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Nigeria records first baby by ‘freezed egg’

Nigeria has recorded the birth of its first baby conceived through the oocyte (egg) freezing protocol.
The feat was recorded by The Bridge Clinic, Lagos, on February 16, with the delivery of a male child, named Tiwatope.
The oocyte was preserved through cryopreservation, which is the cooling of cells and tissues to sub-zero temperatures to stop biological activity and preserve the cells for future use.

Saturday, June 9, 2012

‘I didn’t know that treatment for our issue was a bus stop away’

the quadruplets below:Elizabeth, Samuel, Mary & Deborah
Seventeen years ago when they got married, Samuel and Victoria Olayiwola had no idea of the battle they had to wage against childlessness. Doctors told them they were perfectly normal to have kids. But they didn’t, until they read an article in Sunday PUNCH and their story changed for the better, writes SOLAADE AY-ADERELE. His effusiveness on the phone was palpable. And when he presented himself physically to be interviewed for this story, his joy was infectious. He simply couldn’t contain his gratitude to God and his physician.
His wife was no less happy, though she seemed to be savouring the reality of becoming a mother for the first time after 17 years of marriage.
For Mr. Samuel Olayiwola and his wife, Victoria,
the joy of being parents after nearly two decades of trying for children is indescribable, what with the attendant frustrations and search for solutions that took them to various hospitals before they finally berthed at the Medical Assisted Reproductive Therapy Centre, Lagos, headed by internationally-acclaimed fertility expert, Prof. Oladapo Ashiru.
Tracing the history of their childlessness, Samuel says the problem became more complicated when doctor after doctor told him and his wife that they were perfectly normal to achieve pregnancy as a couple. This was after they had done all that was humanly possible yet unproductive.
“When you are told you have no biological impairment as to be barren, then you wonder what the problem is all about,” the joyous father reminisces. The puzzle and prayer continued until, as Samuel
says, he read an article about the possibility of having children through scientific processes as published in the Sunday PUNCH of February 6, 2011. Without wasting time, he located Prof. Ashiru who was interviewed for the story.
Even after meeting the professor of reproductive
endocrinology, who is one of the two pioneers of in-vitro fertilisation in Black Africa in 1984, and produced the first test tube baby in West Africa in 1989, Samuel still hesitated to access the available treatment; the cultural
bias against the treatment he was being introduced to was a deterrent, never
mind the nights of tears he and his wife had had to endure as a result of their childlessness. Relations on both sides of the divide were able to convince the couple that there was nothing wrong in the treatment on offer, and, some months after the first visit to MART, the Olayiwolas commenced treatment. In less than one year, their dreams were fulfilled via the delivery of a healthy set of quadruplets.
As Samuel and Victoria Olayiwola were interviewed
for their story, it was obvious that the delay wouldn’t have dragged on for so long if the various doctors they had seen earlier had diagnosed the problem. In
fact, the case seemed so minor that, unlike some IVF cases where the patients have to undergo many trials before conception can be achieved, Mrs. Olayiwola
got pregnant the very first time she went through the treatment — a feat which Ashiru attributes to superior technological advancement that MART uses.
Ashiru explains that about 20 per cent of female
infertility can be attributed to tubal causes; and this can be as a result of Pelvic Inflammatory Diseases, infection during medical procedures, when faecal matter comes into contact with the vagina, high fever in children, and sundry other reasons.
In the case of PID, Ashiru says, as an infection begins, the body gets ready to attack. White blood cells and other fluids fill the tubes to fight the infection. If the body resistance is good, it wins; but in the bargain, the fragile walls of the tube get scarred.
“Due to this, the end of the tube towards the ovaries can get partially or completely blocked and scarred tissues form on the outside of the tube. These circumstances can affect the functions of the
ovaries and the fallopian tube and can lead to infertility,” he says.
Because of the sensitivity of couples that come for fertility treatment, Ashiru says, MART takes patients through some counselling sessions, preparatory to the actual treatment, during which they are told the nature of the problem and the appropriate treatment.
