The Bridge Clinic was set up to provide high quality fertility treatment inducing Invitro-Fertilization (IVF) and Intra Cytoplasmic Sperm Injection (ICSI) in Nigeria.
The clinic has been assisting couples experiencing difficulty with conception since 1999 and with the birth of over 923 babies, they gained the experience to meet the needs of their clients.It is a legal requirement in developed countries like the United Kingdom (UK) that all clinics carrying out fertility treatment that involve human gametes such as IVF are licensed by the Human Fertilization and Embryology Authority (HFEA). Unfortunately, there are no such regulatory authorities in Nigeria.But Dr Alla Arilesere, Head of Department, Medical Services, Bridge Clinic, said that the Bridge Clinic recognizing the importance of such regulation have always functioned on if it were one of the clinics regulated by the HFEA.
According to her, “We are mainly focusing on human reproductive medicine, that is helping infertile couples to achieve pregnancy. Naturally, conceived pregnancy in the bedroom that you don’t spend money, you also have about 25 per cent success rate just like Invitro-Fertilization (IVF). The problem could be perhaps fertilization, perhaps implantation, perhaps the ovaries, perhaps the quantity of the eggs or sperm. It takes more than one month for couples without any problem to achieve pregnancy. This is normal, it is acceptable all over the world.“And that is what is applicable to our assisted reproductive technology.
We transfer embryo on a certain day, what happen to them after the transfer, we wouldn’t know their fate. But the aim is to assist them, at least watching them for awhile, at the transfer, after the transfer, may be wonders will happen, at least the woman will eventually get pregnant.On the issue of high cost of IVF, she said, “At the beginning, I mentioned something about quality assurance, for us to be able to maintain the quality, we cannot compromise on that, it is expensive. Quality is expensive. Firstly, we use high technology equipment, which is important. Secondly, we ensure that we successfully deliver services to our customers, we don’t cut such corners. We must deliver at whatever cost. And it has to be high tech.“Everything that we use for IVF is imported, incubators, culture media, all the materials for IVF, scanning machine, microscope, laboratory and training of laboratory staff. We are trained in Leeds in UK which is one of the leading reproductive science institution in the world, running the medical site, these are all expensive.
Presently, there is proliferation of IVF clinics in the country. And there is fear it might promote quackery. Dr Alla has this to say
, “Actually, we have the annual conference of Nigeria Fertility Society, where we look into issues like this, and we are coming up with ideas and suggestions. The Nigerian Medical Association is the one to control the issue of quacks and things like that. basically, any clinic or hospital that has been registered for the practice, every doctor is supposed to have licence for practice which is to be reviewed every year. Not only IVF clinics, so many other clinics are coming up. Who are setting them up?“I hope the government have something on the ground to be able to control it. Not only assisted reproductive hospitals, but any hospital or clinic at all. Because we have also identified the fact that there are no regulatory bodies in Nigeria for IVF, we are bench- marking ourselves with the Human Embryology Association in the UK. We have from there who came here to audit our reports and procedures. Basically, we practice international standards. We are benchmarked with whatever that is going on in the world. We can’t spread our standards to other clinics because they are supposed to do it on their own.Does the proliferation of IVF clinic in Nigeria mean that the infertility rate in Nigeria has increased? Dr Arilesere said, “Basically, from the statistics, in developed countries, the rate of infertility is between eight and 15 per cent. That means between one out of 12, one out of eight. But in Nigeria or sub-Saharan Africa at large, the statistics indicate that the rate of infertility is 25.This is about double or even triple of what it is in developed countries. Perhaps, it is sexual indiscipline, it could be tubal factor because the rate of woman infertility is about 40 per cent. Perhaps early exposure to sexual life, and may be the use of contraceptive drugs, people right from secondary school or primary school take contraceptive to prevent early pregnancy.“At the age of 13 or 14, girls exposed to sex can become pregnant. So what do they do? They go to the back door to remove the pregnancy so that their patents do not find out. In the process of removing the pregnancy, they may be creating future problems like blocked tubes or infections. Over the years, the rate of fertility, even the quantity of the semen is going down. Perhaps it have something to do with radiation, solar energy, temperature factor, stress, too much of computer.Continuing, she said, “There are two types of IVF, Conventional IVF and ICSI Conventional IVF is applicable to couples where the semen quantity meet minimum of 20 million, that is the semen quality. And the strength of the IVF, whether conventional or ICSI depends on the same quality only. So, for a couple to be qualified for conventional IVF, the count must be at least 20 million, motility must be at least 40 per cent, minimum, morphology must be at least 15 per cent, minimum.
“In the history of the Bridge Clinic, since 1999 all the couples that have been coming for IVF treatment, they have conventional IVF. They have fertilization period of up to 80 per cent. That means all the couples that are treated, 80 per cent unfortunately did not reach embryo transfer stage because those couples are not applicable to conventional IVF.“What is ICSI? ICSI is Intra Cytoplasmic Sperm Injection. Any couple that do not meet any of the requirements that I mentioned, like high motility and morphology, they need ICSI. There is not much evidence to show that ICSI give a high rate of abnormality among children born through it. The perception that there is high rate of abnormality among children born through IVF may be coming from the internet or may be some wrong information. Comparing children who are born naturally with ICSI babies, there is no significant difference.”