UNILORIN Teaching Hospital, Mother celebrate birth of first test-tube baby

Mrs. Ramat Jamiu’s joy knew no bounds when she was delivered of a bouncing baby boy in Ilorin, the capital of Kwara State. Her bundle of joy had arrived after nine tormenting years of childlessness and anxiety.

The nursing mother had cause to be grateful to the doctors at the University of Ilorin Teaching Hospital, whose expertise had ensured the safe delivery in the first place.

Jamiu’s baby is the product of the hospital’s first successful attempt at In-Vitro Fertilisation. With this feat, the UITH officially joins the list of teaching hospitals that have undergone this medical procedure in the country. The others are the Lagos University Teaching Hospital, Idi-Araba, Lagos; Obafemi  Awolowo University Teaching Hospital, Ile-Ife, Osun State, and  the  University College Hospital, Ibadan , Oyo State.

In an interview with our correspondent on Friday, Jamiu admitted that initially she had refused to undergo the treatment.  Eventually, she decided to give it a try after the doctors told her that IVF was her only chance of having a baby of her own  – husband, a professor of Islamic and Arabic Studies at the Kwara State University, encouraged her, she noted.

The ‘brand new’ nursing mother said she had visited several private hospitals in Kano, Abuja and Lagos – in search of a solution to her childlessness and had spent a lot of money, but failed to achieve any positive result until her husband advised her to try a teaching hospital.

She said, “It is a shameful experience not to have a baby after several years of marriage. But thank God, I am happy now that I have a baby of my own. I have been to hospitals across the country. I spent so much money, but in vain. Eventually God answered my prayer and things worked well for me at UITH. For the couples who are having difficulty in child birth, they should know that God is capable of giving them a child. When God says your time has come, nothing will stop it.”

Still relishing the arrival of her baby, Jamiu urged Nigerians to have more faith in the public healthcare system. She advised fertility-challenged couples to take advantage of the benefits of modern medicine to solve their problems.

She said there was no reason for Nigerians to seek medical treatment abroad since the local hospitals were capable of handling their cases at cheaper costs.

So far, over five million babies have been born, via IVF, in the world since the birth of the first test tube baby, Louise Brown, in a London Hospital in 1978. Also, an estimated 2000 babies have been born through the same procedure in Nigeria.

The consultant obstetrician and gynaecologist at the UITH, Dr. Lukman Omotayo, said Jamiu was managed by the hospital for about one year before she had the baby through a Caesarian Section last Friday.

Omokanye said, “Infertility in marriage is not just for the woman; both the husband and the wife must be involved to achieve any form of success. That is what happened in this case; we had her husband cooperation all the way.”

He said that after several consultations with the woman and her husband and every possible case of gynaecological deformity had been ruled out, the hospital had decided to try IVF.

“Fortunately we found out that the husband’s sperm, in spite of his age, could fertilise  his wife’s eggs and that she also had viable eggs that could be fertilised by sperm. So, we were expecting a fruitful result. The procedure is to get fertilisable eggs from her. It took us one month.

“First, she was down-regulated with a drug called Suprefact® for 14 days. We prepared her for eggs collection and subsequently we did micro epididymal sperm aspiration to obtain sperm from the spouse to fertilise her eggs through a procedure called intracytoplasmic Sperm Injection.

“We injected the sperm into each egg. This was then incubated for 72 hours and confirmed evidence of fertilisation.  After 72 hours, it became an embryo.  This was later transferred into her womb.  That is what eventually developed into pregnancy. Pregnancy was confirmed after two weeks of transfer into the womb.”

Omotayo said that prior to delivery, Jamiu had been coming to the clinic every two weeks to ensure that the baby was fine because, according to him, the pregnancy was very special.

He said that the pregnancy was uneventful, meaning that there was no complication, apart from the conventional challenges of pregnancy, such as abdominal discomfort and occasional body weakness.

Omotayo said , “We confirmed that she was carrying a baby boy after 18 weeks. She was meant to deliver on August 16, but this kind of special baby could not be allowed to go through the stress of labour. Another thing about this pregnancy is that the baby was coming as a breech (a baby comes with the feet as opposed to the head). However, there were no hitches during delivery. He weighed 3.25kg. This is a memorable day in the history of UITH as the centre also witnessed the inauguration of several projects.”

Also, the UITH Chief Medical Director, Prof. Abdulwaheed Olatinwo, described the development as another major breakthrough recorded by the institution in its quest for medical advancement.

He said, “I am very happy for the family and UITH. We are happy that we were able to do this. For a very long time, we kept our competence and capability in assisted reproductive technology low so that there would not be much noise.

“This is the beginning of good things to come. I said with prayers and the support of people, by the grace of God, before the end of the year, we should have the first baby through laboratory procedure.”

Olatinwo said the UITH was capable of assisting more mothers in Kwara State and beyond to achieve conception. He added that the hospital had also bought some modern medical equipment for this purpose.