While Ashiru says age is no barrier when couples come for IVF treatment, he does agree that after age 40, both woman and man may need a little treatment to boost the eggs and the sperm respectively.
Indeed, according to a 2004 issue of the American
Journal of Gynaecology, in one study of couples undergoing high-tech infertility treatments, researchers concluded that a man’s chances of fathering a child decrease with each passing year.
In the study, the odds of a successful pregnancy fell by 11 per cent every year; while the couple’s chances for obtaining a successful live birth declined even farther. “In such situation, the man receives medications to make the semen viable,” Ashiru says.
Hence, when Samuel demurred after his first visit to the clinic, Ashiru warned that considering that both husband and wife were in their 40s, it was advisable to get the job done while the window of opportunity was still open.
Ashiru also discloses that sometimes, a woman can
be taken through weight loss programme prior to IVF treatment if she’s considered overweight. Victoria went through this, shedding almost 20kg in the process.
While studies connecting obesity to anovulation
(failure to produce eggs or to discharge them from an ovary) are not new, a study led by Dr. Van der Steeg, a medical researcher at the Academic Medical Center in The Netherlands shows that even women who regularly ovulate experience sub-fertility when their body mass index is in the overweight or obese category.
In other words, the researchers found that women
with regular cycles and otherwise no obvious fertility problems still have a hard time getting pregnant if they are overweight. They also found that the
more overweight the woman is, the lower her chances of pregnancy.
Ashiru says excess weight in women prevents
fertility by many factors. “For one, ovarian hormone is destabilised, making
hormonal stimulation complicated when undergoing IVF treatment, as treatment can disappear into fatty tissues, among others; hence the weight loss advice
where necessary, which we have found to be effective over the years.”
While the couple would not put a price to the treatment they received, Ashiru jokes that they paid for a child and got four in the bargain. What happened is this: generally, in any IVF treatment, embryos are transferred into the woman. In the early days of IVF, more embryo transfers
took place in part because the rate of success was quite low; and patients sometimes went through several trials — sometimes as many as 10 or more cycles
before conception could take place. Then, it was common to have sextuplets.
However, as technology advances, the picture becomes clearer and, to make for the health of mother and child(ren), fewer embryo transfers are done. In fact, in recent times, experts advise that no more
than three embryo transfers should be done. So, the Olayiwolas had three embryo transfers, and an egg later divided into two, with all of them surviving till birth. The
couple had three girls and a boy.
After Victoria’s pregnancy had been confirmed, the Olayiwolas didn’t want to take chances. Samuel decided to take his wife abroad, where he thought she could obtain the best monitoring while the pregnancy lasted. The couple obtained South African visas, but Ashiru
successfully talked them out of it, referring them rather to a trusted colleague of his, a professor of Obstetrics and Gynaecology at the Lagos University Teaching Hospital, Godwin Ajayi, who nurtured Victoria under his
care, successfully delivering her of the children on February 9.
When asked what his advice is for couples-in-waiting, Samuel says it’s better for them to seek treatment once it has been confirmed that something is amiss.
Indeed, doctors advise couples to seek viable
treatment if, after one year of unprotected sexual intercourse they fail to achieve pregnancy.
Samuel says that until he came about the Sunday
PUNCH article, he wasn’t aware of any such treatment. “Knowledge is power,” he confesses.
Ashiru commends the Olayiwolas for “putting a
face” to the IVF treatment. This becomes necessary, he says, because couples are almost always reluctant to come out in the open to say they’ve accessed IVF
treatment simply because of the ignorance and cultural bias that people still have about the procedure.
Explaining the scientific advancement that has
been achieved through the IVF, Ashiru says, “with IVF, even couples who are both sickle cell carriers can have absolutely normal children without a trace
of the disorder. We deploy a technique called pre-implantation genetic diagnosis (PGD) to determine the healthy genetic status of embryos before transfer. Ditto for other genetic disorders like Down’s Syndrome, etc.
“Children born through the IVF are as normal as
any child and there is no reason whatsoever to see them otherwise,” Ashiru concludes.
SOURCE PUNCH NIGERIA

