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“Everybody Must Not Go Through The Natural Way Of Conception"

By Odimegwu Onwumere
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Some people are today proud parents with the help of IVF but their children and them are facing stigma upon acceptance sensitization groups are building around IVF. The cost of IVF might not be for the poverty-stricken, but experts’ opinion is that people should speak out if they achieve a successful pregnancy through IVF,Odimegwu Onwumere writes

Couples in Nigeria who have tried to conceive naturally but failed are opting in numbers for In-Vitro Fertilization, popularly called IVF.

With stigma that women with challenges of fertility are enduring in the country, fertility specialists are not sleeping on their oars to encourage couples to go for IVF to restore or boost fertility, because research has shown that IVF is a successful way for conceiving and also, treating for men and women similarly.

IVF has brought excitement on the face of a 34yr old lady who preferred not to be mentioned in the media, after she was delivered of her baby. This was subsequent to 10yrs of childlessness in marriage.

Her body language suggested she was invariably avoiding stigma, after the delivery, due to her conception methodology.

However, the University of Port Harcourt Teaching Hospital, UPTH, and its environs were agog on January 12 2019, as the news of her successful delivery filtered in the air.

Some couples that were expecting fruit of the womb wished they were her. At least, have a child of theirs and avert insults people rain on them, because of childlessness. Others might not want to be her, given the process of her conception.

The significance of her glorious delivery was that she was the first to break the jinx of IVF, at the UPTH, two years after the hospital instituted the expertise.

Those in the Gynaecology Department headed by Dr. Preys Fiebai and the Assistant Conception Unit, headed by Prof. John Ikmalo, were all jubilant.

The Chief Medical Director of UPTH, Prof. Henry Ugboma was not left out, as he sermonized that the fruition of her delivery was the ebullient efforts of the Obstetrics and Gynaecology Departments and Conception Unit.

Prof. Ugboma nonetheless asked those having challenges of fertility to come forward as there are many women who are now pregnant through the IVF process. Hence, Prof. Ugboma told our reporter, “Everybody must not go through the natural way of conception.”

Breaking Barrier Of Infertility
While the lady who was delivered of her baby at the UPTH was not ready for identity divulgement, Halima Danladi was all out to tell her story.

Danladi’s story was a sorry tale owing to the fact that she was barely 25 when she got married. Before then, her expectation was that it was only aged people that had problem of taking in. But fate had a different lesson to teach her.

The husband who was 28 and she, did all they could to have a child, naturally.

Her clock was ticking at this point, betraying her already prediction that by 40, she must have finished having her children.

Mrs. Danladi had a dream of having four children. But as much as she tried to conceive, her monthly menstruation would return. In some months, she would Google to understand what early pregnancy signs were. This could not help, occasioned by her menstruation that always returned. Books on a woman’s fertility signs she read seemed not working, either.

Poverty could not be held responsible for her ordeal, as her husband and she were doing very well. She was a banker and her husband, a lawyer. She was always thinking what the problem with pregnancy not coming her way was.

As they expected pregnancy, she was already 28 and her husband, 31. Five years down the line they were married, there was no child. Family members and friends cajoled them and many said that Halima preferred her career to raising children.

Much as her beloved ones’ words were piercing her, she was hopeful but only started avoiding those making caricature of her. But when she looked around, some couples who were yet to think of marriage when she married her husband, had children. She was dumbfounded and broke down in several occasions. One day, her husband and she considered IVF treatment.

UK Trip That Opened The Eyes
When Halima traveled to the UK as she always did, the myth she had grown up to believe which was that only aged ladies find it hard to conceive, was broken. On discovering this, she did not know what to make of the advise from her doctors in Nigeria, which was that her husband and she were young couple and should not tremble over infertility.

Halima was shocked in the UK when she discovered that under 37 women, made two-thirds on the line of women receiving IVF treatment. It was like a mud on her face – a reality, to also discover that women who were aged between 18 and 34 comprised about 44 per cent of IVF patients. She said that women aged 40 only occupied 20 percent of women seeking for IVF. She was worried of what her husband and her problems were.

Series of tests were conducted on Halima and her husband right there in the UK. It was later discovered that her husband had “anti-sperm antibodies”. This was not explained to them all the while they were junketing from one hospital to another. At this point, Danladi was already 34. Still young to perform as man if all had been well.

Danladi was having obstacle of blood and semen flowing properly that could make her wife pregnant, according to explanation by an expert. It was suggested that this could be as a result of injury he sustained in the cause of doing a hard job or illness that resulted to attack on his semen.

Problem Not Always From Women
Consequently, Dr. Abayomi Ajayi, the Medical Director/CEO, Nordica Lagos, Abuja and Asaba, said in his numerous open presentations on fertility test, that men should always go for medical checks, just as their wives do and should not, apportion blame on their wives for challenges of fertility in marriage, because results had proved that problems also come from men.

In his words, “In Nigeria and perhaps much of Africa, the common thought regarding infertility is that the problem lies within the woman’s physiology. This is because a woman’s reproductive organs can be more easily damaged than a man’s.”

