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.

Monday, December 21, 2015

“How IVF saved us from childlessness” – Women count their blessings, become advocates

Mrs. Ifeoma Emekwue had fertility problems after signing the dotted lines with her husband several years ago. She became a proud mother after undergoing In-Vitro fertilization (IVF). Was she afraid of stigma, having conceived through Assisted Reproductive Technology (ART) or IVF? She snapped, “No. From the day I was told I was pregnant, I called my mother and mother-in law to tell them I was pregnant. My children are now 16 years old, and they know they are products of ART.”

Mrs. Ifeyinwa Kpaje, a mother of five, who had her first four children through IVF, except the last child that came naturally, noted that the problem of infertility in Africa can drive couples and families involved to the edge that at some point they will not care about the ‘how’ of the conception of the children they so desperately want.

Kpaje said that “at a point, the mothers-in-law want to see children and not how you got them. I had 4 children through ART, and the last one came naturally. I have 5 children now. My first son looks like my husband. They resemble us because the sperm they used are from my husband and the eggs are from me, only that it was assisted conception.”

On the resemblance of IVF children to their parents, Mrs. Ifeoluwa Okusanya, a beneficiary of IVF, said “… the genetic identities are so strong.”

Mrs. Titilayo Aketi, another beneficiary of assisted reproductive technology said, “ After some period of childlessness, when I took in, people were like ‘are you sure?’ After I put to bed, my son is not only like the father in appearance, he (also) walks like his father.”

However, experts agree that if the sperm and eggs used for the IVF are not from the couple, there may be no genetic resemblance. Experts also maintain that children from IVF are normal children.

Today, Ifeoma Emekwue, who is Brand Ambassador of Association for the Prevention of Infertility and Promotion of Reproduction Health and Rights (ASPIRE) has challenged the stigma associated with IVF treatments to give it a human face, and is encouraging women with fertility problems to consider IVF. She is not in this alone. Ifeoluwa Okusanya, Ifeyinwa Kpaje, Titilayo Aketi, Lanre Kazeem-Abimbola, Patricia Jibor, all wives, mothers and beneficiaries of IVF are members of the group.

In-Vitro Fertilization, commonly known as Assisted Reproductive Technology, is the process of fertilization by manually combining an egg and sperm in a laboratory dish, and then transferring the embryo to the uterus. Other forms of ART include Gamete Intra-Fallopian Transfer (GIFT) and Zygote Intra-Fallopian Transfer (ZIFT).

Experts say that IVF is used to treat infertility in patients with blocked or damaged fallopian tubes, male factor infertility including decreased sperm count or sperm motility, women with ovulation disorders, premature ovarian failure, uterine fibroids. Also, women who have had their fallopian tubes removed, individuals with a genetic disorder and unexplained infertility.

According to a fertility expert “there are five basic steps involved in the IVF and embryo transfer process. Monitor and stimulate the development of healthy egg(s) in the ovaries. Collect the eggs and secure the sperm.

“Then, combine the eggs and sperm together in the laboratory and provide the appropriate environment for fertilization and early embryo growth.

“In transferring embryos into the uterus, the following steps are taken: Fertility medications are prescribed to stimulate egg production. Multiple eggs are desired because some eggs will not develop or fertilize after retrieval. Transvaginal ultrasound is used to examine the ovaries, and blood test samples are taken to check hormone levels.

Eggs are retrieved through a minor surgical procedure that uses ultrasound imaging to guide a hollow needle through the pelvic cavity to remove the eggs. Medication is provided to reduce and remove potential discomfort. The male is asked to produce a sample of sperm, which is prepared for combining with the eggs.

“In a process called insemination, the sperm and eggs are mixed together and stored in a laboratory to encourage fertilization. In some cases where there is a lower probability of fertilization, Intra Cytoplasmic Sperm Injection (ICSI) may be used. Through this procedure, a single sperm is injected directly into the egg in an attempt to achieve fertilization. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos.

“The embryos are usually transferred into the woman’s uterus three to five days following egg retrieval and fertilization. A catheter or small tube is inserted into the uterus to transfer the embryos. This procedure is painless for most women, although some may experience mild cramping. If the procedure is successful, implantation typically occurs around six to ten days following egg retrieval.”