Friday, April 20, 2012

Sex selection: Between desire and necessity

dr. ogunkoya


GOD gave us choice so we have the right to choose!” Henrietta was telling John,
her husband why they needed to have a girl third time around. The couple
already had two boys, Kenneth and Kevin who were 5 and 3 respectively.
Now Henrietta was pregnant again and
her belief was that baby No. 3 should be a girl. But John was being more
practical. “Let’s not tempt God. It doesn’t matter whether this child turns out
to be a boy or girl. If God wanted us to be choosing, He would have asked Adam
and Eve to choose,” he argued.
According to John, God didn’t give
Adam and Eve choice for their children’s gender, rather, in His wisdom, He gave
them Cain and Abel, both boys.” We should be thankful that we even have
children that are healthy and normal. Children are the same after all.”
But Henrietta would have none of
that. “Children are not the same because there are boys and there are girls.
They are different and we should have both. We already have two sons and that
is enough. I want a daughter and I am willing to do whatever is necessary to
get one,” she said with finality. The argument continued.
The Abahs had a similar challenge.
Like every other couple in this part of the world, Josephine and Joseph Abah
looked forward to having children with a balanced gender bias. Eleven months
after their wedding vows, their first child arrived. It was a boy.
Their joy knew no bounds, more so
when they live in a parochial society where male children are give preference.
But this joy was short lived. Few months later, it was discovered that the baby
boy had Haemophilia, an abnormal blood clotting condition more common in males.
The Abahs were devastated. They
tried again for the second child. The second baby also turned out to be a boy.
Alas, he also came down with the same disease condition. Neither Josephine nor
Joseph could explain their predicament.
The search for treatment began.
During one hospital visit, they met a doctor who explained more about the
condition and possible treatment. They were told the disease is sex-linked and
prevalent in the family, and that a way out is to try sex selection principles
through assisted reproduction to reduce chances of having another male child
with such condition
Said Josephine, “It dawned on us
that even though we are capable of making children naturally, we can only have
healthier children through In-Vitro Fertilisation, IVF. We went to a very good
fertility treatment centre in Lagos. We did it and we were able to select the
preferred sex for our baby.”
However, gender balancing or gender selection
has remained an issue, especially in Nigeria. Many homes have been broken but
with the advent of science of gender selection many homes will be saved.
Hope Valley Fertility Clinic is a
major player in the technique. Thanks to the technique, Josphine now has a baby
girl.
Toyin Odoh also benefited from the
wonders of IVF. Diagnosed with Turner ’s syndrome, a condition that results
from a missing or incomplete sex chromosome, for Toyin and her hubby, Ben, it
was like there was not going to be normal children.
After two years of unsuccessful
attempts, they turned to fertility clinics. Although, they were in London,
Toyin returned to Nigeria for treatment. The couple’s testimony was moving. “In
199 I was diagnosed of Turner syndrome and this means I cannot conceive
normally. We have been married for two years wish to have our own children”
At first, “I read an interview of
Dr. Michael Ogunkoya of Hope Valley Fertility Centre, Victoria Island, Lagos. I
called him from London, explained my condition and he invited me over. I came
to Nigeria in April 2009 and he placed me on medication for IVF and one month
later to God’s glory, it was successful.
After all my treatments abroad, it
was at the Hope Valley Fertility Clinic, I was treated and conceived. I thank
God for putting smiles in my home and family,” she noted.
Sex selection fact and myth
A Consultant Gynaecologist &
Fertility Specialist, Ogunkoya who successfully handled the cases enumerated
above gave insight into the many issues surrounding sex selection, as well as
increased reports on male infertility and why multiple births are occurring in
older women.
An experienced physician of
international and local standing, he explained: “Sex selection has always been
on the agenda for many homes in Africa before now. Even the old Chinese
believed that the male sperm comes from left testis. There have been other
efforts around the world to influence sex of babies. In Nigeria for instance,
some people believe that if some people use some back of trees or leaves they
will have male children.”
Ogunkoya who stressed that there
have been so many tales and myths that are completely not true about sex
selection, said: “Sex selection is not all about balancing sex rather the main
aim of sex selection is to reduce and prevent abnormalities.
The fertility specialist who stated
that many IVF babies have been delivered at Hope Valley Clinics said sex
selection has also been successfully achieved. “Apart from gender balancing,
there are other reasons, one of such is to avoid sex link disorders that are
prevalence in some families like colour blindness, haemophilia and acute
haemophilia.
Sex selection allows such families
who are prevalent to such disease conditions to decide the gender that suits
their family. Like in the case of Josephine, the couple was able to decide
whether to have a male child or a female child.
Sperm sorting
Ogunkoya noted that the only
clinically proven method of sex selection was the MicroSort Sperm Sorting
Theory. “The MicroSort principle is a clinical technique used to sort and
separate the two different types of sperm, X and Y, that is the female and the
male sperm.
Once the sperm is sorted out, it can
be artificially inseminated (IUI), in this case you would need the sperm
sorting to be done on the day of ovulation.” Although it said that sperm cannot
be sorted into the two types 100 per cent accurately, clinical examination has
shown success rates for girls is 90 per cent while male chances of success fall
around 75 per cent.
According to him, “For a Nigerian
couple that needs the procedure, we are living in a parochial society where
there are much desire for male children, here if somebody has good sperm and
wants a male child we collect sperm from him and freeze it and send to
MicroSort abroad in a special container and when it gets there the separate the
male sperm and female. So separation has always been on our agenda but it
attracts extra cost”.
Explaining how the separation is
done he said: “The principle of MicroSort is based on the fact that the female