 

Couple breaks ice on IVF success

SAMUEL, 48, and Victoria, 42, Olayiwola have become the first couple to publicly acknowledge that they were able to have quadruplets after 17 years of marriage, at first attempt, through In Vitro Fertilisation (IVF) in Medical Art Centre (MART), Maryland, Ikeja, Lagos. The Olayiwolas, pastors at Living God Preparatory Assembly (Rehoboth Basilica), Abule-Egba, Lagos, on Thursday, February 9, 2012, became proud parents of three girls and a boy – Elizabeth, Mary, Samuel and Deborah. The quadruplets were delivered under the watchful eyes of Prof. Godwin Ajayi at Lagos University Teaching Hospital (LUTH), Idi-Araba.

The Olayiwolas, who celebrated their 17th wedding anniversary on Sunday, March 4, 2012, got to know of the services offered at MART by the Joint Pioneer of IVF technique in Nigeria and Adjunct professor at University of Illinois United States, Oladapo Ashiru, through an article published in newspapers.

When the couple got to MART, Victoria was diagnosed with blocked fallopian tubes and overweight. She was put through a detoxification programme and had to lose 20kg before the technique started. Victoria and Samuel were put on some antioxidant drugs to boost the quality of eggs produced by the ovaries and the sperm from the testicles.

How did it all happen? Samuel during a thank you visit to MART recently told The Guardian: “I am here to show my appreciation to the man God used to bring joy to my family.

“Two things worked for us; our faith in God and level of education. Number three is our family members; maybe because they believe in God they did not put much pressure on us. Finally what helped my wife was that I had the insight that when you are talking about infertility it may not necessarily be the lady. My wife and I, we prayed and the day I saw professor’s interview in the newspapers, the spirit of God said to me ‘this is an opportunity you should not allow to pass you by.’

“When we finally got to Prof. Ashiru he told us that we could not wait any longer trying other methods due to our ages, that we have to go straight to the sure method. My wife had blocked fallopian tubes. When Prof. heard our ages he said ‘where have you been?’ I am 48 and my wife 42. I got assurances from Prof. that my sperm and my wife’s eggs were okay. He said I was okay but needed to take some drugs to make my sperm better.”

What were the challenges? Samuel explained: “When it was confirmed that my wife was pregnant I was weary when I was asked to go and sign an undertaking that if anything happened, the hospital would not be liable. But Prof. explained that it was to make sure that I understand that if problem arises that the two teams will solve it together and not to heap the blame on the hospital.

“Another issue was during the period of transfer of the embryo back into my wife, Professor travelled and left it for his assistants. My wife was worried but I told her that Professor must have set everything right. After the implantation, the first scan showed three fetuses but by the second one, the fetuses were four; this was because one of the embryos turned to twins, it later divided again.

“Another issue was when two of my babies needed blood and my blood was taken to check whether it matched for possible transfusion. I was jittery because of stories I read of the use of donor sperm. But I prayed that my blood corresponds to theirs. I did not doubt MART but you know naturally I was worried. But when it was confirmed I was very happy.

“Another challenge was when Professor advised that my wife needed the best obstetric care for the babies to be delivered successfully. We wanted to travel abroad for the delivery but we had problems getting United Kingdom (UK) visa. I already had South Africa visa so it was easier to get for my wife. Along the line I was told that South Africa may have the facilities but Nigeria has better hands. Prof. Ashiru recommended Prof. Godwin Ajayi of LUTH. He said Ajayi is one of the best hands.

“When we got to Prof. Ajayi, he did not allow my wife to go home that day. She was immediately admitted in his clinic at LUTH. We had problems during the January strike against fuel subsidy removal. The doctors were helpless in helping. But we prayed that the strike got resolved quickly.”

On why benefitting couples were not enthusiastic to come forward? Samuel said: “People are not keen to come forward to accept that their children were born through IVF probably because of societal perceptions. As a man of God I feel I should not cover it. Personally, this issue of nobody coming out is somehow. But I said that if God will answer me I would testify publicly. In this modern age there is nobody that is not assisted by technology whether it is scan or drugs. The first time I met Prof. Ashiru he was talking about his new technology. He said ‘don’t let this woman get beyond the opportunity.’”

Samuel in a letter of appreciation to Prof. Ashiru made available to The Guardian said: “On behalf of myself and my wife, I wish to appreciate you for deploying your God-given wisdom and knowledge at ensuring that we have children of our own. Sir, you are a channel who God used to give us everlasting joy; this we are very much grateful.

“…I must add Sir, that with this type of opportunity and prayer, many would stop visiting herbalists that usually compound their problem. Words cannot express our gratitude.”

To this, Ashiru responded: “I think we should recognise that the gentleman that came here is the first to go public. We at MART have been well commended to be the best in Africa. We have improved the technique in such a way that we are now having several multiple pregnancies. But in the developed world now, they do not want to hear the word

multiple pregnancy. They are looking at the economies and all the complications.

“So, the preaching is to reduce the number of embryos. We have done that and the multiple pregnancies we are having this year is less than what we had three years ago. Two years ago we were having quadruplets because we were using four embryos. Now we have reduced the number of embryos we are putting back to just three. But as God will do it, this three ended up four because of twinning.

