Wednesday, May 8, 2019

Bringing IVF to the streets

Two of a kind—young, brilliant and ambitious, Drs. Adeleke Daramola and Charles Oluwabukunmi Kolade are bonded by a common passion.

As the Medical/Clinical Director and Gynaecologist/Chief Operating Officer, Androcare Fertility Centre, Lagos, respectively, Daramola and Kolade have special interest in fertility treatment. They assist couples challenged by infertility to have their own babies. They also teach other doctors and healthcare providers how to make babies in the laboratory

Their  common agenda  is to bring IVF to the streets. Six years ago, they started off Androcare as the first and only fertility centre in Akowonjo, a Lagos suburb, offering tests based on achieving the cause of the infertility for couples by running advanced diagnostic tests. 

“ We are bringing IVF to the streets,” Daramola remarked during an encounter. “Androcare is a centre for those on the streets not only for the rich. By this, what we mean is that we do not want IVF to be only for the rich. Everybody should have access. “We know IVF is an expensive process and unaffordable for many as a result. That is one of the reasons we are here. We want to help many people to find a way to enable them achieve results they desire,” he asserted. Androcare runs a fertility academy in the belief that it will enable doctors that want to have training on the field of fertility medicine can benefit. 

Normally doctors interested in this specialist field in Nigeria travel abroad as there are no such facilities in Nigeria. “We are one of the pioneers of training for healthcare providers interested in fertility medicine, we have things in place for them to be trained. “Averagely 10 percent of Nigerian couples have issues with fertility and we lack enough doctors to cater for the problem, so we are helping to train doctors as that would make the work easier and enable everyone to have access to fertility treatment. “We give room for doctors that are skilled in these procedures but have no centre to do their treatment.” 

“We are bringing fertility to the streets because there are infertile couples that wait for years for a miracle to have a baby because they cannot afford to pay for IVF. We do not want it to be like that. It would be nice for those without the money to pay for IVF to be parents also. “On the streets we make the cost of IVF not to be scary for people, and not to market to get more clients.  We are trying to offer something that is cheap but also of quality standard. “We have the ideal standard embryonic laboratory, this also determines the success of the treatment as a whole. We don’t try to scare people away to achieve conception, “ he argued. Infertile couple fulfills parenting dream through IVF 

Daramola asserted that setting up a fertility centre is challenging. “It requires financial power. Our Centre is available for interested doctors to utilise as we have state-of-the-art facilities for them to have their procedures done.” The medics advise couples that are having difficulty getting pregnant for at least one year, that it is wise to  carry out some investigations on both partners. Daramola continued: “There was this issue of unexplained infertility we had to deal with in which the man and wife were okay, but never achieved conception. Thanks to the advent of the procedure known as Sperm Chromatin Assay Structure (SCSA), we were able to help out. “It tells us the DNA make-up of sperm cells which means it is possible for some men to have normal sperm cells, yet due to the abnormal DNA they carry, they are unable to fertilize the eggs or they are able to fertilize the eggs but the embryos come out in a poor fashion. “This procedure helps many couples to know the next step to take, whether to go straight for IVF treatment or for Intra-cytoplasmic Sperm Injection, ICSI, which is an advanced treatment for low sperm count and other problems with sperms produced by the man himself or donor sperm.

 “This procedure has opened doors and made couples smile. Knowledge is power, so most men that feel that just having normal sperm count is enough should not just relax,” Daramola noted. “Our goal is to make things easy. We do not want infertility to be a stronghold in Nigeria. So there is all round benefit for the couples and medical professionals.”

 Noting that prevention is better and cheaper than cure, he observed that most cases of infertility can be prevented, but many people lack such knowledge. He said among the commonest causes of infertility in Nigeria are blocked fallopian tubes in women and low sperm count in men. “This problem of low sperm count is increasing yearly, and the causes are largely unknown.  The issue of blocked tubes arising from pelvic infections that are not properly treated is very common. “So if the younger ladies can take care of such things early enough, and take preventive measures, they should know of the implications of blocked tubes. We have been trying to go to schools to educate on fertility health for youths.” In their views, the medics explained that low sperm count is caused by varicoceles. “Men have enlarged veins in their scrotum which starts from childhood, and if not early detected and corrected could lead to zero sperm count in the future. 

“Last year, Androcare in collaboration with another NGO organized a seminar for teenagers. For the males, we taught them to do a self-testicular examination and for the women, we encouraged breast self-examination. The participants were taught the common symptoms of STIs so they are aware.”

Kolade pointed out a scenario: “For instance, testicular mumps affect fertility from childhood, this is why mothers should check their sons’ testicles when bathing them. If the testes are not in their normal position by the time a boy is 4 years old, he may be infertile for life. “The problem must be fixed before he attains age of 4, not even at 5 or at 6. This and other abnormalities happen over a period of time but can be corrected when detected early.” 

On the issue of blocked Fallopian tubes that are commonly called toilet infection, Kolade affirmed that medically, there is nothing like toilet infection. “We know it  more as sexually transmitted infections. Toilet infection is a slang and there is no diagnosis for it. It is essentially utilised  to make the condition acceptable to the layman. “A woman can have vaginal discharge that is whitish or yellowish, with or without odour. There could be accompanying pelvic pain, in the left lower side of the abdomen. There could also be itching and discomfort. These are signs of infection and it is important for ladies to properly get treated when they see such signs. “Go for vaginal swab, do microscopic culture and consult a doctor to treat the infection properly so there is no recurrence. Maintain proper hygiene, avoid STIs and obey the ABCs of prevention of STIs, that is, A for abstinence, B for be faithful and C for utilising condoms if you cannot abstain, Daramola advised. 

Speaking further, Kolade said one of the drivers of female infertility is pelvic infection or infection after pregnancy. “In this part of the world, pregnancy termination is not legal and there is tendency to do it in a clandestine manner. So there is that aspect of termination of pregnancy that is predisposing pelvic infection. “There are rampant cases of women getting pregnant and having a baby three months after marriage and then not being able to get pregnant again because of the process of the pregnancy, so there is also that part of infection through sex following previous pregnancy, delivery or even a C-section. “If there is an infection, it could make things complicated. Infection generally is a big problem for fertility for men and women. “If there is abnormal DNA, we put the man involved on drugs to see if there could be some form of repair, but there is no particular drug that treats low spem count. However, ICSI helps.”

 On whether there are factors in the environment that influence declining fertility rates in Nigeria, Kolade stated: “What I can say is that in 2003, myself and a few colleagues did a study,  we compared sperm parameters in a particular IVF unit for 1,000 people and compared with sperm parameters for 1,000 people in 2013 and we discovered that the parameters were worse. The sperm counts were worse, the motility worse, morphorlogy worse and fertilisation rates worse. “The only thing different apart from climatic change is that our lifestyle is getting Westernised. There’s more of polished food and canned food being consumed. Even people in the Western world are experiencing the same thing.” Continuing, Kolade stated: “Recent activity showed us that 1 out of 4 people between 25 and 40 years old, has abnormal sperm parameters in Europe. And that’s why they are trying to talk about organic meals now.  They have noticed because  our lifestyle is getting westernized, it is gradually affecting our fertility,” he argued. 

Essentially, Androcare has a plan to help couples that have undergone failed IVF cycles but want to try again. They give discounts in such cases saying failures help to attain success and also encourage preventive means. The medics observed that some people really don’t need to do IVF if they can do the right thing and can prevent themselves from infection.