Thursday, December 25, 2008
John Idowu, a resident of Lagos, has been on wheel chair since 2004 when he was knocked down by a hit-and-run commercial bus. Idowu has accepted his fate and he is getting on with life.
But the concern of the 34-year-old man and his wife now is their childlessness. “I married in 2003 and was involved in the accident in 2004. Since then, I have not only lost the use of my legs, but also my erection. My wife would have left if not because she is a faithful woman. Doctors have told me that there is hope for me. According to them, we can have children through assisted reproduction techniques.”
As a result of the growing problem of infertility confronting many Nigerians, including Idowu, experts at the 2008 scientific conference of the Association of Resident Doctors, Lagos University Teaching Hospital, Idi-Araba last Wednesday, discussed the challenges of assisted reproduction in Nigeria.
The experts said that between 10 and 25 per cent of couples in developing countries, including Nigeria, were infertile. According to them, one out of five couples in Nigeria is infertile. A gynaecologist, Prof. Frank Giwa-Osagie, in a paper titled, “Assisted Reproductive Technique in West Africa and Nigeria-Its evolution and challenges,” said that infertility had grave consequences.
“Childbearing has a pivotal place in survival and flourishing of marriage and lineage. Infertility leads to social stigma, unhappiness and marital as well as sexual problems,” he said. The professor stated that despite the high rate of infertility, assisted reproductive techniques were still beyond the reach of million couples who were agonising because of infertility.
Also, the Medical Director of St. Ives IVF Centre, Ikeja, Lagos, Dr. Tunde Okewole, noted that the awareness about assisted reproduction was still low in Nigeria. Explaining the relationship between spinal cord injuries and male fertility, Okewole confirmed Idowu’s statement. He said that the physically challenged man could benefit from assisted reproductive techniques.
Okewole stated that men with spinal cord injury could find it difficult to achieve erection because the nerve that propelled erection in the lower part of the spine had been damaged. “Without erection, the sperm cannot be released. In in-vitro-fertilisation, the sperm is retrieved artificially and used to fertilise the egg,” he said.
IVF involves fertilisation outside the body in an artificial environment. It includes placing the sperm with an unfertilised egg in a Petri dish to achieve fertilisation. The embryo is then transferred into the uterus to begin a pregnancy or cryopreserved (frozen) for future use.
A cycle of IVF involves stimulation of the ovary to produce several fertilisable eggs; retrieval of the eggs from the ovary; fertilisation of the eggs and culture of the embryos in the IVF laboratory and placement of the embryos into the uterus for implantation, called embryo transfer (ET)
IVF was originally devised to permit women with damaged or absent fallopian tubes to have a baby. Normally a mature egg is released from the ovary, then enters the fallopian tube, and waits in the neck of the tube for a sperm to fertilise it. With defective Fallopian tubes, this is not possible. The first IVF baby, Louise Joy Brown, was born in England in 1978.
In Nigeria, assisted reproductive techniques were pioneered by Professors Frank Giwa-Osagie and Oladapo Asiru at LUTH in 1989. Currently, there are 14 IVF centres in Nigeria, leading Ghana that has four; Cameroun, two and Senegal two.
Giwa-Osagie said that about 3,000 cycles of IVF were done annually in Nigeria. According to him, the 14 IVF centres in Nigeria comprise 12 private and two public institutions. The two government hospitals that have IVF centres are the University of Benin and the National Hospital, Abuja.
The professor put the cost of IVF per cycle in Nigeria at between N350,000 and N900,000. From Giwa-Osagie’s presentation, it is clear that not all cycles of IVF succeeds. He explained that for standard IVF centres, the pregnancy rate is 15 to 33 per cent per embryo transfer. An embryo is an egg that has been fertilised by sperm in a Petri dish. The pregnancy rate in low cost IVF is 15 to 20 per cent.
Explaining challenges facing ART in Nigeria, Giwa-Osagie said that they included its high cost and absence of regulation. He stated that the procedure had not attracted government’s attention because of the high disease burden in the country. “In a country that official minimum wage is $80, it is unaffordable to many Nigerians,” he said.
The professor predicted that increasing number of HIV positive Nigerians would seek assisted reproductive techniques to prevent transmitting the disease to their children. According to him, in Uganda, assisted reproductive techniques are on a large scale among people living with HIV.
Calling for regulation of the procedures, Giwa-Osagie stated that there should be minimum standards. According to him, the right to health should include ART.
Another expert, Dr. Ibrahim Wada, said that to make IVF affordable to many Nigerians, more public hospitals should establish the centres. He stated that a funding mechanism should be devised for low and middle low groups.
Insisting that the In-vitro Fertilization (IVF) service delivery has become elitist in the country, he said such a law, when enacted, would reduce the cost of IVF delivery and enable the poor to benefit from such service since infertility was an issue that affects both the poor and rich. Prof Ajabor, who is also the Medical Director of Saint Anita hospital, Benin, made the call at the 11th annual conference and scientific meeting of the Nigeria Fertility Society, which took place in Benin Noting that there has been a steady increase by couples who want children through the IVF delivery system.