“But among the people who have benefited, the Olayiwolas are coming out to break the ice in such a way. The last time we had this type of event, the woman wanted to but the husband did not allow her. People should recognise that there is a technique that can help people. People are now coming from throughout West Africa to benefit.”

On whether there were challenges in handling the Olawiyolas case? Ashiru said: “I think they were very lucky, there were no hindrance. There was little or no challenge. All they had to do is to take medication to make sure the ovaries and sperm were fully functional. They took antioxidant drugs to ensure better sperm and ovarian production. The next thing was that the woman had to lose weight. She lost 20kg. She had to go through our detoxification and weight loss programme.”

Ashiru, who is also the medical director of MART further stated: “This thing will demystify IVF. In some years back if people delivered through caesarean section they did not want people to know. I thank the Olayiwolas that they are able to come forward. I hope by so doing Nigerians will know that IVF is a normal process and these babies are normal children.

“I have been in this process since 1981 but the successes have been hidden because people do not come forward and even when they do, they come with pseudo-names. The Olayiwolas’s success is the reward for patience and dedication. I take this as God’s help from the Almighty. To me this call is a call to humanity, to service.”

‘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

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

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.

Lagos Hospital Delivers Nigeria’s Oldest IVF Mother

A Lagos based specialist hospital, St. IVES has successfully delivered a 57-year-old woman, Mrs. Adeyemi Taiwo, of a bouncing baby girl. This was achieved through the Invitro –fertilization, IVF, unit of the hospital.
According to the Chief Medical Director of the hospital, Dr. Tunde Okewale, the delivery is the oldest case he has handled since the Fertility Unit of the hospital was established.

“The woman is arguably the oldest IVF mother in Nigeria. Interestingly too, the baby weighed 2 kg when it was delivered at 7.45 a.m on May 11, 2010 after 35 weeks of gestation,” Okewale stated.

The baby was delivered through C/S after comprehensive IVF treatment at the hospital by a team of five doctors which comprised of Obstetrician and Gynecologist, Embryologist and Neonatologists.

How IVF Saved a-20-Year Old Marriage

Lagos — If only Felicia knew she could be relieved of her infertility problem with money, she could not have spent two decades in agony looking for a child, notwithstanding the embarrassments from her husband's relations.

When she was married 20 years ago, she was full of expectation that after some months, she will have a baby but unfortunately, she was disappointed. She continued hoping that one day her desires shall be met. Even when she thought of adopting a child, she had probably thought of the implications.


But the joy is full when you have your own baby. This issue could have probably become the centre of discussion during her husband's family meeting, and the option of marrying another wife would have been the most desired solution.
But, her shame and agony became a thing of the past last year when she gave birth to a set of twins through In Vitro Fertilisation (IVF), an assisted fertility means of getting pregnant.
Only the environment could explain how joyful the entire family of Mrs. Felicia was as well as the management of St. Ives Hospital in Ikeja, Lagos State.
The babies were delivered through Caesarian Section, and were said to be doing well as they were now out of the incubator. The mother was not disposed due to some medications she is being placed on but it is gathered that she and her babies are doing well.
According to medical research, IVF has become the major treatment for infertility when other methods of assisted reproductive technology have failed. The process involves harmoniously controlling the ovulatory process, removing ova (eggs) from the woman's ovaries and letting sperm fertilise them in a fluid medium.
The fertilised egg (zygote) is then transferred to the patient's uterus with the intent to establish a successful pregnancy. This is used when parents are having infertility problems or they want to have multiple births. The first test tube baby, Louise Brown, was born in 1978.

In an attempt to put the woman on interview to share her experience during those years of looking for the fruit of the womb and how she felt now that she has seen her joy come to pass, the matron of the hospital, Mrs Kudirat Adetoun who happened to be on duty throughout her pregnancy period, spoke to Saturday Vanguard and revealed some of Felicia's expressions when she gave birth to her children.

Mrs. Kudirat Adetoun, told Saturday Vanguard that the first time, Felicia set her eyes on her babies, the first statement that came out of her mouth was, "So it was because of N500, 000 that I'd waited all this while.," "If I had known, I would have come to this hospital earlier," then she started crying, said Mrs. Adetoun.
"Then I answered and said, may be this is the right time that God has destined for you to see your children.
When God is ready to visit you, all that I know is that He will do it and nobody will share in His glory", she continued.
I remember, the first day, she came to this hospital and complained that she couldn't take in not even once. As one of the matrons, I was assigned to be her companion based on the test carried out on her. She had undergone series of tests and according to the doctor's findings, it was discovered that she wouldn't be able to conceive on her own except through assisted reproduction.
So, she was put on, IVF, and when the virginal scan was done, it became a multiple gestation and when she came after the procedure, she was put on pregnancy test and it was positive although, nobody knew, the result was going to be a set of twin.
My surprise is that, women who are in her category hardly come out positive because her case was a special one and that was why she was on a special payroll. Even if, she was going to conceive naturally, it has to be through counseling because of her age.

