DR. Michael Olugbenga Olukoya is the Managing Director of Hope Valley, a fertility centre, whose offices are scattered across Lagos, Abuja, Port Harcourt, Kaduna and Benin City.
In this interview, the University of Lagos trained fertility specialist revealed that the challenge of infertility is a shared responsibility between couples. The former Managing Director of Dolphin Medical Centre, Lagos, also dispels the popular belief that children born through In-Vitro Fertilisation (IVF) are less human, saying that they are as perfect as any human being conceived through naturally.
What is the level of acceptance of In-Vitro Fertilisation (IVF) in Nigeria?
We have to talk about the level of awareness first of all. The awareness level of In-Vitro Fertilisation (IVF) system is very low. We are trying our best to create awareness. And that is very expensive.
Why is the awareness low?
Our people generally are very slow in imbibing new technology and culture. Some don't even believe that it exists even though it has been in the world for 35 years now.Our level of education is a major factor in the acceptance of IVF. Otherwise, many people just go to the mosque or the churches to seek succour.But when you are very educated, you are more likely to seek knowledge in the scientific field, rather than go to the unknown field of babalawo (native doctor).
I also think that our government has not done enough not only in fertility treatment, but also in creating awareness for it. We usually do immunisation for polio, meningitis among others for children. Thank God that we are doing something about that in Nigeria. But there are many other areas in medicine where the government needs to have been involved before now. But our government has not done these.
To those who may not be familiar with IVF, what is it all about?
In-Vitro Fertilisation (IVF) is the process of fertilizing eggs for conception outside the body of the woman. Naturally, they are fertilized inside the body of the woman. It is the egg and the sperm that become the baby. The egg is released from the woman and the sperm goes to meet the egg during intercourse. That is what happens naturally.
But in IVF, we don't allow that to happen. We take the egg from the woman outside and take the sperm from her husband, and mix them together outside her body. When they have united, we put the union back to her womb where it normally should be and that would results in pregnancy.
Why do you do this?
We do this because for some reasons. Some women are not able to get pregnant on their own for three, five, six or more years. Therefore, to create solution to this abnormality, some scientists began to work on that problem some 35 years ago. That was how IVF became established.
How true is the popular belief that IVF children are less human and that they have a lot of challenges?
That is not true. Like any new thing, IVF is subject to speculations. When IVF first came to the world some 35 years ago, all these fears were there. Like everything scientific, facts and evidence have come to assure us that babies born through IVF are as normal or even more normal than those born through non-IVF methods.
Any example in the world to show for this?
Many as I just told you. Science does not believe on hearsay. There must be proof. Over 10,000 babies have been born worldwide through IVF. Scientists have done research on their developments, their intelligence quotients (IQs) and their abilities to re-produce. And the results are marvellous as they are perfect.
Oftentimes, when couples fail to have children, the woman, not the man, is often blamed for the abnormality. As a fertility specialist, is it true that the woman is always the cause of the problem?
The problem of infertility occurs in about one out of six couples. We are confident to say that the problem is as common in the male as it is common in the female. Generally speaking, we say it is 40 per cent the male problem, 40 per cent the female problem and 20 per cent should be shared between them. So, the woman should not be blamed all the time.
What are the challenges of practising IVF or assisted re-production system in Nigeria?
First of all, not a lot of people can to afford it because of the cost. Therefore, you see a lot of people coming to you and begging for discount. That is a bit difficult. And one has to bring the things needed for the system, not from Nigeria, but from abroad. We have mentioned that a lot people don't even know that we have IVF in Nigeria. And those who know find it difficult to accept it as they prefer babalawo. And when they cross that Rubicon and come for the treatment, to be able to afford it is a big challenge.
For those who overcome that problem, it is a big challenge for us because we have to source the materials we need, not from within Nigeria, but from abroad. Just imagine the problems that would create -problem of foreign exchange, transportation, and storage among others.
Operating in Nigeria means that we have to have electric supply through generator 24 hours of the week and 365 days of the year. Because of the challenge of inconsistent electricity supply, you find us having two generators, UPS, Solar electric system as alternative power sources. Those are heavy challenges indeed. My colleagues who do the same thing abroad don't have to bother about erratic electric supply, or even expend money on generators and alternative electric supply. They don't have problem of electricity failure.