He said that since the first baby was delivered by IVF in the University of Benin Teaching Hospital (UBTH) on April 28, 2008, 12 other babies have been delivered in the hospital through the same system and commended the management of the hospital for bringing its IVF services to the reach of the poor.
The acting Chief Medical Director of the hospital, Dr. Mike Ibadin, in his address, said that the hospital has reduce the cost of IVF treatment to about N350,000-N400,000 to enable poor couples benefit from such services.
Saturday, July 26, 2008
The Medical Director of St. IVES Specialist Hospital, Ikeja, Lagos, Dr. Tunde Okewale, has attributed the increasing rate of infertility in Nigeria to stress, pollution and exposure to harmful chemicals.
He advised Nigerian women against late marriage. The expert warned that late marriage could worsen infertility, especially in women.
Okewale stated these while speaking with journalists in Lagos on Tuesday on the first invitrofertilisation baby delivered by the hospital. He put the rate of infertility in the country at 25 per cent.
The medical director disclosed that the IVF baby was conceived through the parents’ sperm and egg. He further said, “Two other women are due for delivery in July and August 2008. Eight others are in various stages of pregnancy at the IVF unit.”
He also blamed the problem of infertility on late marriage, particularly by women. The consultant added that fertility in women decreased with their ages.
“For example, the probability of a woman in her 20s getting pregnant is higher than the one in her late 30s,” the consultant said. The medical director also stated that a lot of women, because of educational pursuit and inability to find willing suitors, married late.
“While about 40 per cent of infertile couples will get pregnant by themselves through changes in their lifestyles and by standard gynaecological treatments, 60 per cent will require assisted conception techniques,” he added.
Okewale said the cost of IVF in the country could be reduced by cutting down a series of tests that would not affect the outcome of the procedure. In Nigeria, the cost of IVF ranges from N500,000 to N1m depending on the hospital.
He said, “Efforts, time and money should not be wasted by concentrating on a list of useless and fanciful tests and investigations that do not affect the treatment and the outcome of IVF.
“It is bad enough being infertile, but going through tests that add no value to the outcome of the procedure drains the couples emotionally and financially. Keeping the treatment complex helps some clinics to justify the abnormally high fees they charge.”
According to Okewale, IVF is used for women, whose fallopian tubes have been blocked due to surgery or infections. He added that it could also be used for a man with low sperm count or immotile sperm.
The expert explained, “IVF treatment involves the administration of fertility drugs, monitoring of the cycle, collection of eggs, mixing eggs and sperm together outside the woman’s body in a dish or a test tube. The resulting embryo are left to grow and the best embryo are then transferred into the woman’s womb.”
Advising women that want to get pregnant, he said they should avoid smoking and alcohol. He added that women that had just gone through embryo transfer in IVF should take folic acid, refrain from oven and avoid strenuous exercises.
Okewale also supported the call for regulation of assisted reproduction in Nigeria. “Before you establish an IVF clinic, there must be a regulation that will guide you,” he said.
Urging Nigerians to shun quacks, Okewale stated that infertility in some couples was worsened when they were treated by quacks.
Thursday, June 12, 2008
The baby boy, Christian, weighing 3.0 kilogrammes and measuring 50 centimetres in length was delivered by 1 p.m. on June 7, 2008, after 37 weeks of pregnancy. The baby was brought forth through a Caesarean section after a comprehensive IVF treatment by a team of five doctors, including an obstetrician and gynaecologist and embryologists.
IVF is a technique in which egg cells are fertilised by sperm outside the woman's womb, in-vitro. It is a major treatment in infertility 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 (zygote) is then transferred to the patient's uterus with the intent to establish a successful pregnancy.
The medical team was led by the Head of the IVF Unit, Dr. Tunde Okewale, a consultant gynaecologist and fertility expert. Other experts on the team were Dr. O. Ogundimu; Dr. A. Obi; Dr. S. N. M. Onigbinde and Dr. H. Oguike.
The couple aged 30 (woman) and 40 (man) have been married since 2001. But five years after marriage, they could not conceive and they sought medical intervention. After medical investigation, it was discovered that the woman had a blocked tube and the man a very low sperm count. They were advised to go through IVF.
When The Guardian yesterday visited St. IVES, which was established in July 2007, the mother and baby were well and stable. The mother was still in a deep sleep. The father refused to speak to the press.
However, The Guardian learnt that the mother is a housewife and the father is a top executive in one of the leading financial institutions in the country.
Okewale said: "What could have been recorded as our first IVF baby in April 2008 ended in a premature still birth at 26 weeks in February 2008 because of severe pregnancy hypertension, which complicated the pregnancy. This particular woman was part of the first batch but she was not successful. But on second trial, she conceived and was due for delivery last week of this month. But she came in here yesterday with very high blood pressure and in order not to lose the baby, we opted for an emergency Caesarean section.