Secondly because she has been infertile for many years, there is a natural tendency that she is tensed up, the blood pressure might be on a high side, so there is need to check and balance, not forgetting that naturally there is pregnancy induced hypertension, so it has been counseling and placing her on drug before she was able to be monitored till date and today, she has her twin babies.
When asked to give account of her condition during the period of pregnancy and the delivery especially on her health, the matron confirmed that the condition was not different to a natural way of getting pregnant and there was no complication due to the fact that she had adhered to all medical instructions which is capable of keeping her fit for the condition.
"Her health was encouraging because, she had adhered to all medical instructions; her drugs, the salt- free diet, in fact, there is nothing she was told to do that she wouldn't do as a person. I remember that whenever she was told to do anything, she only replies and says, " I don't mind doing anything, if only I would see my child, I wouldn't mind".
No wonder people say, "Money answers all things, in fact, there is little that money cannot do. If she hadn't gotten any money, she wouldn't have been a mother now let alone coming to this hospital for IVF . She would rather remain in her formal position crying all the way.
Although there are so many rich women outside there who are not ready to use their money on such thing but she was different and we thank God that day, she has gotten her children. There is hope for the hopeless".
When asked to predict the joy of a woman who has been looking for a child for a long time and now has a set of twin, Mrs. Adetoun, said, "Even when she doses off, she still wants to remember those moment, the first time, she set her eyes on her children and when she carried them on her arms because it was like a dream that will never come through but now becoming reality. Truly, there is nothing like you having your own child.
However, she noted that, although, Felicia's case was the first of its like in the hospital but after hers, there have been lots of women with similar experience, but could now rejoice because they are now mothers. "Apart from Felicia, there are other women who have been placed on IVF in order to have their children; adding that there is no month that the hospital will not have an additional of one or two babies born through IVF.
The medical doctor, Tunde Okewale, Chief Obstetrician and Gynaecologist at the hospital who carried out the operation on Felicia also revealed the IVF unit was established at the hospital based on the findings that there had been an intense increase in infertility amongst couples in the country.
"When this hospital was established 11 years ago, there was no plan for any IVF unit, but when it was discovered that there had been intense increase in infertility problem, research was carried out on how to curb or drastically reduce the number of people who are affected and that was why an IVF unit was established in July 2007. And by June 2008, we celebrated first IVF baby at the hospital.
Sharing his experience, the doctor said, "the operation has been fantastic and it has become an eye opener to infertile couples, some of whom have been relieved of their troubles.
"With IVF, those who are written off can have cause to rejoice. Felicia came to this hospital last year August, although she has lost hope that she was going to have a baby of her own due to her condition and on the condition that she has been barren for the past 20 years.
According to medical research, it was discovered that her tube had been blocked and secondly, the husband's sperm was low. Apparently, they have tried all the possible means of fertility prospect and management, but there was no result until they opted for IVF as the last resort.
"What makes her case special is that, apart from her 20 years of infertility, she has out-grown the age that she could probably conceive a child, she was 45 years, the less likely that a successful IVF will be carried out on her. The success rate at her age was 16 to 20 per cent, so she was really lucky, I believe that God was ready to favour her, he continued.
"Like other unit world wide, the spark of the IVF operation in any unit always call for celebration. The first one is always the biggest one and subsequently. Every IVF baby is always special because of the circumstances behind them. The price paid during the infertility period, the pain, the anger, the depression that the woman or the couple passes through is enough to tell the story.
The truth is that a child born through IVF cannot be differentiated from a natural born baby. Another thing is the IVF babies are always brilliant children. There was a case of a woman who after IVF gave birth to her children on her own without an intervention of IVF, so these children have no problem.
"The scope of IVF has been expanded as couples prefer to have their children through IVF. And the truth is that, the people might later be having their subsequent children without any assistance.

"At times, the effect of the injection given through IVF also helps in producing lots of eggs as the eggs produced are being fertilised during IVF operation. Another aspect is that when the eggs are matured, it is brought out from the woman which is called, retrieval of the egg from the woman. The third part has to do with the proper IVF, which involves mixing the eggs of the woman with the sperm of the man which is called the In Vitro Fertilisation, IVF.
"The last part is that the embryos that have grown will be put into the woman which is called embryo transplant. At this period, the process of IVF usually last for 21 days and the doctor will have to wait for another 14 days, before conducting the final pregnancy test.
Asked what the cost of an IVF service worth, he said, "IVF is not cheap anywhere in the world because the cost of setting up an IVF unit on its own, or employing dedicated professionals and the facilities to carry out the operation is very expensive".
Speaking on the present situation of infertility as a major problem amongst couples in the country, he said, a woman or man could become infertile after having unprotected sexual intercourse for a year on several occasions.
The problem of infertility is epidemic in Nigeria to the extent that there is an increase in the number of people who are infertile now unlike in the days of our parents, it was very rare to find two women out of 10 women still looking for the fruit of the womb.
But nowadays, there is an increase in the rate of sexually transmitted diseases STDs including gonorrhea which are poorly treated based on people's ignorance to go for proper medical check-up which apparently may result to infertility.
"Apart from this problem, the inability of the lady to get married on time has also contributed to the increase in infertility problem.
According to medical research, "The peak of a woman's fertility is between the age of 20 and 30. But, due to different career pursuits in life by people, some women prefer to marry at the age of 37 or 38 and at that time her fertility capacity tends to drop and that is another issue.

