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.



ORIGINAL ABSTRACT

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: denrele@tigger.uic.edu
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*Corresponding author
E-mail: halaszg@ana2.sote.hu