"Two other women from the unit are due for delivery in July and August 2008. Eight others are presently at various stages of pregnancy in the unit.
St. IVES, IVF & Fertility Unit is committed to providing state-of-the-art Assisted Reproductive Techniques (ART) such as IVF, Intra Cytoplasmic Sperm Injection (ICSI), Intra Uterine Insemination (IUI), Sperm & Embryo Freezing at an affordable cost and with high pregnancy rate, in a comfortable and informal atmosphere."
In Nigeria, it is estimated that about 25 per cent of couples in their fertile age group are infertile and studies have shown that the incidence of infertility in the country is on the rise because of urbanisation, pollution, stress, chemical exposure, carrier orientation, late settlement in life, among others.
It has also been shown that while about 40 per cent of infertile couples will get pregnant by themselves, by changes in their lifestyles and by the standard gynaecological treatments, up to 60 per cent will, however, require some form of assisted conception techniques such as IUI, IVF, ICSI among others to achieve pregnancy.
The first authenticated and documented live delivery of a baby by IVF - ET (embryo transfer-test tube baby) in Nigeria was in 1987 at the Lagos University Teaching Hospital by Prof. Oladapo Ashiru and Prof. Osato Giwa-Osagie.
However, the first IVF or rather, test tube baby - Louise Brown - was born in the United Kingdom in July 1976.
Source: Guardian newspaper. Article by Chukwuma Muanya
Monday, June 2, 2008
MEDICAL FEAT AT LAGOS HOSPITAL AS WOMAN GIVES BIRTH THROUGH PRE IVF FLUID INSTILLATION SONOHYSTEROGRAPHY
LAGOS-Hope has again been rekindled for childless couples in the country following the birth of a baby girl to a couple in their forties, through a novel assisted reproduction procedure termed Pre IVF fluid instillation sonohysterography (PIFIS) at the Medical Art Center, LOFOM House, Mobolaji Bank Anthony Way, Maryland, Lagos.
The medical feat which is already causing excitement within medical circles in the country, was made possible by a team of experts at the Center led by renowned fertility expert and endrocrinologist, Prof Oladapo Ashiru, who first reported the procedure of PIFIS and UGET at the International Symposium of Morphological Sciences in Budapest and at the First International Con-joint Conference on Fertility, Anatomy and Morphological Sciences in Lagos in August and September 2007 respectively.
Announcing the birth in Lagos, Ashiru, who is also Chief Medical Director of the Medical Art Center, said the latest birth was the second to be recorded through the pioneering assisted reproduction procedure at the health facility. His words: “The couples who are excited about the delivery of their daughter are in their forties. The wife, a forty-two year old lady has been married to her husband for over 12 years, and this is their first baby. The first IVF-ICSI was unsuccessful but following PIFIS in the second attempt she had 12 embryos and three were transferred. The remaining eight embryos were frozen and are stored for future frozen embryo transfer (FET).
“This brings to two deliveries out of the first series of five patients undergoing PIFIS procedure since 2007. This case is particularly interesting since the take home baby rate (delivery of baby following IVF) in patients over 40 years of age is very slim, global estimate is about 9 percent success rate.”
Further, Ashiru remarked: “The PIFIS procedure was performed the month before the IVF cycle, and followed by another procedure called Intracytoplasmic Sperm Injection (ICSI) and subsequent embryo culture and ultra sound guided embryo transfer (UGET). The healthy baby girl was delivered through caesarian section at a private hospital in Lagos on November 8th 2007.
Improving the pregnancy rate in IVF with pre IVF fluid instillation sonohysterography (PIFIS) and ultrasound guided embryo transfer (UGET)O.A Ashiru*, A.A Adewusi, L.J Shittu, M Oladimeji, R Ojugbo -IVF Unit, Medical Art Center, Mobolaji Bank Anthony Way, Ikeja, Lagos, Nigeria.
Objective: A practical effort to improve pregnancy rate in in-vitro fertilization and embryo transfer by the instillation of a fluid cocktail of saline and antibiotics to artificially distend the uterine cavity in the cycle prior to IVF, and the use of ultrasound guided embryo transfer. Design: Prospective study. Setting: Private fertility clinic and Academic center. Patient(s): 5 patients undergoing IVF and ICSI (Intracytoplasmic sperm injection) treatment with prior failed IVF cycle with hydrosalpinx or sub mucous fibroid and had to go through sonohysterography to exclude uterine abnormalities or evaluation and location of sub mucous fibroid in the cycle prior to the IVF cycle. Intervention(s): A saline fluid containing antibiotics cocktails was instilled in the uterine cavity through a plastic intrauterine insemination catheter attached to a syringe. Transvaginal (3-dimensionnal) ultrasonography was performed concomitantly. After IVF and ICSI embryos were transferred with ultrasound guidance ensuring placement in upper uterine cavity. Main Outcome Measure: Clinical pregnancy. Result(s): One patient with severe hydrosalpinx distending into the uterine cavity got pregnant and delivered a baby boy, after prior failed attempt, another patient with sub mucous fibroid and prior failed IVF attempt is currently pregnant. Remaining three patients had ET done and are clinically pregnant. Conclusion: The use of PIFIS and UGET does appear to improve the pregnancy outcome in IVF. Support: supported by grants from OARS Foundation.*Corresponding author E-mail: email@example.com
Thursday, May 29, 2008
The announcement was jointly made by the Chief Medical Director (CMD), Professor Eugene Okpere, and the Programme Director, IVF Unit, Department of Obstetrics and Gynaecology, Professor A.A. Orhue, on Thursday in Benin City.