Meanwhile, ASPIRE, primarily aimed at tackling the silence and social stigma associated with infertility, seek to lend a helping hand in partnering with individuals who may not necessarily have had IVF treatment but wish to support the cause of shattering the silence of couples with such challenges.

The group, courtesy of the quality treatment received from the foremost fertility center in Nigeria, The Bridge Clinic, also seeks to encourage couples going through such challenges to move above the prevalent prejudices and seek for quality treatment of their health conditions.

In the recent re-lunch of ASPIRE, Brand Ambassador Emekwue said the advocacy group seeks to redress the challenges of development, which almost all groups of this nature experienced in their early days. The advocacy group is made up predominantly by people who have overcome the challenges of infertility at some point in their lives. However, as part of it’s success, the group seeks to deploy their experience in assisting couples going through infertility challenges.

Emekwue said: “The association, which started as group of people who overcame the challenges of infertility, targets to extend to other regions as well, although not in the same magnitude as the Lagos region, and expects to scale up their reach in many other cities.

“It’s objectives include shattering the social stigma associated with IVF (and dispelling the rumours that IVF children have challenges.) Also, fostering and encouraging open dialogue about causes of infertility and its prevalence in sub-Saharan Africa.

“The group also seeks to mentor couples about to undertake or currently undertaking the journey.”

She said: “Against the backdrop of proliferation of Assisted Reproductive Technology (ART) centres in Nigeria, ART is unregulated in Nigeria and that is one of the causes we are fighting. The government should move into the sub-sector, and put order to its practices to save Nigerians from the many fraudsters parading themselves as fertility experts.

“It is for this reason that we work with The Bridge Clinic, the foremost ART center in Nigeria, as our technical partners due to their experience (16 years), high success rate, the quality management system and their international affiliation with IVF Professor Zech (who ensures they are at the cutting edge of ART services both in delivery and outcome).”

Source: dailyindependent

Thursday, June 25, 2015

The Hannaniya's quest for a child

It was gladness and great joy as embryos frozen more than 5 years earlier in England were sent to a Lagos clinic, transferred to Gladys’ uterus, successfully implanted and ended in a delivery of twin girls 29 weeks later...

 Dr. Gladys Duruyani and Dr. Ishmael Hannaniya were married for 20 years and just like any other couple, they tried to have children.

However, unlike others, it took them several years to conceive and despite the challenge with conception and their expectations, all the pregnancies unfortunately ended in miscarriages.

This was a very grievous deal for them because the babies would grow to about five or six months in the womb and then a miscarriage would occur and some of these miscarriages were for multiple babies.

The enlightened couple utilized their globe-trotting exposure to seek medical solution overseas, all to no avail. Eventually as time progressed, Duruyani became ill and was diagnosed severally with various kinds of ailments.

She developed a type of cough the doctors could not understand and on the film some dark spots were seen in her chest region and lungs. Being devoted Christians, they sought medical solution to all the challenges yet committed them all to the Lord as they expected some miracle.

Eventually the Lord took this strange ailment away from her. Their challenges were numerous, and one day, while they dined at a Chinese restaurant in Abuja, Duruyani began to bleed.

She knew what was happening. Her husband, who is a microbiologist, a specialist neuro-physician, also rushed her to three different hospitals. Unfortunately, in each hospital, the senior doctors had all gone home.

After the third stop, he rushed her to the National Teaching Hospital where he found out again that all the senior doctors had also closed for the day.

At this point of desperation, he had to take the bull by the horn, choosing to go against the ethics of his profession that advise against a man performing such a major surgery on his spouse. He had a vague idea of what to do, besides there were some junior doctors around.

With the few junior doctors on duty, they quickly set up the theatre and began the surgery to take out the blood clot that was about to snuff life out of his beloved wife until an experienced doctor who came around the hospital for an entirely different reason heard of the situation and ran to take over the surgery already in progression.

On another day, she felt ill and in the cause of seeking a medical solution in South Africa, they were told that the blood result was bad news. The South African doctors gave the verdict; they were shaken and took the challenge once more to the Lord in prayers.

They said, “it was a rare form of blood disease.” The couple were shocked and torn apart for a while but braced up, rejecting the doctor’s report and holding unto the Lord’s report.