sperm has a bigger DNA and attracts more dye to the DNA, when you now put the
sperm on a conveyor belt, on either side you will now put an anti- dye which
will now attract DNA.
The anti dye will therefore attract
the sperm that has more dye to the female sperm to the side. So female sperm
tends to aggregates more to the side of the conveyor belt while the male sperm
remains at the centre. The sperm has a head, neck and a tail. This head is
where the DNA is. The female sperm DNA is fatter, and sluggish in movement, and
because the female sperm is fatter the DNA is more and that of the male sperm
is slimmer but faster.
Male sperm vs female sperm
“When the sperm is poured on the
conveyor belt, and the anti – dye, on either side, you put an anti- dye; the
dye will stain the head of the DNA because the DNA attracts the dye. So the
head of the female will attract more dye because it is a bigger DNA.
The sperm is moving along the
conveyor belt and the anti dye both sides will sort of, attract the dye like a
magnet and iron. If you put a magnet here and an iron is moving there, it will
attract the iron because the magnet is there.
If you put the sperm with the dye on
their head and an anti dye on the same axis, but all along the conveyor belt,
you find more dye by the side than the centre. And because of the dye on the
head of the sperm, it will attract more dye
“At the edge of the conveyor belt
you find more female sperm at the periphery while the anti dye is at the centre
where you find the male sperm. They have used the mere fact that the male sperm
contained less DNA and less dye than the female sperm which contained more DNA
and more dye in separating them since the anti – dye attract and the female
sperm to the side.
So the principle is therefore
separating the female sperm and male sperm. At a distance, you discover that
many of the sperm at the side will be female and many of the sperm at the
centre will be male. And it is the only objective demonstrating method of sex
selection known. It is still under research. It is still not available.
So for some reasons when you
separate such sperms, the person who wants female will take and the person who
also wants the female will use the female”
However, due to extra costs, most
clients opt for another method of sex selection which is a bit more scientific.
“It is the fact that some people make love around the time of their ovulation.
This involves timing of intercourse.
The idea is based on the fact that
female sperm are larger and slower and Male sperm is faster but more fragile.
So a few days before ovulation favours the larger but slower female sperm while
sex at the time of ovulation favours the faster male sperm”.
However, Ogunkoya counseled that
this method requires careful counting and ovulation testing to determine
exactly when the ovulation will occur. The fertility expert who noted that the
recipe for success is not just simple but a combination of so many factors
which includes diligence, hard work and transparency to patients emphasized on
factors such as regular updating of equipment, training and retraining of
staff.
Desire for male children
According to him: “There is more
desire for male babies but statistically most IVF babies tend to be male a
ratio of about 8 to 2 or 4 to 1. We cannot tell you precisely, the basis for
that. In our practice we have noted that. In our practice we have sort of noted
that there must be a factor within the concept of Assisted Reproduction which
imposes that. We are yet to find out the science behind it.
“Somehow, the process of IVF relies
on the fact that sperm should be able to fertilise the egg to make embryo. It
is usually that the sperm that is moving faster to get to the eggs should make
the embryo. We still don=t know. A lot of efforts have to be put into it. May
be we should start marking sperm to know which one makes the embryo. It is also
possible to actively influence sex by selecting them”
Explaining the advent of multiple
births in old women, he notes; “During the process of IVF we normally transfer
more than three embryos back to the woman’s womb although these days, you only
need to transfer less than three embryos.
In some cases one and the idea is
that most European communities rather not have multiple pregnancies and
deliveries because of the social preferences. In Africa, we like multiple
births and in fact we celebrate them. The tendency therefore is that if you go
to such countries today, if you have 10 embryos, the highest they can transfer
is two.
And if you probably have twins
before and you do IVF again, and the eggs are beautiful, they will probably
transfer only one egg. There is the advocacy for two embryo transfer or one in
some countries. But in Nigeria we still transfer up four embryos for reasons
that we welcome triplets. If the three or four embryos are implanted properly
that may result to triplets or quadruplets. So there is propondence of multiple
births in Assisted Reproduction than in non assisted births.
Male infertility
“Yes as a woman gets older, the eggs
become older as in fewer quality and quantity because as she gets older at age
13, the eggs that are being released are of a better quality than the eggs
later in life. That is the law of natural selection. But to a man is the same
but that of a man is to a lesser extent because the sperm of a man of 20 years
is definitely better than that of a man of 30 years.
As a man’s age advances, the sperm
gets poorer. It is easy to say that more men are getting problems of
infertility but all is enough awareness. The apparent increase of male problems
is created out of increase awareness. If there is any increase at all, it could
be traced to environmental problems and nutrition.
Increase awareness, a lot of people
now know where to go for their problems, there is no true increase in male
infertility it is increase in awareness. Women are now being encouraged to come
forward and the women are also being encouraged to bring their husbands along for
necessary tests.
Multiple births
In Africa people do not talk about
their pregnancy and a lot of people do not talk about achieving pregnancy
through IVF. They prefer to keep it secret. Anybody who gets pregnant at the
age of 42 is mostly through IVF but I am not saying that at 42 women cannot get
pregnant on their own.
But in reality, after age 45, it is
really difficult for women to get pregnant on their own apart from assisted
reproductive system. If they introduce two to three eggs and most times the
result came out to be multiple births and for somebody at that age, will want
to have three or more children at a time and forget about having more.