While presenting the second of the two babies delivered through the IVF process, popularly known as test-tube babies, the duo expressed joy at the delivery from the process which they described as unique.
Professor Okpere said the baby being publicly presented was a pregnancy resulting from August Batch of 20 couples from which eight pregnancies occurred.
He explained that the delivery followed an IVF treatment which took place at UBTH about 2:15 p.m. on April 28, 2008.
According to him, two of the women had miscarriage at two and three months, stating that the remaining six pregnancies had all attained viability and were now achieving delivery one after another.
Okpere added that the parents of the first baby reside outside Benin and were unable to be present at the occasion because they were only discharged on May 5.
He said the feat was the first ever achieved in UBTH in its 35 years of existence.
Monday, February 11, 2008
CLICK IN THE BRACKETS BELOW TO READ REALLY WONDERFUL BABY STORIES
Mr. and Mrs. Michael Idiake in the last 20 years, waited on God to bless their marriage with a child. Last month their prayer was granted as they told Jibola Oyekunle
February 4, 2007 was another special day for Mr. and Mrs. Michael Idiake. It was singing and dancing galore at the Dominion Cathedral of the Redeemed Christian Church of God at Gowon Estate, Ipaja area of Lagos.
Idiake, 50, and his 41-year-old wife have had it quite rough in the last few years. But now, they have a special reason to be happy once again. Their joy was brought about by their baby, whom they had waited long to have for two decades. “We gave her many names which all have their various meanings,” said the excited father at the end of the dedication of their beloved baby to God.
“You can call her Osekweme, which means ‘ I am thanking God’ ; we also named her Osayande, meaning, ‘Season and time belong to God.’ The baby also shares the same name with her mother. “We also christened her Joy and Faith, which are also the names of her mother, my wife,” Idiake enthused.
He said further, “The word Joy, as the name implies, represents our happy mood. With her, God has brought permanent joy into our marriage. I personally chose her mother’s name for an obvious reason: it was my wife’s faith that kept us going at some difficult points in time when my mind became weak. In those periods, God made her to get stronger in faith and she kept reassuring me that we were close to God’s time, when He would answer our prayer and bless our marriage with a child.
“You know as a human being, it is natural to feel depressed when after waiting for so long a period of time, you find out that the situation still remains the same. Judging from experience, some similar situations that have broken up some marriage relationships were not as bad as our own. Yet, some couples have found it difficult to live through it. But I thank God for my life and that of my wife. Both of us happened to have known God closely before we got married. And after our marriage, we became stronger in faith. It has not been easy but our faith has really helped us.
How did the duo manage such pressure? Faith, Idiaka’s wife, who is a nurse by profession, responded: “Yes, there were pressures from my family and that of my husband. But apart from the faith we both have, there is a strong love between us. Two, my husband’s father loves me so much and throughout this long period that we had been waiting on God, he never allowed any of such pressure to outweigh the love my husband and I have for each other.”
*FOR CONTACT INFO ON IVF CLINICS IN NIGERIA, PLS CLICK ON THE FOLLOWING LINK: http://www.ivfnigeria.blogspot.com/
She was managed for some endocrine abnormalities that were discovered on examination. Mrs. RD was then given a preparatory treatment to enhance her fertility and prepare the uterotubal catheterization with special medication. She was to come for IVF cycle as soon as the period starts.
The period never came and she was found to be pregnant three weeks later. All she needed was endocrine management and the uterotubal preparation for rejection and enhancement of implantation. That was during her second month of consultation. She delivered a healthy baby girl.
Mrs. UG had infertility of 11 years standing. She had been to a clinic in England where the hope of pregnancy had been removed since the husband did not produce sperm. He had a congenital absence of the ejaculatory duct. She came to our center and evaluations confirm the findings from England. In addition we also discovered some endocrine abnormalities in the couple. They were both treated for the endocrine problem, and then prepared for IVF. The husband was sent to our colleague in Urology, Dr. Lawrence Rush and had Testicular Epididymal Sperm Aspiration (TESA). We were able to get a good amount of sperm cells that were stored frozen until the IVF cycle. The value of earlier hormonal treatment on sperm recovery cannot be overemphasized. At a later date the wife was then stimulated for IVF using the ICSI technique. Three of the four fertilized embryos were transferred to her. She became pregnant and delivered a baby boy.
