Speaks on the challenges of childless couples and IVF
COUPLES often face hard decisions when experiencing infertility and harder
choices when going through fertility treatments, and yet if they are
successful, they face many other decisions as well. Thirty six years ago, on
July 25, 1978, Lesley and John Brown faced such decisions prior to successfully
undergoing a complicated and at that time, relatively unknown assisted
reproductive procedure known as In Vitro Fertilisation, IVF.
The birth of their famous daughter, Louise Joy, at Oldham General Hospital,
in the UK, ensured that the Browns will be forever remembered as the world’s
pioneering IVF parents.
It is thanks to efforts of English scientist Robert Edwards, and his medical
colleague Patrick Steptoe, that Louise, technically the world’s first “test
tube baby” baby was created through the procedure of introducing fertilised
eggs into a woman’s womb for a successful IVF pregnancy.
Millions of couples all over the world challenged by infertility have since
been inspired to toe the path of the Browns by adopting the revolutionary IVF
intervention to become parents of their own biological children. To date more
than five million IVF babies have been born.
On September 14, 2004, in Lagos, Nigeria, precisely 23 years after the
historic birth of the world’s first IVF baby, Emmanuel and Francesca Onwudijo,
joined the growing list of happy parents of perfectly healthy IVF children with
the birth of their son, Julian Oluchukwu (God’s work).
Nobody knew for certain that Julian, who was conceived through a combined
Assisted Reproduction Technique, ART, of IVF and Intracytosplasmic Sperm
Injection, ICSI, was going to be the first IVF baby at Nordica fertility
Centre, Lagos, until after his mother got pregnant at the first attempt.
Although separated by space and time, in several ways, the Browns and the
Onwudijos had a lot in common. While the Browns had been trying to have a baby
for the better part of a decade, the Onwudijos had been searching for
the fruit of the womb for five agonising years.
Like all IVF babies, at birth, Louise and Julian were miracles to their
parents. Louise, who is now a mother of two, marked her 36th birthday
earlier in July, while Julian clocked 10 Sunday last week.
Like Lesley, he was successfully delivered through a Caesarean Section.
In a chat, Julian who loves Jollof rice and chicken, is currently in Basic 6,
and would like to be an engineer, told Sunday
Vanguard that his mother told him about the origins of hid
conception a long time ago and how, she and his father didn’t really have an
option after going public to let other couples know how he was conceived and
born.
Journey to motherhood
In a trip down memory lane, Julian’s mother, Francesca, recalled the long
journey to motherhood. Unlike Louise’s mother, Lesley, whose fallopian
tubes were blocked, Francesca recalled that she had no such impediment.
“I got married in July 1999 and had Julian in 2004 – that was five years
interval. I was taking treatment at Lagoon Hospital, but went to the
internet to search for solution. You know when a woman is looking for the fruit
of the womb, she would do anything and go anywhere. I was in the office and was
just going through the internet when I saw the website of Nordica Fertility
Centre, I took the address, at that time the clinic was at VGC, in Lekki. I
went there and made enquires. That was how I met Dr. Abayomi Ajayi who I had
known at Lagoon Hospital. I tried the first time and and to God be the glory,
it was successful. There is never any harm trying.”
Francesca who said she has never had had to defend the fact that she gave
birth to an IVF baby, had no problems about the issue of stigma.
“We went through the normal tests, there was nothing wrong, I was 24 or 25 then
I could not wait to carry my baby rather than waiting and doing nothing. I was
not intimidated by the cost. I had no fears or reservations at that time.
“I read a lot found out what the process was about. It was a kind of
assisted process. I knew that. It wasn’t as if the baby was going to fall from
heaven, it is a natural process, I made enquires and was satisfied. Julian
wasn’t the first IVF baby in Nigeria. He was a normal baby and has grown into a
normal child. He was perfect at birth and has been perfect in every way a baby
should be. Julian has grown to be very intelligent, normal and smart just
as babies from normal conception. I have not observed any abnormality
whatsoever.”
Nothing to hide
Francesca, who had to rely on her trust in the church and has stood before
congregations to talk about her experience, said she has never had to defend
what she did or hidden it from anybody. “I had no problems about the issue of
stigma. I have never hidden the fact that I did assisted reproduction. There is
nothing to hide because he is my blood. It was my egg that was taken as well as
my husband’s sperm. So there is nothing to hide. For those that are hiding, it
is ignorance. They need to be better educated about the process”, she stated.
“The church I attend does not preach against IVF. I recall a few years ago,
a doctor was invited from Abuja to lecture women on the IVF. He did with his
team and educated women and asked the church to bring out three women to be
given free IVF cycles. They did. Out of them, one was 54 years old; now she has
two kids, twins – a boy and a girl. The husband was 69 last year. Another is
carrying her baby now.