source: vanguard; by chioma obinna

Tuesday, February 14, 2012

ANOTHER FEAT IN IVF RECORDED BY NAUTH GYNAECOLOGIST



Another feat in Invitro Fertilization (IVF), has been recorded by the Nnamdi Azikiwe University Teaching Hospital, NAUTH, Nnewi, Gynecologist, Professor Joseph Ifeanyichukwu Ikechebelu, the Medical Director of Life Specialist Hospital, Nnewi with the delivery of a baby boy – Favour, through Invitro Fertilization (IVF).This brought to five women who have delivered through the process in the hospital within the last 6 months.



Confirming that the mother and child were in stable condition, Ikechebelu, said the baby boy delivered Saturday by 8.02 weighed 2.7 kg.



Ikechebelu who is a Professor of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital Nnewi and his team of doctors, nurses and embryologists performed the cesarean operation to deliver the baby and concluded other processes within 45 minutes.“This is the fifth time this processes is being carried out in this hospital. Our first baby-baby Joseph through IVF was delivered on 6th August, 2011, second was triplets delivered on 17th November, 2011; third baby boy was delivered on Nov 28, 2011.The 4th were triplets again delivered on December 26th, 2011 and this one now.‘‘We have over ten women already pregnant and carrying their babies and we are monitoring them pending their time of delivery’’.



Life Specialist is the only fertility hospital in Anambra State specialized in putting smiles on the faces of our women who could not ordinarily conceive and deliver their babies normally’’.Every couple still have a chance of having their own babies. Here we specialize in turning tears into joy.”Her mother (the babe’s grand mother) , name withheld by this medium said she and members of her family were overwhelmed by joy at the sight of the baby.



“We are happy for this opportunity because for sometime now, she was unable to conceive and deliver her own baby but we are happy and to God be the glory.



Dr Osuorah Chidebele Donatus , a Pediatrician with Nnamdi Azikiwe University Teaching Hospital, Awka described the processes of IVF as an artificial way of conception through some complex medical procedure outside the woman’s womb before implanting it back into the woman’s body through surgical process.