Nisa Premier Hospital was established in May 1996, with the vision of an International Centre of Excellence for Gynaecology and Infertility treatment.
A pioneering breakthrough in In Vitro Fertilization (IVF) was achieved and authenticated by the Federal Government in February 1998.
The hospital then achieved Nigeria’s first IVF Twins, Triplets and the first delivery from frozen embryos.
In April 2001, Nisa Premier Hospital teamed up with Nordica International of Denmark to jointly run, the “Nordica Fertility Centre", in Abuja.
The correct mix of manpower, standard equipment and environment has allowed us to sustain very good IVF, ICSI and IUI pregnancy rates which are similar to results obtained in top European centres. The overall success range is from 25-35% per attempt, but we have succeeded in more than 40% of women aged below 35 years.
The National Hospital, Abuja on Thursday, said it had produced six test tube babies in 2007 through its newly consolidated In Vitro Fertilisation Centre.
It said the number of test tube babies was expected to quadruple in 2008.
The Assistant Director, Information Services of the hospital, Mallam Yahaya Sadiq, who spoke on behalf of the Chief Medical Director, disclosed this in Abuja.
Yahaya said that the centre, which was put in place last year by the government, had initial hiccups.
He however said that since its consolidation in 2007, the centre had produced babies for parents who could not ordinarily have children.
He said, “The most important achievement the National Hospital has recorded in 2007 has been the consolidation of the production of test tube babies in its new IVF Centre.
“More than six babies were produced in the first session, but in 2008, we expect the number to quadruple. Don’t forget that the National Hospital is the first government hospital to do this.
“In 2007, another significant achievement was the installation of the Magnetic Dissonance Imaging Machine, which is used to diagnose ailment in any part of the body.
“The hospital had also installed Gama Cameras for the easy and speedy diagnosis of cancer in the body.”
IVF is a technique in which egg cells are fertilised by sperm outside the woman‘s womb. It is a major treatment in infertility.It can also reduce the need for surgery on the fallopian tubes.
By Victor Sam, December 21, 2007
Dr. Tunde Okewale, consultant obstetrician and Gynaecologist, St. Ives IVF and Fertility Unit speaks:
SUCCESS RATE: We calculate the success rate in two ways: the pregnancy and the take home babies. It is possible to have baby but not take home as in case of still birth. Our success rate so far is 50 per cent. We started the IVF unit in July (2007) and we have three on-going pregnancies. Since July, we have three cycles and the pregnancies are about 18 weeks, and we have new ones that have just tested positive, but until the pregnancies grow, we would not make any noise.
The success rate varies from hospital to hospital, some 25 per cent to 50 per cent. Over 60 per cent rate was recorded in India.
COST OF IVF: the more the number of people that offer themselves for IVF, the more there are clinics and the more the companies that produce the media will come into the country. At present there are none. We have to import all what we need and these cost more. For instance, in India and America there are many clinics and there is a lot of competition. All the disposables that we use are from India. But what we have in St. Ives, our cost is still the cheapest.
The reason is, part of the things that inflate the IVF cost are unnecessary investigations before IVF is finally arrived at. For most infertile couples, when they come to hospital, doctors would write down the list of investigations to conduct. Most of the investigations do not have anything to do with the success of the IVF. Most of the investigations would have been done by the patient somewhere else. But we still tell them to do it. You find out that infertile couples go around dong doing the same set of tests and everybody pretends they are doing something. All these add an extra cost. If you come to St. Ives and you have done some of the investigations in the last one year, we offer you direct, what is necessary for you in the procedure.
COMPARATIVE COST OF IVF: In the United Kingdom it is $4,000 to $6,000. In America $10,000 to $25,000. In St. Ives, excluding the cost of the drugs, it is N250,000. In other IVF clinics around, it costs about N500,000 to N600,000. The cost of drugs is from N70,000 depending on the drugs.
Culled from P.M.NEWS Thursday 8 November 2007
A COUPLE who had been childless for eight years have become beneficiaries of in-vitro fertilisation with the birth on December 29 2002 of test tube triplets.
The triplets, a boy and two girls, were born after 35.5 weeks of pregnancy to Mr. and Mrs. Emmanuel George, aged 38 and 32 years, at Roding Medical Centre, Lagos.
The boy who weighed 1.9 kg and the girls, 1.7kg and 1.5kg were delivered through caesarian section after a comprehensive IVF treatment by a team of five doctors.
The team led by a consultant obstetrician and gynaecologist, Dr. Faye Iketubosin, included Dr. Adewunmi Adeyemi-Bere, Dr. Fidelis Akabosun (both consultant obstetrician and gynaecologists); an embryologist from the United Kingdom, Mr. Bryan Woodward and a resident embryologist, Miss Omowunmi Taiwo.
