BY CHIOMA OBINNA
Despite the devastating nature of infertility, it has remained one problem anyone would want to bury. Why? It is perceived as a taboo.
Today, statistics available show that one in six couples seek treatment for infertility. But, despite the breakthroughs in reproductive medicine, one in 20 couples still do not succeed. Experts say breaking the silence by accepting the available technological innovations would eliminate the stigma and challenges associated with the condition.
In an interview with Vanguard Features, Dr. Michael Ogunkoya, a Fertility specialist and the Managing Director of Hope Valley International Clinic in Lagos said instead of Nigerians suffering from infertility to continue to experience the various stigmas and challenges associated with the condition,they should embrace the technological innovations aimed at helping them with conception.
Hope Valley International Clinic is one of the successful Assisted Conception clinics in Nigeria. The clinic, has its headquarters in Lagos and other centres in Kaduna, Abuja, Port-Harcourt and Benin.
“To the glory of God, we have over 1000 babies delivered through Assisted Reproductive Technique (ART). As I speak to you now some people are about to deliver. As at the last count, we have 1008 babies and we are still counting and we have to continue. We have four centres scattered all over the country. We pride ourselves with high success rates which is probably due to the diligence we have here.”
According to Ogunkoya, there is no need to hide the problem because women having troubles with conception are now being assisted to conceive through various scientific procedures ranging from artificial insemination to surgical sperm retrieval, assisted hatching to ovulation induction and cycle monitoring. In Vitro Fertilisation (IVF), as it is commonly called, has become a global concept helping childless women conceive with amazing results.
He said one way to eliminate some of the stigmas and misunderstanding is by breaking the silence about infertility, which he said is happening globally.
Encouraging couples with infertility problems to utilise IVF treatments he debunked insinuations that IVF children are different from naturally conceived children. “People have a misconception about these things but where will be the difference when we already said that we achieve pregnancy by putting together the woman’s egg and the man’s sperm.
There is no difference. Experience of over 30 years have proven clearly, that there is no difference at all in any of the parametres you are using to judge child development, behavioural development, IQ, social interaction amongst others. The first IVF baby now has a baby and her baby is fine. It’s just another way God has designed to help these couples. Remember science originates from God.” Couples who have tried for three years without success should better consider IVF treatment.
Professionals playing God
I will put that question back to you. There is no basis to say anybody is playing God because the egg comes from the woman and the sperm still comes from the man. If you have a boil in your nose what will you do? You will remove it and may even take antibiotics.
Will I now say you are playing God because you use antibiotics? That problem will never go on its own. So if a woman is not getting pregnant and we know that it’s the egg from her and she has no eggs, we will get it from somewhere else. A person who has no left limb from an accident and wants to be productive, he will go for artificial limb. Will you say he played God?
These are facts. If somebody is not getting pregnant and you take the egg and take the sperm put them together as it would have been done inside her body then put them back into where they would have settled, I don’t think anybody is playing God in this situation.
The issue of playing God does not arise. We are just doing what science does and good knowledge God has given to us.
Rise in infertility problem
“I don’t see any increase in infertility problems rather it is the awareness that is increasing. Increase in accessibility or acceptability of modern ways of treating the problems. More people are now coming out to say they have the problem. More patients read about these things in the papers. That did not happen in the past.
Other reasons which may fuel infertility is that there are more women who are going to school now than 30 years ago. Many of those who are going to school want to push their careers at the highest level and thereby delaying settling down into marriage and child bearing. These days, instead of marrying at 25, they get married at 35 or 36 years and by that time, the fertility clock is about winding up because a woman’s fertility begins to dwindle even right from the late 20s although, very slowly, until about 36. It slows down more sharply and by 40, it becomes a problem. By the age of 40 or 42, a woman will need donor egg to achieve pregnancy.
Many people are coming into the practice but unfortunately, many quacks appeared to have their way through the media. Many more doctors may be interested in obstetrics and gynaecology and fertility treatment, but the reality is that we need more. As long as such a centre is set up according to the acceptable standards. If you consider the population of this country, you will agree with me that we need more. In London alone we have 72 assisted reproductive technique centres. But the standards have to be there.