They sought medical solution in the UK afterwards and the doctors became puzzled and asked “who said she had a blood disease, a rare form of blood cancer? To the glory of God, the results of the latter test showed there was no trace of the cancer.

Did a miracle take place? They rejoiced and praised the Lord. Soon after this great news, they got a call from the South African doctors stating that there was a mix-up with her tests.

They investigated further and confirmed that she did not have any form of cancer in her system. Having gone through so much and having wailed on the Lord in the secret place of the Lord, they remained sober and thankful for once more sparing her life from the clutch of death.

After a while, they tried to have children again but it was to no avail as the series of miscarriages continued. Eventually they figured that since her womb could not keep the pregnancies, they would consider the option of surrogacy.

Their Harley Street doctor who is one of the first doctors in the world to successfully deliver in-vitro (IVF) babies had been very sympathetic to their cause and after series of the failed IVF had suggested surrogacy to them.

They began the necessary procedures and as embryos could be stored for years, they decided to store the excess embryos while they sought for a surrogate mother to carry their child.

Unfortunately, the surrogacy laws in Britain were so strict that it would have been impossible to find a mother to carry the child. The doctor who was natively Greek suggested that they find a surrogate in Greece.

They quickly embraced the idea but it was soon forgotten because there was a serious problem with the transportation of the embryos out of the region. When that failed, they tried to transport the embryos to Nigeria but the results were the same as that of Greece. It seemed like they would never be able to have their own children so they opted for adoption.

They adopted a little boy now six years old and they later adopted a girl who is now aged four. Duruyani’s body had gone through so much strain over these years and age was not on her side as she was classified as High Risk Pregnancy (if she took in).

On two occasions she had been diagnosed with a strange form of cancer, and later lymphoma, she had suffered a hemorrhage, suffered from a strange cough which left dark patches on her lungs, she had suffered emotional, physical and psychological trauma at the travails she had gone through amongst other health challenges too numerous to mention. She had also been on total bed rest all through these series of pregnancies that resulted in miscarriages.

Yet from all these, the Good Lord delivered her from the cold hands of death. Her husband, Hannaniya, who is a rare Igbira man from Kogi State and a distinguished gentleman remained a most loving husband to her, an Igbomina from Kwara State and kept all their travails away from family and friends.

THEY loved and doted on their two adopted children and once more wondered if it was necessary to have more children having gone through so much agony in their quest for their own biological children.

The Lord understood the desires of their heart and decided to seal their faith with a remarkable gift to them in the year 2014. They got a call from their doctor in Harley Street that the Law had lifted the storage limit of the human eggs/embryo which negated the earlier law of five years. Perhaps because they were silently thinking once more of their unborn children, they became expectant as a result of the serendipity they experienced.

Once more at this point in time, her embryos were still available and having tried all to no avail, including the suggestion of surrogacy that could not hold for statutory reasons, their deciding to try once more was not out of place.

This time they asked for the frozen embryos to be sent to Nigeria and this became the appointed time for them, as they were able to transport these embryos and implant them in Lagos, Nigeria.

Twenty-nine weeks after the implantation of the embryo, Dr. Hannaniya, while at work, got a call from the surgeon that his twin baby girls had been delivered weighing 0.9kg and 1kg respectively. He could not believe his ears and questioned the time and date of delivery to which the surgeon responded that it was either they were saved at that point in time or they were lost like all the others gone.

Dr. Hannaniya, knowing what everybody in this country and beyond knew which was that the babies had a slim chance of survival in a country like Nigeria, did not get excited. He did not worry either but chose as usual to leave this one more challenge to God.

For the first time their babies had been delivered alive so it was clear that the Lord had given them the miracle of an identical twin birth but with the incessant power outages and the inadequate medical care especially for neonates in the incubators, what would be the fate of these little ones? As usual and with wisdom, he chose to keep the news away from family and friends for he did not want to get excited over his preterm babies. They willingly submitted the case to the Lord and waited for time to celebrate if it was the will of God for them.

As God gave his approval, both babies survived and were christened Grace and Esther on Sunday, 22nd March 2015 at the time of their expected date of delivery.