"Pollution and stress are other environmental problems that is contributing to infertility in the country today. About 25 per cent of newly married couples are infertile. 40 per cent of that 25 per cent would get pregnant on their own through some basic infertility investigations and counseling, using some fertility drugs, but 60 per cent of that 25 per cent will require some form of assisted conception which involves IVF.
"Obesity is another problem of infertility. For women, the hormone that controls fertility can get easily derailed by fat that is why it is very difficult to women who are above the required age to get pregnant, some women need to lose their weight before they can be pregnant.

"Before the invention of IVF, any woman or man diagnosed infertile is always advised to settle for adoption but since 1978,and there is a finality to that issue since 1978 when IVF was discovered, it was tested that a man's sperm which is mixed with the woman's sperm can fertilise outside and then placed into the woman's womb, then the embryo continues to grow without being disturbed.

Reiterating that IVF is carried out through an egg brought from the woman and the sperm of the man mixed together in the laboratory and after which it will be returned inside the woman. At that level, the woman, has no control again. It's either the womb accepts or rejects. "For IVF, it is not only one embryo that is used replaced, rather, it is replaced in two, three or four and that is why the babies come either in twice, triplets.
"The first result was was achieved in 1978 in United Kingdom by Edward one of the pioneers and at the same year, the first test-tube was born. And at the same year, Indian reported her own case in November, making the second IVF, by 1980.
Australia reported its own, in 1981, U.S. had its own IVF baby. Few years after that, Lagos University Teaching Hospital, LUTH, reported a successful IVF baby. Then the news spread through worldwide and the people that had been written off, can have their babies. As the years went by the indications for IVF started expanding. And since then, millions of babies have been born through IVF, he added.

BRIDGE CLINIC RECORDS MILESTONE

The Bridge Clinic, the leading assisted-conception unit in Nigeria, reached a major milestone in its 10 year existence recently when it recorded its 1000th live birth.
A statement by Amaka Agu said the baby girl who was born at 8.30am on Thursday 12 November, 2009 at Finnih Medical Centre, GRA Ikeja weighing 3.1kg was born, following a second treatment cycle by In-Vitro Fertilisation (IVF) with Intra-Cytoplasmic Sperm Injection (ICSI), to a couple who had experienced infertility for 13 years and sought treatment at The Bridge Clinic.
The Clinic, an ISO 9001:2000 accredited assisted-conception unit, has successfully set itself apart as one of the leaders in the field of assisted-conception by being the fertility clinic with the highest record of deliveries in Nigeria today.Currently operating three branches in Ikeja, Victoria Island (both in Lagos) and Port Harcourt, the Bridge Clinic provides high quality fertility treatment in Nigeria; treatments which many of their patients believe is comparable to similar facilities abroad.The company’s Managing Director, Dr Richard Ajayi announced that “Our record is currently unparalleled in Nigeria. We are dedicated to ensuring our clients’ main objective of delivering healthy babies is met and our record of 1000th baby is proof we haven’t reneged on our aim.”He declared that the clinic is determined to maintain these impressive results, stressing that the level of professionalism and care would be maintained through continuous staff development and training.
He also stressed that the clinic would always keep up with cutting edge developments in its field of assisted-conception and reproductive medicine in general.Ajayi said, “The joy of the clinic’s 1000th birth is like an early Christmas present for us at The Bridge Clinic; a present that reminds us that all the hard work and dedication we put into assisting couples experiencing delays in childbirth is worth it.”
SOURCE: THISDAY

Governor’s Wife Pregnant Through IVF

The first lady of Oyo State, Chief (Mrs.) Kemi Alo-Akala has been in an unusually gay mood of late. The Oyo State first couple and their immediate family are expecting another baby. The mother of four-year old Olakunle is pregnant and people close to her say that her pregnancy was made possible via invitrofertilisation.

Mrs. Alao-akala, 45 who is the second wife of the Oyo State Governor, Otunba Christopher Alao-Akala, had her first born, when she was well over 40 (also by IVF) and her quest to give her hubby the second issue informed the IVF effort, which has paid off right now. The first lady had been very happy over this development having waited for four years.

SOURCE: COMPASSNEWS

'Infertility Is A Shared Responsibility Between Husband And Wife'

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.

INFERTILITY IS HELL FOR AFRICANS

infertility is hell for africans

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

We’ve had 923 Test tube babies in 10 years

The Bridge Clinic was set up to provide high quality fertility treatment inducing Invitro-Fertilization (IVF) and Intra Cytoplasmic Sperm Injection (ICSI) in Nigeria.

The clinic has been assisting couples experiencing difficulty with conception since 1999 and with the birth of over 923 babies, they gained the experience to meet the needs of their clients.It is a legal requirement in developed countries like the United Kingdom (UK) that all clinics carrying out fertility treatment that involve human gametes such as IVF are licensed by the Human Fertilization and Embryology Authority (HFEA). Unfortunately, there are no such regulatory authorities in Nigeria.But Dr Alla Arilesere, Head of Department, Medical Services, Bridge Clinic, said that the Bridge Clinic recognizing the importance of such regulation have always functioned on if it were one of the clinics regulated by the HFEA.

