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When IVF Fails, Other Therapies Can Help

Wednesday, December 11, 2013

EXPERTS CALL FOR REGULATION OF IVF PRACTICE


IVF experts in the country have raised the alarm that due to lack of regulation, childless couples are being exploited in fertility clinics.

Invitrofertilisation (IVF), a method of conception for couples that cannot have their own babies, is becoming increasingly popular nowadays. So far, over one million babies have been conceived through the test-tube method globally.

Even in Nigeria, where many couples who have fertility challenges are yet to access IVF, over 40,000 babies have been born through the procedure.

Infertility among women and men is on the rise, hence the growing popularity of this procedure.

However, experts have raised the alarm that due to lack of regulation from government, fertility treatment in Nigeria is being infiltrated by quacks.

According to the Chief Medical Director, The Bridge Clinic, Dr. Richard Ajayi, more than 60 per cent of people offering IVF service in the country do not have the facilities and qualified personnel for it, but they continue to do so in order to get money from patients.

Ajayi said that due to the perceived financial benefits and patronage, doctors and health workers who know little or nothing about IVF have continued to take advantage of couples in need by offering services they lack the right infrastructure to offer.

The procedure is not cheap and it depends on one’s location in the country. A round of IVF goes for between N 500,000 and  N900,000.

He said that in addition to knowledge, the state of medical equipment and facilities in an IVF clinic could determine the success of an IVF procedure.

He said, “If you claim to be an IVF expert and you don’t have the right equipment to check if the sperm you have collected from the husband is fertile or the eggs you have collected from the woman are good, then you have offered a sub-standard service.

“If you do not have the right incubator or freezers to ensure that the eggs you collected are properly preserved and stored, then you have exploited your patient.

“If you do not have the machine to ensure that you transferred the right embryo into the womb, then how do you know that it would survive? For a round of IVF to be successful, a clinic must have the right laboratory.

“How many IVF clinics have the personnel and equipment for this? How many women even know this?”

Ajayi noted that because government is yet to see infertility as a public health concern, it has also failed to regulate IVF treatment.

He added, “Some doctors and even nurses claim to be doing IVF. And because it is not regulated, we cannot police or prosecute anybody. So patients are just paying for services that are not rendered.

It is so bad that some doctors even offer money-back-guarantee for IVF. They are marketing it, knowing well that it is not every woman who is infertile that needs  IVF.”

Ajayi stated that this infiltration of quacks in fertility treatment has increased the number of Nigerians travelling abroad for IVF treatments that is available in the country.

He said, “We cannot allow this to continue. Many women have lost millions of naira to quacks in the name of IVF. They are now confused as to where to go because they have done it in one or two clinics in Nigeria and it failed.

“So, it is those who can afford it that can even travel to the United Kingdom for treatment. It is another form of medical tourism that should be discouraged.

“Government must regulate it to protect Nigerians and also stop the millions of naira they spend in foreign hospitals on IVF when it can be done here.”

Professor of Gyneacology and Obstetrics at the Lagos University Teaching Hospital, Idi-Araba and co-pioneer of IVF in Nigeria, Osato Giwa-Osagie,  agrees with Ajayi that lack of regulation has also encouraged unethical practices, such as the transfer of multiple embryos in spite of the dangers it poses to both mother and child.

Giwa-Osagie said that though the ideal practice was the transfer of a single embryo to reduce complications and health risks, many fertility clinics in the country continue to transfer more than two embryos.

According to him, multiple pregnancies has an increased chance of resulting in miscarriage, premature birth and  the mothers often experience a lot of complications including high blood pressure, especially in Nigeria where there is poor maternal health care.

Giwa-Osagie said,“ Multiple transfers are also more likely to result in premature birth  and premature babies are more likely to have congenital problems like cerebral palsy or birth asphyxia. But the practice now is that women who have conceived through IVF have twins, triplets and even quadruplets.

“These doctors endanger the lives of the mother and the babies because when you transfer more than two embryos, you may have more than two babies. When you have three, four babies or more, the complications for the mother and babies are much higher than when you have one.

“In exceptional circumstances, the people who are over 40 may take three because their fertility rate is low. But people should not transfer more than two.”

While canvassing the regulation of the procedure, he noted that such would serve as a check for practitioners who have been making false claims to lure fertility challenged couples to their clinics.

Giwa-Osagie said, “Many claim that they have 60 per cent pregnancy rate when in actual fact it is 25, just to entice women to patronise their clinics. But if it is regulated, we can verify such claims by the number of babies that are born and it will form a basis for licensing of practitioners.

“We must regulate how many embryos should be transferred. We must determine what qualifies you to operate an IVF clinic and what should be the qualification of doctors who offer infertility treatments”
 
by Bukola Adebayo

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