By Emmanuel Edukugho
LAGOS — About 3,000 babies are born yearly in Nigeria by In Vitro Fertilization, IVF, because of infertility of couples caused by infections.
Professor Osata Giwa-Osagie disclosed this during a distinguished professor lecture at University of Lagos, Wednesday.
In a lecture entitled, “The Development and Future of Advanced Fertility Management: A West African Perspective,” Giwa-Osagie said for man to survive, he must reproduce and evolve, referring to a Biblical injunction which instructs man to “go and multiply.”
According to him, statistical models and observation of human couples led to the expectation that 80 per cent of couples engaging in regular sexual intercourse without contraception will achieve a pregnancy within 12 months.
“The 20 per cent of couples who have not achieved a pregnancy are defined as being infertile. These infertile couples are those who require proper investigation and fertility management. Estimates of infertility in populations vary from five per cent to as much as 30 per cent, and have geographical variation, with prevalence rates of 7-10 per cent accepted for most populations of couples.”
Giwa-Osagie said a childless marriage in Africa faces major challenges regarding stability and continuation. That infertility leads to marital breakdown, mental illness, domestic violence, polygamy, adultery, suicide among other consequences.
“Consequently, infertility and its management assume important places in the African context.
Yet Africa has poor economic, health, education and development indices.”
He submitted that proper and appropriate management of infertility requires the application of modern social and technological procedures in the investigation, treatment and follow up of infertile couples. The procedures involve basic history and physical examination with targeted questioning as well as investigation of both male and female partners.
On causes, he said the predominant cause of infertility in West Africa is tubal damage in the women, caused by infections at or after birth in unhygienic environments, complicated abortions, and sexually transmitted infections. These account for over 75% of tubal disease in West Africa.
The woman may also suffer from anovulation and irregular menses, or uterine a bnormalities such as fibroids which occur in up to 40% of infertile Nigerian women.
“In the male, causes of infertility have been found in up to 40% of infertile couples; 55% of the cases emanates from female while in 5-10% there is no cause found.
The major cause is sexually transmitted infections such as gonorrhea, chlamydia and other chronic bacterial infections.”
He stated that in both male and female, a small percentage – less than 5% of causes of infertility are due to congenital abnormalities such as genetic anomalies.
“Of all methods of infertility treatment, induction of ovulation has resulted in the greatest success rates – up to 60-70% of stimulated cycles with 40-50% birth rates.”
Giwa-Osagie explained that overall disappointing results led to:
In Vitro Fertilization (IVF) initially for tubal blockage indications ordered to include low sperm count and unexplained infertility. Overall pregnancy rates is 2040% per embryo transfer.
*Egg Donation – revolution in motherhood. Allows women with no ovaries or non-functioning ovaries or menopausal to have children. They conceive and carry the pregnancy.
*This extends the frontiers in female child bearing beyond 60 years of age in some women. Egg donors are below age 30 years usually, while recipients can be of any age.
*Uterine fibroids – common in black women, 40% of infertile Nigerian women have fibroids.