Well, when Danladi’s infertility predicament was unveiled, intra-cytoplasmic sperm injection (ICSI) was introduced to Halima and Danladi. They went through the processes prescribed to them by their doctors and today, they have a child – Tamani. The couple love their daughter as if they are going to die today.

Myths Around IVF Babies
While many women are proud mothers today through the help of IVF, there are persons who think IVF babies are not normal, being the reason the 34yr old lady didn’t disclose her identity to the media. She would not want further stigma, having suffered much, during the years of her holocaust.

According to Dr. Ajayi on the stigma against IVF babies, “Some say there is nothing, some say they may inherit their parents’ infertility, of course that may not be farfetched because many causes of infertility are inherited.

“So it is possible for that one to happen...Some talk about their intelligence but nothing unusual has been found on that aspect; these are just anecdotal. As far these things go, IVF babies are normal babes.

“From what I have seen, children conceived through IVF tend to be precocious. But this is not backed up with scientific fact. I have seen at least 1,000 of these babies and there hasn’t been any fact to suggest a risk.

“Few may have skeletal abnormalities but these things come from the pregnancy. In summary, certainly do not have any fears about babies born through IVF.”

Notwithstanding, while those who held negative opinion on IVF babies might not expunge their conundrum, in August 2015, Nigeria first IVF baby, Hannatu Kupchi secured admission into European Varsity.

Kupchi was born at Nisa Premier Hospital in Abuja, precisely on February 11 1998.

On the occasion marking his send forth in 2015, Dr. Ibrahim Wada, the medical director of Nisa Premier Hospital that guided the supposedly first IVF experiment in Nigeria said, “It is very difficult to make a statement on a day like this.”

He continued, “When I was out of this country, I knew there were people who wanted babies. I made the decision to come back to Nigeria to help people.

"It happened on the 11th of February 1998, when this historic event occurred at this hospital. The baby of that historic day is going to become a doctor. Because the parents stood firm, we were able to help others."

Proud Of IVF Babies
There are persons and organizations on rampage such as the Fertility Advocate Awareness Initiative, FAAI, sensitizing people on what they should understand about fertility including the use of IVF.

During one of their outings in Lagos, the President of FAAI, Mr. Omoi Evborokhai frowned at the stigmatization and discrimination that some persons trade around IVF children.

Evborokhai said, “I can boast of my child because my child is expensive, very expensive. I have spent money and earned every kobo spent on the child, so my head should be high up there and not bowed down. That should not arise anyhow.

“We are proud of our babies, they bring joy to us, they complete our families and we are proud to talk about fertility treatment at anywhere and anytime.

“IVF babies are not inferior because IVF is special and brings joy to the families. IVF babies are normal; my baby walked when all children her age started school and is doing fantastically.”

IVF Babies Are Normal…This Is How
Professor Oladapo Ashiru, Medical Director, Medical ART Centre, Lagos, highlighted the processes of IVF and concluded that the children are carried in the womb nine months like those conceived naturally.

“In the IVF conception, the egg is removed from the mother and mixed with the sperm in the laboratory dish or tube.

“Then the embryo is now placed into the mother’s womb two or three days after developing in the incubator in the laboratory.

“Basically the IVF baby stays in the womb for nine months; less three days.”

Whether such children are intelligent or not, the professor added, "IVF babies have grown to be very intelligent, normal and smart just as babies from normal conception…

“I truly do not have any concern about IVF babies. Those that can have issues are those with multiple conceptions such as twins, triplets or quadruplets. In these cases once they are exposed to good antenatal care they should be fine."

Dr. Ajayi added a voice in confirmation to the professor’s stance, saying that children born through IVF are just like any other human being.

“If you interact with them, you will agree,” Dr Ajayi advocated. He went down memory lane and said, “Known then as “test-tube babies”, Louise Brown, born in England in 1978, was the first baby to be conceived outside her mother’s womb.

“We have over 1,500 babies that were born at our Nordica centres and we want more people to join them so we can go on to propagate this gospel.”

As if that was not enough, checks revealed that outside Nigeria, a former First Lady of the United States, Michelle Obama, exposed that she and her husband, ex-President Barack Obama, had their two children – Malia and Sasha – through IVF.

The first daughter Malia Ann was born on July 4, 1998; while Natasha (aka Sasha), was born on June 10, 2001, according to the family’s Wiki entry.

Why Some IVF Treatments Don’t Yield Result

What could be misleading couples not to gain pregnancy through this process was that they go for just a cycle of IVF treatment and do not return if this failed.

Dr. Ajayi at the Failed IVF Cycle Open Forum organized by his medical centres in 2018 emphasized the need couples should go for multiple cycles.

The World Health Organisation (WHO), also clamorded that women below 35 with challenges of fertility could go for, at least, two IVF cycles.

This is because research has prevailed to expose that women are likely to achieve their desired result with multiple cycles than those with first cycle.

For instance, a Medical Journal of Australia released a study where success rates of women over the age of 40, having a live baby, climbed from 10 per cent at the primary cycle of IVF, to around 40 per cent at the end of the seventh cycle.