Dr. Iketubosin disclosed that his team recorded 50 per cent success rate with the first set of couples it treated with the IVF procedure. FOR THE FULL DETAILS, PLEASE CLICK ON THE ADDRESS BELOWhttp://www.news.biafranigeriaworld.com/archive/ngguardian/2003/jan/17/article07.html
With a little over N1million, a couple’s five-year search for the fruit of the womb has become history. Late last year, the couple smiled home with a bouncing baby boy delivered normally at the OMNI Advanced Medical Centre in Lagos.
A single lady in her 30s graciously carried the pregnancy at the cost of N200, 000, thus ending the couple’s nightmare.
The N200, 000 was compensation for the lady that carried the pregnancy, while the balance paid was for medical bills and cost of In vitro fertilization.
The lady that carried the pregnancy on behalf of the couple hails from the South Western part of the country and lives in Lagos, while the couple from the South East, reside in the east. But the hospital ensured anonymity between both parties.
The couple who were referred from the east had indicated their interest to have a baby through the procedure, following medical indication that the surrogate mother was unfit to carry a pregnancy to term. It took the hospital one year from the time the couple showed interest to secure a match for the contract.
In the last two years, over 20 couples have approached the hospital for the same purpose including three Nigerians resident abroad. However, only two have had their dreams actualized. Many were unable to continue because of the cost.
Leader of the medical team that performed the process, Professor Osato Giwa-Osagie tells the story:
“We have successfully performed a surrogate pregnancy. We have had two experiences during the last five years. One was through IVF while the other was through artificial insemination. The most recent was through IVF.”
Culled from Sunday Sun, March 5, 2006
History was made on September 14, 2004 when the first successful IVF baby, Julian Oluchukwu (God’s work),the first baby conceived through a combined ART procedure of IVF/ICSI at Nordica Lagos, was successfully delivered through a Caesarean Section.
The parents, Emmanuel Onwudijo and his wife Francesca have been married since July 1999.
Emmanuel Onwudijo, 37, indigene of Asaba, Delta State, and staff of Nigerian Breweries says, “Since we got married in July 1999, we have run from pillar to post, been in and out of hospitals and undergone so many tests than we can remember. We tried so many things, went to several hospitals, herbal homes and churches, but nothing worked until we came to Nordica Fertility Center in January of this year and there was a transfer that resulted in the birth of this our baby.
If I had known something like this could be so readily achieved, I probably would have done it during the first year of my marriage, but then I always thought I couldn’t afford it and was actually planning to save for it, but eventually it was my wife who took up courage and convinced me to do it. She saw the advertisement on the internet and we went down to the hospital for the procedure.
Francesca Onwudijo, 33, indigene of Ibuzor, Delta State and Confidential Secretary with African Petroleum (AP) : “…I would like to advise women battling infertility to try this assisted reproductive procedure. Although I’ll admit that most women are not aware of its existence or capabilities. I believe doctors and perhaps the media should reach out to Nigerian women, churches, hospitals and other relevant organizations to educate them about assisted conception.”
Culled from ‘Nordica News’
“God has done it again! He made it possible one more time! My God has done it again! I feel elated and accomplished.”
These aren’t words of exhortation spewing from a Pentecostal pastor’s mouth. Rather, they are from a fertility specialist Dr. Olugbenga Ogunkoya, a gynaecologist and Managing Director of Hope Valley Clinic located on Etim Inyang Crescent, Victoria Island Extension, Lagos, excited at the successes recorded in his clinic in assisted reproduction.
Such successes are common occurrences at the clinic. But what is not very common are pregnancies in women who are over 42 years of age, even with the help of modern techniques such as in vitro-fertilisation. But this uncommon breakthrough has been achieved in a 45-year old lady through in vitro-fertilisation techniques, using her own eggs. It is probably the first such breakthrough in sub-Saharan Africa, using IVF technology at such an age.
Ogunkoya told The Guardian that through Assisted Reproductive Techniques, many couples in Nigeria have become surprised, happy parents.
And the techniques are varied. The one applied ina particular couple depends on their specific needs. However, each technique or the modalities used in applying it, must be of international standard. And success in the field, he says, depends mainly, if not solely, on two factors, namely equipment and expertise.
“Don’t waste money traveling abroad, Dr. Ogunkoya advises. “It is all here at home. We have brought the technology to your doorsteps at reduced cost and comparable success rate. They don’t have to travel abroad. They don’t have to pay airfare and accommodation fees overseas. But more importantly, they don’t have to leave work for weeks to travel abroad for treatment.”
Culled from the Guardian, Saturday February 25, 2006
“Initially it was like a joke. My husband pleaded with me to see reason and believe in God, even though I was scared not knowing what the outcome would be. But the good Lord did for me and my family through this wonderful clinic. I am now six months and some weeks pregnant with three babies that are kicking, full and bubbling with life, and to tell you how wonderful it has been, I’ve not been admitted for any serious problem. The whole process has been natural.”
