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 façade 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.
Infection
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
Step 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.