The other two children who had been adopted were also christened on the same day aged six and four. There was a lovely celebration of the two healthy babies and their older adopted siblings afterwards at the beautiful event organized by the family in the Federal Capital Territory of Abuja. Their phenomenal testimony was shared by the husband himself and all those present were amazed as Dr. Hannaniya shared this incredible testimony of over 90 minutes while their guests were entertained with food and drinks.

Their parents, siblings, relations, friends, colleagues and well-wishers were speechless and moved to tears of joy for the Grace of God on his beloved children, Duruyani and Hannaniya, as they finally found complete joy in their now family of six.

There were great lessons to learn from the power of prayers and the power in sealed lips for they did not give room to any interference or sympathy from family and friends.

They had toured the world in search of children of their own, they had spent money over the years, the Lord continued to provide for them and eventually when they least expected it, the Lord showed them that something good could still come out of their own country, Nigeria, and this was the serendipity of our Lord, the perfection of science, their dogged hope and above all, the abundant blessings of the Great God they serve.




Saturday, May 16, 2015

Renewed hope for motherhood through IVF

AGBENI Market is a popular market in Ibadan, Oyo State. It as a notorious market for adulterated or fake drugs such that the job of any helmsman at the National Agency for Food Drugs Administration and Control (NAFDAC), cannot be complete without close monitoring of this market. But that is not all about this market at the city centre, as it is home to other goods and services. The best place to visit for household utensils, toiletries and foodstuff, is still Agbeni.

You can then imagine the hustle and bustle going on in this market on a daily basis. Men, women, young and old are engaged in one transaction or the other at any point in time in the market. But tucked in the bowel of this market is 47 year old Muniat Oladipo.

On the outward, she could pass for a well to do trader. And that is what she is. But beyond the fa├žade is an unhappy woman that has been denigrated and called names by her womenfolk in the market for a challenge that was not her creation. She is childless after many years in matrimony.

Indeed, life without a child for a woman of her age bracket is comparable to the taste of solution inside the gallbladder of a famished and dehydrated cow in the mouth of a thirsty marathoner.

Besides, like the Biblical Hannah who was repeatedly taunted by her rival Penninah for being childless in the house of Elkanah, Mutiat, had to painfully bear her “unfortunate condition” for 20years.

“The most painful thing then was listening to deliberate discussions of some women of child bearing age in my presence, of such issues as labour pains, ante natal care, immunization of babies, dentition experienced in baby growth and such other stuffs in an efforts aimed at making me feel as if I am not a complete woman.

“Some called me a witch, others said I had donated my ovaries to the occult world and therefore would not, for life,. be able to carry my own baby. We had visited too many spiritualist we thought should be potent enough to make me carry the seed of the womb to no avail. But throughout all these ordeals my greatest strength was the unwavering supports of my 62 year old husband, Asimiyu, who never, for once, left me in the lurch.”

Time was ticking for Muniat. Hope was giving way and despondency was setting in. Indeed, menopause was knocking at her door. But she was not willing to give up. And just at the nick of time miraculously, a lifeline came from the horizon. This time, through the support of improved technology, Muniat became a proud mother of a baby girl.

Muniat was the cynosure of all eyes at the University of Ilorin Teaching Hospital (UITH), recently when she was delivered of a baby girl through the hospital’s third successive Assisted Reproductive Technology (ART) thus terminating her experience of  20 years of marriage without a conception.

After the delivery via caesarian session at about 10:45 am by a team of Gynaecologists led by the Chief Medical Director of the UITH Professor Abdulwaheed Olatinwo, the mother gazing at the baby weighing 3.2kg said sobbing, “so I can be a mother at last.”

UITH is the third public hospital in Nigeria after National Hospital Abuja and University of Benin Teaching Hospital (UBTH) with the services of the ART unit.

According to Olatinwo, in whose tenure,the Renal unit of the hospital  had performed the first Kidney Transplant in a male patient, added that arrangement had been concluded for the first Open Heart Transplant (OHT) of the UITH by June this year.

The elated Olatinwo, a Professor of Gynaecology and Obstetrics, disclosed how the hospital had sponsored, to India on training, a team of Gynaecologists led by Dr Lukman Omokanye, to learn the  skills of the IVF.