This is the testimony of a woman who recently benefited from the wonders of In-vitro Fertilization (IVF) or test tube baby technology. The woman in question – since safely delivered of her bundles of joy – along with her spouse, are amongst several scores of couples that have successfully overcome the problem of delayed childbearing, thanks to the commitment of a group of health professionals to fertility management at the Bridge Clinic Ltd., Lagos – Nigeria’s first, focused assisted conception clinic. Through comprehensive infertility evaluation, diagnosis, treatment and general provision of the best medical and scientific services currently available in the field anywhere in the world, and its bid to reduce the high rate of infertility in the country, the Bridge Clinic has been at the forefront of new developments within the field of infertility. It is credited with the first pregnancy in Nigeria attained with Intra Cytoplasmic Sperm Injection (ICSI) and Testicular Sperm procedure. The first pregnancy with ICSI and Ejaculated Sperm in addition to the first pregnancy by Gestational Surrogacy was achieved at the clinic.
Culled from Vanguard, Tuesday April 29, 2003
Sunday, February 10, 2008
The main IVF hint is to pamper yourself! An IVF cycle is a very stressful thing and anything that helps you through it without harming a potential baby is okay!
Decide ahead of time where and how you want to get news each day for how much medication to take, etc. This is especially important on the big days of finding out about fertilization and pregnancy test. Those days can be tough if things don't go well! You might want your partner or a good friend around!
Rest is very important, even before transfer. All those developing eggs are taking up a lot of space and energy.
Try to get to know the people who are treating you so you aren't just another patient.
It may help to make a friend or two who is at the clinic for IVF, too.
Bring a book, magazine, or hand-held game with you to appointments. You might be there for awhile.
Make sure they do a mock transfer prior to the actual embryo transfer. This is not fun, but it is necessary that they know the depth of your uterus so they know where to put the embryos.
Do whatever it is you need to do to make this manageable for you. (Naps, backrubs, favorite foods, etc. Be very good to yourself during this time.)
Small amounts of alcohol will probably not adversely affect you or your eggs, but caffeine has been shown to affect fertility, even in small amounts, so try to avoid it.
Buy a good, up-to-date fertility book and try to find out as much as you can about the IVF process beforehand. There are always new advances, so try to keep up with the changes in techniques.
Always ask your RE a lot of questions about your progress, what the numbers mean, etc. That is what they are there for! Also, you should be able to get copies of anything in your file (like your follicle growth and E2 test results and fertilization report). The more knowledgeable you are, the more likely they are to openly share information and take time to explain.
It can be very comforting to find someone, either in cyberspace or in person, that is in a similar situation (factor, cycle) that you can share stories and progress with.
Try to keep a very flexible schedule the week before the pregnancy test. Some people start their periods early and are stuck somewhere where they cannot just be alone and grieve.
Start taking a prenatal vitamin prior to your cycle. At the minimum, you should take 400mcg of folic acid daily for three months before conception to reduce neural tube defects such as spina bifida. The FDA suggests 800 mcg during pregnancy, so it is best to look for a prenatal with that amount.
Some clinics believe that a diet that is high in protein and low in salt and potassium can help you avoid hyperstimulation. Gatorade is a poor choice of fluid to drink to prevent/control hyperstimulation because it contains large quantities of salt. Water or Pedialyte is best, in quantities recommended by your RE. At a certain stage of OHSS, too much fluid can be detrimental.
Remember that some people get very uncomfortable and even have a lot of pain as the ovaries are stimulated. This may get worse as the follicles ripen. Loose clothing may help.
Don’t worry about your weight unless you are tracking it for hyperstimulation purposes. Unless you hyperstimulate, most of the weight gained during an IVF cycle usually disappears once your period starts and if you are lucky enough to get pregnant your weight won’t matter anyway!
If you are not taking birth control pills the cycle previous to your IVF, be sure to use birth control (no matter how ridiculous it may seem). Usually, you will start Lupron before you would know if you conceived or not and Lupron is very dangerous to a developing baby.
The extra fluid your developing follicles are taking up and being NPO before retrieval can sometimes cause constipation. Increasing your consumption of fiber and fluids as you approach egg retrieval may help alleviate this.
Don't talk to your partner too much about his role. This may cause him extra anxiety during an already stressful time and the extra stress can aggravate the performance anxiety that men suffer on the day of retrieval.
If this is your first IVF, be conservative about the number of blastocysts or embryos you transfer, especially if they are of very good quality. You may find that fertilization was your big hurdle and now that is complete you are on your way!
If you have had more than one failed IVF, consider changing clinics, especially if your doctor doesn’t have a change in protocol planned.
Remember that all cycles are not alike. Using the exact same protocol on another attempt even at the same clinic can lead to different results.
Some clinics use medications to prevent embryo rejection (low dose corticosteroids, etc.) which may help your chances of success. Check with your clinic to see if they think it would make a difference for you.