According to her, “We are mainly focusing on human reproductive medicine, that is helping infertile couples to achieve pregnancy. Naturally, conceived pregnancy in the bedroom that you don’t spend money, you also have about 25 per cent success rate just like Invitro-Fertilization (IVF). The problem could be perhaps fertilization, perhaps implantation, perhaps the ovaries, perhaps the quantity of the eggs or sperm. It takes more than one month for couples without any problem to achieve pregnancy. This is normal, it is acceptable all over the world.“And that is what is applicable to our assisted reproductive technology.

We transfer embryo on a certain day, what happen to them after the transfer, we wouldn’t know their fate. But the aim is to assist them, at least watching them for awhile, at the transfer, after the transfer, may be wonders will happen, at least the woman will eventually get pregnant.On the issue of high cost of IVF, she said, “At the beginning, I mentioned something about quality assurance, for us to be able to maintain the quality, we cannot compromise on that, it is expensive. Quality is expensive. Firstly, we use high technology equipment, which is important. Secondly, we ensure that we successfully deliver services to our customers, we don’t cut such corners. We must deliver at whatever cost. And it has to be high tech.“Everything that we use for IVF is imported, incubators, culture media, all the materials for IVF, scanning machine, microscope, laboratory and training of laboratory staff. We are trained in Leeds in UK which is one of the leading reproductive science institution in the world, running the medical site, these are all expensive.

Presently, there is proliferation of IVF clinics in the country. And there is fear it might promote quackery. Dr Alla has this to say

, “Actually, we have the annual conference of Nigeria Fertility Society, where we look into issues like this, and we are coming up with ideas and suggestions. The Nigerian Medical Association is the one to control the issue of quacks and things like that. basically, any clinic or hospital that has been registered for the practice, every doctor is supposed to have licence for practice which is to be reviewed every year. Not only IVF clinics, so many other clinics are coming up. Who are setting them up?“I hope the government have something on the ground to be able to control it. Not only assisted reproductive hospitals, but any hospital or clinic at all. Because we have also identified the fact that there are no regulatory bodies in Nigeria for IVF, we are bench- marking ourselves with the Human Embryology Association in the UK. We have from there who came here to audit our reports and procedures. Basically, we practice international standards. We are benchmarked with whatever that is going on in the world. We can’t spread our standards to other clinics because they are supposed to do it on their own.Does the proliferation of IVF clinic in Nigeria mean that the infertility rate in Nigeria has increased? Dr Arilesere said, “Basically, from the statistics, in developed countries, the rate of infertility is between eight and 15 per cent. That means between one out of 12, one out of eight. But in Nigeria or sub-Saharan Africa at large, the statistics indicate that the rate of infertility is 25.This is about double or even triple of what it is in developed countries. Perhaps, it is sexual indiscipline, it could be tubal factor because the rate of woman infertility is about 40 per cent. Perhaps early exposure to sexual life, and may be the use of contraceptive drugs, people right from secondary school or primary school take contraceptive to prevent early pregnancy.“At the age of 13 or 14, girls exposed to sex can become pregnant. So what do they do? They go to the back door to remove the pregnancy so that their patents do not find out. In the process of removing the pregnancy, they may be creating future problems like blocked tubes or infections. Over the years, the rate of fertility, even the quantity of the semen is going down. Perhaps it have something to do with radiation, solar energy, temperature factor, stress, too much of computer.Continuing, she said, “There are two types of IVF, Conventional IVF and ICSI Conventional IVF is applicable to couples where the semen quantity meet minimum of 20 million, that is the semen quality. And the strength of the IVF, whether conventional or ICSI depends on the same quality only. So, for a couple to be qualified for conventional IVF, the count must be at least 20 million, motility must be at least 40 per cent, minimum, morphology must be at least 15 per cent, minimum.

“In the history of the Bridge Clinic, since 1999 all the couples that have been coming for IVF treatment, they have conventional IVF. They have fertilization period of up to 80 per cent. That means all the couples that are treated, 80 per cent unfortunately did not reach embryo transfer stage because those couples are not applicable to conventional IVF.“What is ICSI? ICSI is Intra Cytoplasmic Sperm Injection. Any couple that do not meet any of the requirements that I mentioned, like high motility and morphology, they need ICSI. There is not much evidence to show that ICSI give a high rate of abnormality among children born through it. The perception that there is high rate of abnormality among children born through IVF may be coming from the internet or may be some wrong information. Comparing children who are born naturally with ICSI babies, there is no significant difference.”

