Thursday, September 8, 2011

Infertility: Nordica offers free IVF

Research has shown that one out of every four couples or 25 percent of couples have fertility problems and would require one sort of intervention or the other, which is part of the reasons why we have appreciable demand of Assisted Reproductive Treatment (ART) solutions such as the popular In-vitro Fertilisation (IVF).

Recently, the excitement was quite high at the Banquet Hall of the Grand Hotel, Asaba Delta State on the occasion of this year’s draws of the Fertility Treatment Support Foundation (FTSF) initiative implemented in partnership with Nordica Fertility Centre, Lagos/Asaba. According to the Medical Director of Nordica Fertility Centre, Dr. Abayomi Ajayi, the idea of organising a public draw, in which 16 Nigerian couples across the federation would, over a two-year period, have opportunity to access series of free IVF cycles under the FTSF initiative formerly known as E.A.R.T (Expanded Access for Reproduction Techniques) and was established as a result of the prevalence of infertility in our society today.

“Affordability of treatment is one of the most common causes for concern of the fertility-challenged couples as a regular IVF cycle in any standard fertility treatment facility costs an average of N650, 000 to N1, 000,000 depending on the clinic and profile of the case. As a result, many couples desirous of conceiving their own babies have been denied the opportunity to have access to the initiative, due to their inability to afford the cost. Hence, to keep the dream of fertility-challenged couples alive, FTSF was born.”

The FTSF has, for years, been committed to the goal of giving 16 lucky Nigerians completely free IVF treatment cycle over a space of two years. The initiative was put together as a platform for enabling all fertilitychallenged Nigerian couples, to have access to the best and most advanced assisted fertility treatment services in the world, at no cost. The two lucky couples, who ultimately emerged from the raffle draw, will benefit from a full IVF or combination fertility treatment novel initiatives. This translates into two Nigerians every quarter.


Bridge Clinic launches LASUTH IVF Facility in Lagos

NIGERIA’S foremost IVF and assisted conception clinic, The Bridge Clinic, has launched an IVF facility known as the Institute of Fertility Medicine in Lagos State University Teaching Hospital (LASUTH) with the Commissioner of Health, Jide Idris, and other dignitaries, in attendance.

The facility, which is a CSR initiative by The Bridge Clinic, is in collaboration with the Lagos State Government and is one that will offer IVF services at subsidised rates to couples who have had difficulty in conception.
Speaking at the launch of the Institute of Fertility Medicine in the LASUTH Complex, the Managing Director of The Bridge Clinic, Dr. Richardson Ajayi, said: “Of utmost importance and concern to us is the well being and happiness of the Nigerian woman and our community at large in the provision of quality fertility services as the same global standard we are known for.

“This is why at The Bridge Clinic we have found it necessary to collaborate with the State Government to set up this clinic as part of our CSR initiative, to reach out to more needing families to help them experience the joy of childbirth, and also try to give back to the community that has given us so much.”

Ajayi said since the IVF procedure involved the employment of expensive resources, such as highly trained staff, expensive equipment and consumables, the cost especially in a developing economy like Nigeria could be high.
This, he said, “makes it unaffordable for the average woman.”

Also commenting on the launch, Idris said: “Lagos State is thrilled to be collaborating with The Bridge Clinic on the launch of this facility (Institute of Fertility Medicine) which will bring the IVF and other gynaecological services to the women of Lagos State at a highly subsidised rate.

“We have no doubt in our minds that The Bridge Clinic, being the first solely focused assisted conception clinic in Nigeria, will deliver top of the range services to every woman that walks through the doors of this new facility we are launching here today. The purpose of partnering with The Bridge Clinic is to ensure the goal of restoring the joy of families is achieved at a subsidized rate.”

Since its establishment in Nigeria, the clinic has achieved a number of firsts, the most notable being the first to achieve a birth by surrogacy and also the first to achieve a birth by Surgical Sperm Collection (SSC).
The clinic has recorded the birth of 1,252 children since opening its operations to the public in 1999.



Following revelations that many Nigerians seeking solution to infertility problems are falling into the hands of quacks, a fertility expert has advocated that In-Vitro Fertilisation (IVF) Treatment must be demystified in the country.

To this end, Prof. Oladapo Asiru, medical director, Medical Art Centre (MART), who made the call said most people with infertility problem that get pregnant and bear children through IVF should reveal the background of their story to encourage others with similar problems to access the same care.

IVF, which is a major treatment in infertility, is a process by which egg cells are fertilised by sperm outside the body: in vitro. IVF is used when other methods of assisted reproductive technology have failed. The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman’s ovaries and letting sperm fertilise them in a fluid medium. The fertilised egg is then transferred to the patient’s uterus with the intent to establish a successful pregnancy. The first successful birth of the baby from this procedure, named, Louise Brown, occurred in 1978.

Speaking further on demystifying IVF, Ashiru who is an experienced endocrinologist and joint pioneer of IVF Research in Nigeria said, “The earlier IVF is demystified in this country, the better it is for the people,” and reasoned that the development will make the procedure a popular and acceptable treatment for infertility.