Always repeat the directions for medication to the nurse and get your E2 level. If something seems wrong or unclear, ask for clarification.Prior to the stimulation part of your cycle, make sure you and your partner discuss how many embryos or blastocysts you plan to transfer. (While remembering that your plan may have to change because of circumstances of the IVF!) If you think you will have extra embryos beyond what you want to transfer to avoid high order multiple risk, decide whether you will freeze them or discard them. Decide whether you would consider selective reduction. These are not things to discuss under pressure right before transfer!
POSITIVE THINKING AND DE-STRESSING HINTS
Try self-hypnosis tapes to keep your mind on warm and fuzzy thoughts.
Keep social contacts to a minimum.
Use the cycle as an opportunity to focus on yourself and on each other.
Try to relax and think positive.
For sanity sake, review the odds of success ahead of time. Some people try to stay as neutral as possible to avoid major ups and downs, others try to stay hopeful to help make all the procedures easier.
Try doing things to take your mind off the process. Visualization may just make the obsessing worse.Try to manage stress in whatever way works best for you. Some suggestions are relaxation or deep breathing exercises, yoga, or meditation.
EGG RETRIEVAL AND EMBRYO TRANSFER HINTS
You will probably need at least the day after your retrieval off of work. You may be in pain or you may just be tired and need the rest. Levels of pain post-retrieval vary from person to person. Some people may have little or no pain and others may have a lot of pain. Be prepared for both extremes.
Prior to retrieval, remind your partner (or the nurse if your partner isn’t there) to keep pressure on your IV site for you once it is removed (especially if you are taking baby aspirin or heparin). You will still be a bit woozy and may not remember.
Often the medication used for sedation for retrieval is one that causes amnesia, so don’t be worried if you cannot remember everything that happened. It is disconcerting, but not a problem. Remind your partner about this so that he doesn’t expect you to remember everything!
Some people have reported that the sedation used for retrieval can cause nightmares.
A heating pad on your belly may help with pain after egg retrieval.
If you are concerned about nausea during the retrieval, ask for something to stem nausea. A drug called Phenergan is a mild sedative and also will help keep you from vomiting or having nausea from other medications.
Have someone there to drive you back from retrieval and transfer.
Make sure that you tell them about any allergies. You may be given a narcotic pain killer afterwards. If you have problems with narcotic pain relievers, you can ask for a non-narcotic pain killer which may work just as well for you.
Eat a low fat diet for a few days before retrieval. Sometimes the embryos are stored in a vial of the mother’s blood, and they don't react well to fat (or is it lipids, or whatever), which can temporarily rise as a result of high dietary fat intake. (You can check with your clinic ahead of time to find out whether they use your blood or not.)
Some clinics suggest you avoid soaps, shampoos, and perfume on retrieval and transfer day as embryos can react poorly to odors.
Don’t wear fingernail polish to retrieval. Some clinics use a clip on your finger to read oxygen saturation levels during retrieval and fingernail polish will interfere with that.
Remember that not every follicle contains an egg, so don't be surprised if the number of eggs harvested is less or more than the number of follicles you've been watching develop.
If you have any significant pain within the first couple of days after retrieval, something may be wrong. LET YOUR CLINIC KNOW IMMEDIATELY! Some people have had a blood vessel nicked which led to internal bleeding so they had to go to the hospital for monitoring.
You may find it very hard to lay still for the required time after transfer (this varies some from clinic to clinic). You may want to bring extra pillows to make you comfortable, or some music to distract you.Many clinics aren't requiring *any* post-transfer rest, as recent studies indicate it has no impact in success rate. If it helps you feel like you are doing everything you can, rest as much as you feel necessary.Most clinics recommend you avoid the following after transfer: swimming, saunas, baths, intercourse, orgasms, lifting over 10 pounds, exercise that breaks out into a sweat. So, look forward to taking it easy!
The cost of a cycle of IVF treatment in Nigeria ranges between N500, 000 – 900,000.00, an amount out of the reach of many couples and unfortunately there is no government funding at the moment. However it is possible to benefit from free IVF treatment if you fall within certain criteria.
Free treatment is available to a woman who VOLUNTARILY shares some of her collected eggs with another infertile couple. The eggs will be shared only if the number of eggs you produce are sufficient so you do not lose out. You may be required to bear just the cost of the initial test/assessment that will indicate if you are suitable for the treatment. The recipient couple however, may bear this cost in which case the process will be at no financial cost whatever, to you; this arrangement varies with each clinic.
GENERAL QUALIFICATIONS AND CRITERIA FOR FREE TREATMENT:
*You should be aged between 19 and 34.
*Weigh less than 85kg.
*Have regular menstrual cycles.
*Have 2 ovaries.
*Have had a maximum of 2 previous failed IVF attempts and not less than 6 collected eggs in each of these cycles.
*Have an FSH (Follicle Stimulating Hormone) level of less than 9.0 when measured between day 2 and 6 of your natural menstrual cycle.
*Have an LH (Luteinizing Hormone) level of less than 10 when taken at the same time as above.
*Do not have significant fibroids or polycystic ovaries (PCO).