The Bridge clinic hosts 10th anniversary photo exhibition

The Bridge Clinic, a renowned Fertility Clinic in Nigeria recently organised a five-day photo exhibition as part of the events lined up to mark its 10th Year Anniversary at Terra Kulture, in Lagos State.T

he exhibition tagged Celebration of Achievements” to reflect the mood of The Bridge Clinic after one decade of successfully assisting couples to fulfil their dreams of parenting their own children, was declared open by Mrs. Ibukun Awosika who is the Chairperson of Chair Centre and former Chairperson, Women in Management and Business (WIMBIZ).“Celebration of Achievements” had on display photos of children from birth to nine years old and also of The Bridge Clinic’s facility, all telling pictorial stories of the children’s successes and excellence.The uniqueness of the photo exhibition was evident in the sophistication of the imagery which portrayed artistically the very advanced technology at The Bridge Clinic. Also, the young talented photographer, Seyi Body-Lawson, creatively captured the essence of each child’s special achievements, talents, dreams and personality in vivid images that spoke volume.The children had outstanding records in sports, art, computer technology and exceptional academic performance from their various schools, at home and abroad. One of them represented Nigeria at an international gymnastic competition in Singapore recently.

Mrs. Awosika congratulated The Bridge Clinic for the “Celebration of Achievement” initiative commending the artistic and creative qualities of the photos of the children. She also advised couples to take advantage of the fertility technology available at The Bridge Clinic to resolve their fertility problems which can be a huge challenge in a society like Nigeria.Dr. Richard Ajayi, the Medical Director of The Bridge Clinic during his speech at the event revealed that The Bridge Clinic” has assisted a lot of couples and have been blessed with the birth of about 1,000 babies. He said: “Celebration of Achievement’ is organised to celebrate the accomplishment of these children.

Today we celebrate these children who have all grown to become great assets to their parents and also a source of our own fulfilment.” He attributed the facility’s achievements to the commitment, loyalty and professionalism of the staff over the years.The Bridge Clinic is known for its many innovations which have improved the standard of fertility medicine in Nigeria. It is the first ISO certified clinic in Nigeria and its many milestones include Birth of the first babies by Intracytoplasmic Sperm Injection (ICSI) in 2000, delivery of the first baby by ICSI and Surgical Sperm Collection (SSC) in 2000, birth of the first baby through IVF Surrogacy in 2003, implementation of an internationally certified Quality Management System by TUV Austria in 2004 and the Launching of “Let I Happen Naturally” (LIHN) in 2004The Bridge Clinic is currently the only fertility centre in Nigeria to publish its results (including pregnancy rates). The Bridge Clinic also has its results independently verified by Akintola Williams Deloitte.

Pre-implantation genetic screening holds in Lagos with 25 IVF patients

THE Medical Art Centre (MART) Maryland, Ikeja, Lagos, has started a Pre-implantation Genetic Diagnosis (PGD) with 25 In Vitro Fertilisation (IVF) patients.

Co-pioneer of IVF technology in Nigeria and Consultant Reproductive Endocrinologist at MART, Prof. Oladapo Ashiru, at the monthly clinical meeting of the Nigerian Society of Endocrinology and Metabolism (NSEM), hosted by the Centre last week, presented the technique for pre-implantation genetic screening, which was currently used for 25 IVF patients at the Medical Art center between April 21st to April 28, 2009.

"MART has commenced the technique of pre-implantation genetic selection for genetic abnormalities and sex selection in Maryland Ikeja. The first batch went through oocyte recovery, Intra Cytoplasmic Sperm Injection (ICSI), PGD biopsy, and Embryo Transfer between April 22nd to April 28th, 2009," he said.

Ashiru, who is also an Adjunct Professor at the University of Illinois at Chicago, United States, in his lecture titled "Highlights of Assisted Reproductive Technology and The place of pre-implantation genetic diagnosis in Nigeria", said PGD is the next focus of cutting edge work in the IVF field. He said PGD is for the elimination of abnormal genes and gender selection.

MART, in January 2009, announced the establishment of pre-birth genetic screening for sex selection and sickle cell disorder.
His colleague from Mumbai Dr. Satish Sharma, who is the only person in India running a satellite PGD, amplified the presentation in details.
The meeting was chaired by Prof. Oladapo Ladipo, the President /Chief Executive Officer of the Association for Family Health, Ibadan.

The other speaker was Dr. Satish Sharma, who spoke on the technique of pre-implantation genetic diagnosis. Those present at the seminar included Prof. Osato Giwa-Osagie, who with Ashiru recorded the first IVF delivery in 1989, Prof. Akin Osibogun the Chief Medical Director of LUTH, several other professors and senior doctors from the NSEM.

WHY MOST NIGERIAN MEN HAVE LOW SPERM COUNT

Professor of Anatomy and Reproductive Endocrinology, Medical Art Centre, Ikeja, Lagos, Oladapo Asiru, traces the history of in vitro fertilisation in Nigeria and gives reasons for increasing infertility in the country, in this interview with NIYI ODEBODE.

There has been controversy over the history of in vitro fertilisation in Nigeria. Can you give a brief history of the practice?