In spite of these challenges, what has been your breakthrough and high points in the practice?
It has been quite rewarding, when we look at where we are coming from nine years ago. We will soon hit the 700 mark of IVF babies we have delivered. That is a huge leap and satisfying result.
We have received many awards including Development in Nigeria Merit Award (DINMA) for excellence in medical science in 2004; Diamond Award for Professional Excellence in Human Medicine (DAPEHM) in 2005. We have also won the West Africa Direct Marketing (WADM), West Africa's Merit Award of Excellence in Fertility Services in 2007 and West Africa's Best Gynaecologist and Fertility Consulting Hospital of the Year.
Even being able to make a woman pregnant is a big reward. Each time we come with positive result, it is a celebration time for the patient. A special high point was when we achieved pregnancy in a 45-year-old woman using her own eggs. And that is the first to be done for a woman above 40 years in sub-Sahara Africa. We have been able to make many mothers deliver twins and triplets so many times or get pregnancy in some abnormal situations. We have been able to make a Turner Syndrome patient get pregnant and delivered of her baby. Turner Syndrome is a syndrome in which a human being is born, looks like a female, but the ovaries are very tiny in size, just because something happened during the genesis inside the womb. Therefore, they are not well developed. Their chromosome pattern is abnormal. Therefore, they are born with very small vagina, with small uterus and the ovaries are almost non-existent. This category of women create a challenge for the gynaecologist and big challenge for the fertility specialist.
How satisfied are you with healthcare funding in Nigeria?
The health sector has been under-funded. We have not really started. Let government tackle the challenges we have in the primary healthcare (PHC) system first, such as immunisation, health screening, health awareness creation before talking about assisted reproduction.
What do you want Nigerians to know about IVF?
I want Nigerians to continue to imbibe the faith that there is always treatment option for those couples who have challenges with having babies. And they have to help themselves by coming forward for help.
What do you want government to do to boost fertility treatment.
Government should try and do its best like what foreign countries are doing in helping couples with these challenges. In countries like Sweden and Norway among others, government helps these types of patients financially. Government may not pay fully for the cost of the treatment; it can offer to buy the drugs or subsidise the cost of the drugs. This is what is happening all over the world.
Do you see the National Health Insurance Scheme (NHIS) playing a role in insuring these types of patients?
No. It can't play a role because of the cost implication. No, it does not fit in. Unless government sits down to formulate some policies, I can't see that happening.
Wednesday, October 28, 2009
Sunday, October 4, 2009
Fertility technique selects healthier babies
Ten successful pregnancies from a new in vitro fertilisation (IVF) technology in Nigeria, called Pre-implantation Genetic Diagnosis have been announced by the Medical Art Centre, in Ikeja, Lagos.
The technique was first announced at a clinical meeting of the Society for Endocrinology and Reproduction, in April 2009 and it is said to be able to predict embryonic future thus selecting healthier embryos (product of fertilisation).
“The process will in turn reduce the chances of a repeatedly failed pregnancy through IVF and secondly, prevent children born with abnormalities such as sickle cell anaemia, Down Syndrome, Leukamia, et cetera,” said Professor Ashiru, Director of the Centre. “We diagnosed 20 women using this new technique in April 25th-28th; today, 10 of them are pregnant and five of these are carrying twin pregnancies.”
Not new
The method, though not new, is yet to be administered by the 16 IVF centres in Nigeria, Prof. Ashiru explained. The current pregnancy rate achieved by IVF is 30 per cent or lower, this according to IVF experts is due to abnormal chromosomes in embryos. But this new technique, he said, promises to select the healthiest embryos, at the laboratory level before implanting into the mother’s womb.
“This is another level in IVF and it helps us detect abnormal chromosomes in embryos and discard them,” Ashiru said.
“For instance when we can take a woman through IVF, we can get 10 embryos from her. Out of these 10, we will get a biopsy to get the genetic composition of these embryos. We can decide whether these embryos are male or female embryos, we can decide whether they have sickle cell, or whether these embryos will have leukemia in (the) future or whether it will be diabetic, we can know some of the abnormalities that may occur in a person a late age, by looking at those embryos.”
Explaining further he said, “For example in a couple who are AS, we can now select the AA embryos alone and transfer them to the mother.