The unfortunate thing in Nigeria is that these things get abused. You will agree with me that we have lapses in all the system in Nigeria. These lapses are not being tackled by the government.
Now, the practitioners are looking at ways of sanitising that particular aspect of medicine. We should have done it a long time ago, but very soon all hands will be on deck towards that area. We are going to call a meeting of all interested parties to form a body and that body will elect officers, committees and sub committees that would address certain issues including registration of such professionals by certain standards, at least minimum standards that is required to establish an IVF laboratory to prevent patients from being ripped- off.
As it is, anybody can just set up an IVF unit today in Nigeria because there is no monitoring or control. Some who had already set up an IVF clinic are not even gynaecologists. I don’t know where their endocrinology knowledge will come from but is just a matter of copying.
I remember years ago when scan first came into this country, people who are not doctors owned scan. People who have never been trained on the use of scanning machine owned scan as long as they can move the probe and something click out of the screen, they will scream that is your baby. I personally experience that. So these are the issues, I hope that very soon, there will be standards established to take care of the situation.
Effect of activities of quacks in IVF practice
On the part of the patient, you do not only talk about the money wasted, but the emotional torture. Somebody comes to a place to get his or her problems solved and at the end fell into a wrong hand that do not have any knowledge of what he is into. Certainly, the patient will not get pregnant, if she eventually does, she would have got pregnant anyway.
If you have 100 patients who are seeking to get pregnant, if you leave them alone untouched without any medication, some of them will get pregnant in the next one year. That is statistics but most of them will not because they are not getting the right treatment from the quacks. But more important is that by the end of the day, their emotions would have been bastardised because their hope have been dashed. They no longer know where to go because they have given it their all as they think.
We have doctors in this country who are practising Invitro – Fertilisation Technique. We know them, we are not saying they cannot have the business established but they must get a gynaecologist, who is professionally trained to manage such clinic.
Challenges of IVF practice in Nigeria
Talking about IVF, it is not a Nigeria thing. It is a technology that is based on science. Science is very specific in its requirements. You cannot afford not to do the right thing in science. In this business, we depend a lot on certain things. For instance power. Our colleagues in other parts of the world don’t have to generate power by themselves because power is constant. But here we don’t only have to own generators, we have UPS, we have inverters with all the problems those ones will cause you not only money, noise and pollution, time wasting.
Even to set up, we have to go abroad to get trained because we don’t have the man power here. We have to get the expatriates to train us for a couple of years. Personnel is a heavy constraint. We don’t have ready-made personnel to do this for us. We have to train people and retrain them and sometimes import expatriates who will collaborate with us. This is another heavy constraint that requires a lot of foreign exchange.
Even when you train Nigeria personnel they may not be as reliable as those of our colleagues abroad because for some reasons you cannot appreciate the issues involved in this type of society.
Other constraints have to do with cost. How many Nigerians can afford the treatment of IVF? We have battle all these issues and yet IVF is not a procedure that you can continue to cut down cost because many things we use are not what you manage.
There are cultural issues too. But we can manage it by counselling.
Hope for IVF patients
A lot of patients should be very careful. It is unfortunate, that our healthcare is not properly fine-tuned. A lot of patients have been man handled. Usually, when you asked them about their past you get all sorts of harrowing stories. A lot of patients’ vaginas have been burnt.
Many of them were deceived that when they insert something into their Vagina, their fibroid will drop and this has led to so many of their vaginas being burnt seriously. At the end of the day, they will just destroy the anatomy of the place and sometimes, the cervix is burnt and not accessible and it touches the heart that such things do happen.
Like I said, apart from the money that they spend, they are emotionally bastardise and when such people now come to a place like Hope Valley and you listen to them, they get surprised that you gave them opportunity to express themselves. At Hope Valley clinic, we listen to them very well and get the best approach for their treatments.
And this is a recipe for good results. However there is need to create more awareness about the treatment. Patients should also find out about their problems and ask questions before they plunge into any treatment procedure. I advise that patients should go to their doctors and ask questions.
Any doctor who does not answer your question, leave the doctor because he suppose to serve you. Approach a gynaecologist, and if after one year or two years you are not breaking results request them to refer you to a fertility specialist. If they don’t, find your way.