Already, the IVF unit of the hospital, has become a much sought after centre by patients and their relatives just as it has equally become a financial autonomous section.

The CMD noted: “We don’t need to travel outside Ilorin for what can be done here. The IVF depending on its type can be done here with a paltry sum of about N600,000. We even give some rebate, through the hospital revolving funds, to some indigent patients.

“But we are canvassing more of private supports for the unit, especially in the area of adoption of some couples in need of its services. Today, we are training doctors from other hospitals on the IVF. Very soon, we shall be receiving patients from outside the country paying us hard currencies to strengthen the nation’s exchange rates capacity.”

According to the mother of the baby, “I had lost any hope of having my own baby in life. I had been to many hospitals, visited countless spiritualists to no avail. But today, looking at this baby, I know that there is nothing God can’t do. I thank God and all the health workers who took very good care of me here at the UITH.”

She was married to her husband some 20years ago. She recalled how she was diagnosed of Fibroid (Myomectomy) 12 years ago in a private hospital in Ibadan and the growth was also promptly removed.

When all efforts at conceiving failed even after the operation, the woman, now exhibiting knowledge of many medical terminology apparently due to her ordeal and frequent contacts with medical practitioners  said she was referred to the UITH for more investigations on her reproductive system. This according to her was five years after her last menstruation.

“The UITH doctors told me of the need to make my womb active because a woman of my age and who had last seen her menstrual period some five years ago would practically be having a dead womb.

“They commenced treatment by first placing me on medication. When it was time, they fertilised my eggs with the semen of my husband. On the third day, they transferred three embryos into my activated womb. After three weeks, they conducted a pregnancy test on me and it was positive.

“It was like a dream to me when the doctors asked me to commence ante natal at the sixth week of the pregnancy. My husband asked me to hide in Ilorin. I had to put up with my brother, Alhaji Ajibade Suleiman until I was delivered of this miracle baby. I never thought that a woman at menopause could still have a baby.”

Speaking with The Guardian on telephone from Ghana, the husband, said the day of the birth of the baby would remain indelible in his mind and a date that has taught him the greatest lesson that God is just and loving to those who diligently await his promise.

He added, “I am extremely happy today and will be eternally grateful to God and all the medical team at the UITH who assured us of the success of the IVF when we commenced the treatment with them.

“I must confess to you, I never thought it would work out well at the initial stage, but my wife was very optimistic of the positive outcome of it. She increased my faith on the IVF and today we are grateful to God and all those who stood by us in our sad moment of life.”

For Suleiman, the elder brother of the proud mother of a new born baby, the love of the husband of his sister remained the impetus that sustained the woman throughout her waiting period.

Suleiman said: “he did not just profess love to my sister, he showed what love is. Even though my sister is not his only wife, he showed her exceptional love and refused suggestions of a divorce common with many African men, including my humble self. Today, he has showed us the results of being patient.”

Speaking with The Guardian in Ilorin, Omokanye the Reproductive Medicine Clinician of the UITH advised couples with challenges of conception not to lose hope of a reversal of their conditions but with a caveat that early presentations of their cases would boost their chances under the IVF.

Besides, he praised the UITH management for the vision of the programme, just as he urged women already carrying the toga of barrenness to have faith in God and seek for more medical solutions to their challenges.

“We always emphasis the issue of age in IVF procedures, because early ages make women to have the ability to produce fertilisable  eggs. So women with this presentation should, apart from putting their trust in God, seek early medical solution towards boosting their chances.”

Although, two previous successes had been recorded before this feat at the hospital, Omakanye said the case of Oladipo was unique due to her menopausal stage when she presented at the hospital.

However, while medical experts said IVF is the best treatment for certain kinds of fertility problems, they are of the opinion that it can be demanding and doesn’t always result in pregnancy.

They suggested that if one is about to start a course of IVF, such person should find out as much as he can about the treatment, adding that knowing what to expect can make IVF easier to manage.

What is IVF?
When a couple conceives naturally, sperm from the man and the egg from the woman meet in the woman’s fallopian tubes. These are the tubes that join the ovaries to the uterus (womb). One sperm penetrates the egg and fertilises it.