In addition, he said it will open the door for people to access IVF treatment from genuine and reputable fertility health facilities.

He made the call at a Clinical Presentation on High Incidence/Order of Multiple Pregnancies and Multiple Births in the Last Two Rears in the Medical Arts Centre at LOFUM House, Maryland, Ikeja, Lagos State.

According to Ashiru who founded the Medical Arts Centre and runs it with other fertility physicians and embryologists, many people in the country just get pregnant through IVF, but they do not reveal the success story behind the procedure of that conception and successful delivery.

However, he lamented that this problem of secrecy is not limited to infertility alone, adding that even regarding menopause, some women do not want to own up that they have attained menopause. “Whereas, menopause is a normal process of ageing”, said Ashiru..

He lamented that because there is not much awareness about IVF as a treatment option for infertility, people are going to wrong places and are being mistreated. “Some patients receive the worst of quackery,” said Ashiru.

On the successes recorded at the Medical Arts Centre in the area of multiple pregnancies and multiple births between 2009 and 2011, Ashiru said, “We recognise the fact that in 2009 series, we had mainly twin pregnancies while in 2010 series, we had higher number of gestations such as quintuplets. Thus, we reduced the number of embryos transferred in IVF treatment this year 2011.”

Explaining the reason why women seeking IVF treatment at the Medical Arts Centre are not only recording successful pregnancies, but also multiple babies in twins, triplets and even quadruplets, Ashiru said the multiple pregnancies at the centre are due to the effectiveness of the stimulation protocol, the efficiency of the laboratory, especially with Intra cytoplasmic sperm injection (ICSI), the high quality of embryos as well as the use of ultrasound guided embryo transfer. “We equally recognise the role of our pre-IVF evaluations such as Hysterosonography, ovarian improvement regime, and the use of immune support are contributing factors to the successes.

Besides, he noted that the quality of the embryos and success rate is due to additional services in the Medical Arts Centre such as the use of pre-implantation genetic diagnosis (PGD) and blastocyst transfer. PGD is a technique used to identify genetic defects in embryos, created through IVF before pregnancy).

Similarly, the centre has an efficient management team on ground. “Currently, at our centre, the overall pregnancy rate is about 45 per cent in all ages per embryo transfer,” said Ashiru.

Highlighting other reasons why people choose IVF treatment in other countries, he said the procedure is now being done for other reasons. “Some people are now doing IVF because of convenience,” he said.

For instance, a woman who is married to a pilot that is constantly traveling and is away from home may not be able to utilise the ovulation period and the woman can be missing intercourse during ovulation day for a whole year. “So, he just brings his sperm, stores it in the laboratory and when his wife is ovulating, the sperm will be used for her. So, IVF is now done as a programmed thing as well as for elderly patients to eliminate abnormality in their kids,” said Ashiru.


Monday, September 5, 2011

IVF still an all-comers affair in Nigeria

The absence of a regulatory framework for fertility treatment in Nigeria has continually put a growing number of couples in need of In vitro Fertilization and other Assisted Reproductive Techniques (ART) on the vulnerable edge.

Added to this, is the growing incidence of public distrust for the health system in Nigeria, has encouraged quackery in the highly specialized field of medical technology.

This has become a major issue of concern to experts, especially at a time debates are raging over what passes for ethical or not in Assisted Reproduction among various groups of people.

This played up at a recent jaw-jaw session held in Lagos between medical experts, representatives of religious groups, media and others organized by the Bridge Clinic, one of the first few fertility treatment centres in Nigeria.

There, it was reiterated that a growing number of Nigerians, especially females are faced with the sad society-induced consequences of not being able to conceive and have babies naturally.

Managing Director, Bridge Clinic, Dr. Richardson Ajayi, noted many Nigerian couples are truly finding it difficult o have babies naturally, but added that the advent of IVF and similar techniques have brought succor to many people in the country as well.

He, however, said, “The absence of regulatory framework has made it difficult to ensure standards are kept, as some people, because they have the money to buy equipment would just go into fertility treatment.”

At the Society of Gynecologists of Nigeria (SOGON) conference held earlier in Abuja, Ajayi emphasized that all stakeholders must look at the state of regulation around the world and focus on ethical issues that might have to be considered in Nigeria before making proposals for deliberation.

At the Lagos session, he noted that “the United Kingdom and other countries already have resounding frameworks for the regulation of fertility treatment,” adding that Nigeria must begin to think in that light.

Meanwhile, in a collective resolution, experts, religious, leaders and others present at the Lagos meeting agree that IVF, is an ethical practice, although questions were raised by the religious groups

“The catholic does not support any act that would amount to termination of life and in IVF and similar procedures we do know that the unwanted embryos, which by all definition is already a life are destroyed to avoid multiple implantations are destroyed. This the catholic does not accept,” Catholic priest, Sylvester Nwutu, noted.

According to him, the catholic supports natural means of procreation because it fosters the God-given union between the couples involved.

