University Teaching Hospital (LUTH), Idi-Araba.

IVF, which involves placing an egg and sperm together in a petri dish for conception, and a sub-category known as ICSI (intracytoplasmic sperm injection) where the sperm is inserted with a micro-needle directly into the egg, have become commonplace.
But it has proven controversial over the years, with some fearing it paved the way for so-called designer babies whose characteristics are chosen by parents.

The Vatican considers it immoral because of the wastage of a large number of embryos, and the procedure has been criticised for allowing women to have children until a much older age.
Olushina Eghosa Oluwaremilekun was born to the family of Mr. and Mrs. Pius Oni after five years of painstaking research by Profs. Osato Giwa-Osagie, an obstetrician and gynaecologist and Oladapo Ashiru, an endocrinologist.

Ashiru, the joint pioneer of IVF in Nigeria, said the country had recorded 40% increase in IVF pregnancy success rate from 10 per cent in the 70s to 50 per cent in the 2010s. He said since the first success 23 years ago at LUTH, about 4,000 babies had been born through IVF in Nigeria.

The European Society of Human Reproduction and Embryology (ESHRE) in a story published recently by Agence France Presse (AFP) said as the initial controversy over man’s scientific manipulation of nature has faded, about 350,000 babies conceived in petri dishes are now born every year. That represents about 0.3 percent of the 130-million-odd babies added to the world population annually.
The International Committee for Monitoring Assisted Reproductive Technologies (ICMART) at the 28th annual meeting of ESHRE, which opened in Istanbul, Turkey, on Sunday said the five million IVF babies mark was based on the number of IVF and Intra Cytoplasmic Sperm Injection (ICSI) treatments recorded worldwide up to 2008, and estimates for the years thereafter for which confirmed figures are not yet available.

The data showed that about 1.5 million IVF and ICSI treatments are now administered around the world every year - more than a third of them in Europe.
ESHRE noted that success rates have stabilised, with about a third of fertilised embryos implanted resulting in a live birth.

While reacting to the global estimate released by ESHRE, Ashiru told The Guardian that that scenario was due to improvement in the pregnancy success rate of the technique.
Ashiru said: “The overall pregnancy rate has improved significantly from five to 10 per cent in the late 70s and early 80s to 20 per cent in the 1990s. The current global pregnancy rate is between 25 and 50 per cent depending on several factors like age, weight, and state of health of the couple as well as the facilities and expertise available at the IVF centre.”

He noted that the technique was enjoying a lot of patronage in Nigeria because most hitherto infertile couples now had their own babies. He said IVF had helped couples select the sex of their child and avoid genetic abnormalities through Pre Implantation Genetic Diagnosis (PGD).

Ashiru, who is also an adjunct professor at the University of Illinois Chicago, United States and Medical Director of Medical Art Centre (MART), Lagos, further explained: “I am familiar with this compilation. The International Federation of Fertility Societies (IFFS) compilation last year was estimating the numbers to be over 4.5 million babies as at 2009. The latest, which is to be presented at the ESHERE meeting of over five million is to be expected. Babies born in Nigeria through IVF should be approaching 4,000 based on the performance indicator we get from various centres across the country.
“It is also correct to say that now in the year 2012 with over 5000 IVF Clinic world-wide, of which about 26 are from Nigeria the number of babies born word wide daily would be substantial.”

According to Ashiru , IVF centres abroad run an average of 10 to 100 IVF cycles per month and that the Medical ART Centre runs an average of 25 cycles per month.

He, however, said that there were several comments on IVF cost and the use of ICSI as opposed to the conventional IVF in the publication.
Ashiru further explained: “I want to say that each person makes comments based on their preference. Those that do not have the IVF programme say the cost of IVF is expensive, while those who do not have the facilities for ICSI in their IVF programme says that ICSI may produce abnormal babies. From our experience at the Medical Art Centre and some other centres in Nigeria there is no difference between the conventional IVF and IVF/ICSI.

“What we have experienced is that some people especially those with advance maternal age have the tendencies to have abnormal embryos. When they go through our screening with PGD during their IVF treatment, we found out that some embryos that could have been considered normal for transfer are not and hence not transferred while only the normal embryos are transferred. This way one is sure that should the conception occur it will be from chromosomal normal embryos, thereby reducing the chance of abnormalities.

He added: “We have equally done this successfully in couples who are sickle cell carriers that end up with normal babies with AA or AS genotype eliminating the risk of SS genotype babies.”

Ashiru said the improvement in IVF pregnancy rate had come with a cost.

“With regard to cost, the truth is for the IVF success to have moved from a 10 per cent pregnancy rate to about 35 per cent rate, a lot of improvement came from the various manufacturing industries from the drugs to the media and expertise as well as the equipment to achieve the greater success; those improvement don’t come cheap,” he said.

Chairman of the ICMART, David Adamson, said: “Millions of families with children have been created, thereby reducing the burden of infertility.”

A member of the team that helped conceive the world’s first IVF baby, Louise Brown, born in 1978, Simon Fishel, said: “The five million milestone ‘justifies all the legal and moral battles, the ethical debates and hard-fought social approval.’”

ESHRE said there was a trend in Europe to implant fewer embryos at a time, causing a drop in multiple births, which carry a higher risk of complications for the mother, a lower baby birth weight, and developmental difficulties.

The number of triplets has fallen below one per cent, said the statement, “and for the first time, the twin delivery rate was below 20 per cent.”

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