“We don’t have to wait until the baby is born or the pregnancy is formed to abort the pregnancy which is what they do now. We can do it at the embryo level. We can do it at the embryo level and it will take three to four days in the laboratory.”
In vitro fertilisation
IVF is a process where infertile couples can get children through artificial insemination. The woman’s egg is fertilised by her husband’s sperm outside the body (in a test tube in the laboratory), the product, called an embryo is then implanted into the woman’s womb, where it grows into a normal pregnancy.
Nigeria has one of the highest infertility rates in the world with one to four individuals experiencing difficulty getting pregnant. However, fertility experts say causes are due to sexually transmitted diseases, hormonal and lifestyle factors.
An adjunct professor at the University of Illinous, Chicago, Prof. Ashiru said he was determined to create such a centre in Nigeria, following four in United States and two in India, using expertise from both countries.
“Pre-implantation diagnosis will save the cost of Nigerians travelling out of the country to seek help,” he said.
He added that though it costs an additional 3,000 US dollars over the normal cost of IVF which is from N500,000 - N700,000, the cost is justified, when compared to that of IVF and the aforementioned risks.
Women who have reached an advanced maternal age and those with repeated IVF failures or miscarriages, form the clientele.
“The pregnant women are in their 14th week now and they attend the antenatal clinic at our centre twice every month,” he revealed. “The next batch will be in August.”
SOURCE: 234next
The technique was first announced at a clinical meeting of the Society for Endocrinology and Reproduction, in April 2009 and it is said to be able to predict embryonic future thus selecting healthier embryos (product of fertilisation).
“The process will in turn reduce the chances of a repeatedly failed pregnancy through IVF and secondly, prevent children born with abnormalities such as sickle cell anaemia, Down Syndrome, Leukamia, et cetera,” said Professor Ashiru, Director of the Centre. “We diagnosed 20 women using this new technique in April 25th-28th; today, 10 of them are pregnant and five of these are carrying twin pregnancies.”
Not new
The method, though not new, is yet to be administered by the 16 IVF centres in Nigeria, Prof. Ashiru explained. The current pregnancy rate achieved by IVF is 30 per cent or lower, this according to IVF experts is due to abnormal chromosomes in embryos. But this new technique, he said, promises to select the healthiest embryos, at the laboratory level before implanting into the mother’s womb.
“This is another level in IVF and it helps us detect abnormal chromosomes in embryos and discard them,” Ashiru said.
“For instance when we can take a woman through IVF, we can get 10 embryos from her. Out of these 10, we will get a biopsy to get the genetic composition of these embryos. We can decide whether these embryos are male or female embryos, we can decide whether they have sickle cell, or whether these embryos will have leukemia in (the) future or whether it will be diabetic, we can know some of the abnormalities that may occur in a person a late age, by looking at those embryos.”
Explaining further he said, “For example in a couple who are AS, we can now select the AA embryos alone and transfer them to the mother.
“We don’t have to wait until the baby is born or the pregnancy is formed to abort the pregnancy which is what they do now. We can do it at the embryo level. We can do it at the embryo level and it will take three to four days in the laboratory.”
In vitro fertilisation
IVF is a process where infertile couples can get children through artificial insemination. The woman’s egg is fertilised by her husband’s sperm outside the body (in a test tube in the laboratory), the product, called an embryo is then implanted into the woman’s womb, where it grows into a normal pregnancy.
Nigeria has one of the highest infertility rates in the world with one to four individuals experiencing difficulty getting pregnant. However, fertility experts say causes are due to sexually transmitted diseases, hormonal and lifestyle factors.
An adjunct professor at the University of Illinous, Chicago, Prof. Ashiru said he was determined to create such a centre in Nigeria, following four in United States and two in India, using expertise from both countries.
“Pre-implantation diagnosis will save the cost of Nigerians travelling out of the country to seek help,” he said.
He added that though it costs an additional 3,000 US dollars over the normal cost of IVF which is from N500,000 - N700,000, the cost is justified, when compared to that of IVF and the aforementioned risks.
Women who have reached an advanced maternal age and those with repeated IVF failures or miscarriages, form the clientele.
“The pregnant women are in their 14th week now and they attend the antenatal clinic at our centre twice every month,” he revealed. “The next batch will be in August.”
SOURCE: 234next
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