Similarly, a Muslim cleric, Suleyman Fulani, noted that some of the procedures are accepted as medical exigencies by Islam so long it is not performed by the opposite sex in cases that require the patient baring intimate parts of the body.

It was difficult convincing attendees at that event that surrogacy, was indeed ethical as some of them believe, there are other means of achieving this.

The catholic cleric, just like an Anglican Priest at the event, thinks adoption is a good option for those desiring of babies, considering the huge tendency of parental crisis that could emanate.

Consultant Obstertrician and Gynaecologist (O&G), Professor Friday Okonofua, however, pointed out that surrogacy does not run foul of ethics.

“In surrogacy, the sperm and egg that achieved fertilization are actually from the couple and not the person carrying the baby. There is no genetic input from the surrogate mother at all,” Okonofua said.

It was, however, unanimously accepted at that meeting that IVF and ART for single women and same sex couples should not be encouraged, hence rated as unethical.

Consultant O&G at Lagos State University Teaching Hospital (LASUTH), Dr. Niyi Oduwole, said, “Agreed, westernization is catching up with us, but we should also be cautious to imbibe, as much as possible, the good things and not the bad ones. IVF for same sex, singles should not even be in our thinking otherwise it would be a lost fight to ever convince anyone that the process is ethical at all.”

In Anglican priest’s words, “we are raising a society of responsible people. Any woman who wants to have babies should just go and get married otherwise, should adopt a child.”

Mr. Emmanuel Ugoji of Ipas Nigeria, however, added another tilt to the arguments, when he said, “In all of this, choice should determines what action a couple takes. What if you are neither a Christian nor Muslim, and not guided by the respective laws and doctrine. What do you do when you are confronted with issues on childbearing in a country like Nigeria. The couple still must make a choice on what is good for them, although the eventual decision must be guided by adequate knowledge.”

IVF and Intra-Cystoplasmic Sperm Injection (ICSI) are two commonly used procedures to achieve conception in couples with ICISI being specifically used to treat male factor infertility.

According to experts, one in every four couples in Nigeria may have difficulty achieving conception through natural means, highlighting the increasing problem of infertility. Most of these cases are caused by infections over time, of the female reproductive tract, tubal blockage or rupture as well as low sperm count and poor sperm quality, among others.

Although, infertility among many couples is perceived as mostly from the female, studies have shown that a growing number of males factor infertility, which is associated with various factors.

A case-control study of risk factors for male infertility in Nigeria by Friday Okonofua and four others Infertility is associated with various proxies of sexually transmitted infections (STIs) and poor healthcare-seeking behavior for STIs in Nigerian men.

The study, which also featured in the Asian Journal of Andrology, found, in a multivariate analysis that male infertility was significantly associated with bacteria in semen cultures, self-reporting of previous use of traditional medications and moderate to heavy alcohol intake, but not with smoking and occupational types.

They also found that infertile men were significantly more likely than fertile men to experience penile discharge, painful micturition and genital ulcers. They are also less likely to seek treatment for these symptoms and more likely to seek treatment with informal sector providers.


Friday, September 2, 2011

IVF centre ‘records high pregnancy rate’

prof. ashiru

A LAGOS in-Vitro Fertilisation (IVF) centre, Medical Art Centre, says it has recorded the highest pregnancy rates in the history of IVF in the country.

According to its Medical Director, Prof. Oladapo Ashiru, the accomplishment was due to the effectiveness of the stimulation protocol, the efficacy of the laboratory especially with intracytoplasmic sperm injection (ICSI), staff and quality of embryos coupled with the use of ultrasound guided embryo transfer.

Ashiru disclosed this during the clinical presentation of the centre. It was tagged high incidence/ order of multiple pregnancies and multiple births in the last two years.

He said during an 18-month period from 2009 to 2011, 20 women within the ages of 30 to 35 had multiple pregnancies from twins and quintuplets, adding that of those women, one delivered a singleton, six twins while three delivered triplets. Another woman also delivered quadruplet while two delivered quintuplets.

In addition, three women are currently carrying singleton, two twins, one expecting triplets and two women quadruplet pregnancies.

Ashiru said: “We recognise the role of our pre-IVF evaluations such as hysterosonography, ovarian improvement regime and the use of immune support as contributory factors to the success.”

He praised the quality of embryos, pre-implantation genetic diagnosis (PGD) and blastocyst transfer for the successful pregnancies.

Ashiru said many of the women before their successful IVF treatment had psychosocial and emotional issues. “For example, many marriages were saved,” he added.

He said it is left for couples to narrate their stories, adding that people are still skeptical in our society to share their personal experience after a successful IVF treatment.

Ashiru said: “It is important to dispel the myths around IVF treatment and IVF babies. IVF produces normal babies who grow up to be bright and intelligent children.”

He said people should be encouraged to share their stories which may help other couples find succour.

“We believe the more people talk about their success openly, the better it would be for those who need such services and the more acceptable the process would be, he said.