The experimental work on in vitro fertilisation was started in Nigeria in 1983 by Dr. Akin Abisogun and me. When we succeeded in performing IVF in experimental animals, we started it in humans in the latter part of 1983. For the first time, in 1984, it led to a pregnancy. The first pregnancy ended up as a miscarriage. Following that, it became a big household event. Our success generated a visit of the then Minister of Health, Dr. Emmanuel Nsan, to our centre as well as a visit by his successor, Prof. Olikoye Ransome-Kuti, who established a ministerial panel to look into our work.

Prof. Osita Giwa-Osagie and I were successful in achieving the feat, which was among the few in the world. By 1986, we had delivery from gamete intra fallopian transfer. In 1989, we succeeded in having a baby girl born from IVF. The mother was a woman whose two fallopian tubes had been removed in England as a result of an ectopic pregnancy. She came to Nigeria, we were able to do IVF for her and she got pregnant on the first attempt. The Lagos University Teaching Hospital's magazine published it. Mr. Onajomo Orere of The Guardian reported it when Mr. Lade Bonuola was the editor. It was also reported by Ms. Luisa Agunyi-Ironsi of Tell magazine.

By 1998 and 2001, two other doctors joined the IVF programme in Nigeria. Today, we have about 15 IVF centres.

With your explanation, what would you say about a claim that the first IVF baby in Nigeria was delivered in Abuja in 1998?

It is totally incorrect. The first IVF baby was delivered in 1989. She is still alive. It was well publicised as I had said. The woman was interviewed. When the publicity became too much, her lawyer wrote to us that we should stop it.

What are the recent developments in assisted reproduction?

We are moving to another level in assisted reproduction, which is pre-implantation genetic diagnosis. Before we can take a woman through IVF, we will have a biopsy to know the genetic composition of the embryos. We can know the male and female embryos. We can decipher an embryo as a sickle cell embryo or whether an embryo will have leukemia in future or whether it will have diabetes. We can know the abnormalities that occur in foetus by looking at the embryo. For example, if an AS person marries an AS person, we can select the embryo that is not SS and transfer it to the mother.

We can do this at the embryo level, which is about four days in the laboratory. We have set up the technology in collaboration with my colleague, Dr. Satishkumar Sharma of Craaft Clinic, Mumbia, India. We have about 25 patients going through it. At the end of the day, the pregnancy and the baby will be normal because we would have selected the embryo. We are doing it for those that are very old, those who have had failed IVF and those who have had repeated miscarriages. Many people, who are pregnant, lose the pregnancies because the embryos are not normal.

If you go through IVF, if you have three embryos, if one of them is not good, it will affect the other two. If you remove the bad one, and use the two good ones, the pregnancy will survive. What we do simply is to discard bad embryo and take those that are good and transfer them into the woman.

What is the financial implication? It is expensive, but it is better to go through it than to spend money on IVF and not get pregnant. The technology was developed in Chicago. My colleauges from America, who were supposed to come, were afraid of coming to Nigeria because they felt they would be detained and kidnapped.

When you are transferring technology, your partners must come here and use your system. I went to India and Chicago. I felt that it could be done in Nigeria. We have people who need it, especially the sickle cell people. Instead of asking them to go to America, which is very expensive, we can do it here. Even in America, there are about four centres that are main centres. We plan to make this place a centre of pre-implantation genetic diagnosis in Nigeria.

We can then have satellite centres coming to use the facilities here. You have not talked bout the cost implication. You know IVF is between N800,000 and N1m. With this technology, you will need another $3000. Government can assist by removing taxes and cutting duties on the drugs, which are very expensive.

You mentioned miscarriages. What causes miscarriages?

The commonest cause of miscarriage is abnormality in embryo. Nature will not allow abnormality to occur. If the child is going to be abnormal, there may be a miscarriage. We have found out that a high percentage of miscarriages are due to abnormality of the embryo which are equally environmentally induced, such as exposure to X-ray, chemical and toxins.

There are many centres that claim to do infertility treatment, particularly assisted conception and reproduction. Can you differentiate between the two?

Some people think that if you take the sperm and introduce it to the woman, that is assisted reproduction technology. No, that is assisted conception. In assisted reproduction technology, you must take the sperm and take the egg and manipulate them outside the body, in the laboratory, and take it to the woman. Some people do not need IVF; they only need artificial insemination. If I have a woman that is 22 years and trying to conceive and there is cervical hostility, artificial insemination is sufficient. But by the time women are getting old, there is no time for trial and error. IVF is the answer.

I must add that there are some people who are not medical doctors but claim that they are doing infertility treatment and IVF. They are all over Lagos deceiving couples who need treatment. People are being deceived because of the prevalence of infertility in Nigeria. What are the causes of infertility? We have male factors.

Most of our men in this country have low sperm, particularly those ones I see in my clinics. And what are the reasons? They include infections, alcohol, cigarette smoking, occupational hazards, pesticide, toxic pollution in the environment, use of artificial sweeteners like saccharine and wearing of tight pants.

For women, the causes include infections, blockage of tubes and occupational hazards which affect ovaries.

Are more people coming for IVF in Nigeria?

There is more awareness of IVF in Nigeria. More people are coming for it because they know there is a solution. More men are now coming out. They know there is a solution. However, many people are not ready to come out to say that they have done it.