In IVF, this process of fertilisation happens outside the woman’s body. A woman’s eggs are surgically removed and fertilised in a laboratory using sperm that has been given as a sperm sample.

Next, the fertilised egg, called an embryo, is surgically implanted into the woman’s womb.

Typically, one cycle of IVF takes between four and seven weeks.

What to expect of IVF treatment
IVF does not always result in pregnancy.

In the UK, around 20-25% of IVF treatment cycles result in a birth. In general, younger women have a higher chance of success. Success rates decrease dramatically in women over 40 .IVF can be a physically and emotionally demanding process. Some men and women have mental health or emotional problems such as anxiety or depression during or after IVF.

If you’re undergoing IVF, ask about counselling to help with the emotional impact of the process and its results.

IVF risks
There are health risks involved in IVF treatment. These include:

Multiple pregnancy
There is an increased chance of multiple pregnancy with IVF. Multiple pregnancy has health risks for both the mother and children as twins or triplets are more likely to be born prematurely and to be underweight at birth.
Ovarian hyperstimulation syndrome (OHSS).

Drugs used to stimulate the ovaries during IVF can lead to ovarian hyperstimulation syndrome (OHSS).

In OHSS, the ovaries enlarge and become painful, causing abdominal discomfort. More severe cases can lead to shortness of breath, fluid retention in the abdominal cavity and formation of blood clots. In these cases, you may need a stay in hospital.

When eggs are removed from the woman, a fine needle is passed through the vagina and into the ovaries. There is a risk of introducing infection into the body, though antibiotics and surgical hygiene ensure that this rarely occurs.

How IVF is performed 
The IVF technique was developed in the 1970s. It may differ slightly from clinic to clinic but a typical treatment is as follows.

For women
tep one: suppressing the natural monthly cycle
You are given a drug that will suppress your natural menstrual cycle. This is given either as a daily injection (which you’ll be taught to give yourself) or as a nasal spray. You continue this for about two weeks.

Step two: boosting the egg supply
Once your natural cycle is suppressed, you take a fertility hormone called FSH (follicle stimulating hormone). These fertility hormones are known as gonadotrophins. This is another daily injection  you give yourself, usually for about 10-12 days, but it can vary depending on your response.

FSH increases the number of eggs your ovaries produce. This means more eggs can be collected and fertilised. With more fertilised eggs, the clinic has a greater choice of embryos to use in your treatment.

Step three: checking on progress
The clinic will keep an eye on you throughout the drug treatment. You will have vaginal ultrasound scans to monitor your ovaries and, in some cases, blood tests. About 34-38 hours before your eggs are due to be collected, you’ll have a final hormone injection that helps your eggs to mature.

Step four: collecting the eggs
For the egg collection, you’ll be sedated and your eggs will be collected under ultrasound guidance. This involves a needle being inserted through the vagina and into each ovary. The eggs are then collected through the needle.

Some women experience cramps or a small amount of vaginal bleeding after the procedure.

Step five: fertilising the eggs
The collected eggs are mixed with your partner’s or the donor’s sperm in the laboratory. After 16-20 hours they’re checked to see if any have been fertilised.

If the sperm are few or weak, each egg may need to be injected individually with a single sperm. This is called intra-cytoplasmic sperm injection or ICSI (see below).

The fertilised eggs (embryos), continue to grow in the laboratory for one to five days before being transferred into the womb. The best one or two embryos will be chosen for transfer.

After egg collection, you will be given medicines, either progesterone or hCG (chorionic gonadotrophin), to help prepare the lining of the womb to receive the embryo. This is given either as a pessary (which is placed inside the vagina), an injection or a gel.

Step six: embryo transfer
The number of embryos to be replaced should have been discussed before treatment starts.

Women under 37 in their first IVF cycle should only have a single embryo transfer. In their second IVF cycle they should have a single embryo transfer if one or more top-quality embryos are available. Doctors should only consider using two embryos if no top-quality embryos are available. In the third IVF cycle, no more than two embryos should be transferred.

Women aged 37–39 years in the first and second full IVF cycles should also have single embryo transfer if there are one or more top-quality embryos, and double embryo transfer should only be considered if there are no top-quality embryos. In the third cycle, no more than two embryos should be transferred.