Cost Of IVF In Nigeria
IVF is not conducted on a platter of gold and seems, it is not for the poor.

This was the story of Tade Alalade and her husband who until they had their twins on November 22 2018 after 11yrs in marriage, they had spent 11 million Naira in IVF treatment.

What pushed them to IVF was that they realized after getting married that they were AS, a condition that could make them breed a child or children who might be patients of sickle cell anemia or SS carrier. Apart from this, it was noted that Tade had several miscarriages.

Investigation revealed that one factor that could affect the cost of IVF treatment was age. Younger couple was positioned to have success quick than the aged. According to experts’ analysis, it was learnt that the IVF success rate for couples below 35 years was 40-45%; and 30 to 35% for couples between 35 to 39 years, correspondingly.

Our reporter learnt from the editor of Nigerian Price (NP), a forum that is bent on health issues, that IVF has financial prices to it. However, experts opined that a typical IVF treatment takes between 4 to 8 weeks depending on the fad of the case and most time there’s usually no need for admission.

“If the egg or sperm isn’t as viable as it ought to be due to age, the couple will have to buy the egg or sperm from donors which tends to increase the overall IVF treatment cost,” as according to experts.

“Egg donation can cost up to N500, 000 while sperm can cost up to N120, 000, but you can get a family member or close friend to donate the egg or sperm to you. This will reduce the cost dramatically.

In a public presentation on 5th January 2019, the NP elaborated the different costs of IVF as they pertain to the Nigerian audience. It was an effort to create awareness on the intending IVF patients of what they should expect.

“The cost of the procedure usually ranges from as N800, 000 to as much as N1, 900, 000. It could be more or less depending on the centre and the treatment plan,” said NP.

It was noted that this money can be paid by bits depending the agreement reached by those involved.

“In some cases, you can pay 50 to 75% prior to starting the treatment,” said the source. “Then you can pay the balance when the treatment is completed.

The source enthused further, “The number of cycles is another vital factor that should be considered when calculating the cost of your IVF treatment.

“For example, at Nordica, a reputable IVF centre in the country, the cost ranges from N870, 000 to N1, 760, 000 depending on the number of cycle.”

Curtailing Quackery In IVF
Across the country, fertility centres are sprouting in the modern times but government is disturbed. It does not want the name of the country to be thrown into the mud; hence it has geared up to checkmate their activities.

For instance, the Lagos State Government and the Association for Fertility and Reproductive Health, AFRH, have been working hand in hand to curb the state of the menace of quackery.

The Lagos State Governor, Mr. Akinwumi Ambode was in the forefront of this battle. In October 2018, he was represented by the Special Adviser on Primary Health Care, Dr. Olufemi Onanuga at the 8thAnnual International Conference of the AFRH, dubbed, “New Frontiers in Assisted Reproductive Technology, ART”.

Ambode told the masses that the government would not leave anything unturned in its efforts to give every helping hand to AFRH to establish a safe environment for couples in need of infertility treatment. The governor does not want anyone to be hoodwinked while seeking for help on his or her fertility challenges.

He was looking at the importance child bearing is in the Nigerian communities and by extension, across Africa. He warned quacks to go out of business because without the Assisted Reproductive Technology today, many couples would be bereft of children.

“As a responsible government, we are willing to collaborate and partner with AFRH to ensure enforcement of the law against fake and unprofessional practitioners. This is a duty to us as a state,” Ambode said.

He continued, “Child bearing in this part of the world is considered one of the most important parameters in accessing successful marriage. This technology has put smiles on the face of couples and helped to hold many marriages that would have been truncated by challenges.

“I am happy to note that as a government we have recorded some progress in this regard through the Institute of Fertility Medicine in partnership with Bridge Clinic, which was designed to make ART services available at affordable rates for indigent couples, and has resulted in successful delivery of 74 babies to couples.”

Ambode was keen to seeing that ethical standard and affordability for couples were of utmost priority to the services rendered by professionals across the 43 IVF Centers that operate nationwide of which 35 being privately owned.

President of the AFRH, Dr. Faye Iketubosin supported Ambode, saying, “The rapidly unfolding development of Assisted Reproductive Technology practice calls for coming together of all Centers in Nigeria as we have done at this meeting, to discuss important issues with a view to check unethical practices and abuse of those seeking our services while obtaining the minimum standard for establishing IVF clinics.”

It has become obvious that many couples are fulfilling their parenting dream through IVF therefore defying negative impression once created around this process of conceiving, no matter the cost attached to it.

The Keynote Speaker at the AFRH conference, Joyce Harper, a professor of Human Genetics and Embryology at the Institute for Women’s Health, University College London, asked the authorities to egg on people who had their babies through IVF to tell their story given that in United Kingdom, there is no negative concern shown about IVF.

A fertility specialist and Medical Director, Lifeshore Fertility Clinic, Lagos, Dr. Taiwo Orebamj also advised those having fertility problem not to keep to themselves, but seek for help in the hands of medical experts. And if they are able to conceive through IVF, they should not allow stigma to erode them, but should speak out.

· Odimegwu Onwumere writes from Rivers State. E-mail: [email protected]