AFRH FERTILITY FORUM

AFRH FERTILITY FORUM

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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.

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

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