“If I were to be in a church that preaches against IVF, since I have gone
through the process, I would try to educate women and let them know that it is
not as if the baby is coming from another planet. It is an assisted procedure
just to aid you to conceive. I can even go to the Pastor and use myself as
example. My faith always works for me, I believe in God and so far he has not
failed me. Why would you suffer in silence when you know there is an
alternative? Why are you dying in pains? Children come from God. You just try
the best you can”.
IVF and controversy
Almost since its inception, IVF has been a subject of ethical and controversy.
Today some arguments once made against the process have fallen by the wayside,
while others remain unchanged. Arguments in favour of IVF have
remained fairly consistent over the years, notably the potential of allowing
previously infertile couples to finally have children of their own. Prior to
IVF, it was more or less the end of the line for infertile patients, but today,
IVF is almost like the rule than the option for infertile couples.
Daily, babies are conceived and born throughout the world, but the
percentage of those born with the help of assisted reproductive technologies
doesn’t appear to matter. Rather, what matters is that the techniques available
to infertile couples work.
It matters that wonderful doctors are helping people have a child, but it
doesn’t matter how those children were conceived or born. What matters is that
they are coming into the world at all. However, people ask if there is need to
get wrapped up in the ethics of reproductive medicines, when the bottom line is
to be helping a couple bring a normal, healthy child into the world.
Effective but expensive
Speaking on the birth of Julian, Medical Director/CEO, Nordica Fertility
Centre, Lagos, Asaba and Abuja, Dr Abayomi Ajayi, said it represents a new
beginning in the history of Nordica, a new hope for parenthood.
“Julian is like a son to us all here, our greatest achievement indeed.
In view of our successes recorded, first with Julian our first
baby and all those that came thereafter has necessitated the need for further
advocacy by the parents in order to share the good news”, Ajayi said.
“Whilst we have achieved monumental growth in the number of babies
conceived, we have equally not neglected our corporate social responsibility.
Working in conjunction with the Fertility Treatment Support
Foundation, FTSF, free fertility treatments have been made available to
over 58 couples with diverse infertility challenges. We also work
with the ESGN, Endometriosis Support Group Nigeria, the only
Foundation supporting this cause in West Africa”.
On IVF, he described it more as a necessity than an option for infertile
couples.
“It is unfortunate that infertility is seen as a personal problem. We know it
is a social problem. In Nigeria, unfortunately, the government is not and
probably cannot for now sponsor fertility treatment. But government still needs
to look at some of these things, and may be providing more centres that can
cater for people who are might not be able to afford IVF.”
Noting that IVF treatment isn’t cheap anywhere in the world, Ajayi remarked
that the way out is for government to help put the issue on the front burner.
“An experience I’ve seen i s that IVF treatment is not only taken up by the
rich because we place a high premium on child bearing in this part of the
world. And what people do is that it is like a family challenge. Once somebody
has infertility in the family, I’ve seen people contribute money for people to
have treatment. It is like a family challenge. Now that the government cannot
measure up now, banks are coming up with initiatives that can make you pay in
instalments. We know that there are companies beginning to take fertility
treatment as part of their staff welfare. They are very few, but there is light
down the tunnel and this is what we need to keep doing.”
The doctor, who maintained that IVF success rate is the same everywhere in
the world, however, regrets the lack of nationwide data in Nigeria.
‘Success is age-dependent’
“The success rate is age-dependent. Julian’s mother had age in her side,
because life comes primarily from the egg, so the younger the egg, when every
other thing is normal, the better the success rate. This is why we tell people
not to leave IVF as the last resort, because if you do you are actually
compromising on success rate”, he said.
“We want people to report early so that there will be proper assessment and,
if you need IVF, do it when chances are best, and the best can be done for you.
For people above 35, we still have above 40 percent success rate; the problem
in Nigeria is that a lot of people above 37 are doing IVF. But things are
getting better.
“When we started 10 years ago, about 80 percent were above 37. The picture
is getting better. The younger people should report early so that the success
rate can be the best for everybody. It is not on even for us when we have to be
doing this 4-5 times and asking people to be using donor eggs when they are not
really prepared.
“Do proper assessment on time and if you need IVF, do it. It is
age-dependent. If you are below 35, and you have tried for a year, and there is
no pregnancy, see a gynaecologist. If you are above 35 and you have tried for a
year without success, see a gynaecologist”.
Challenges with couples
According to Ajayi, sometimes there are couples that are seeing the traditional
gynaecologist who is doing the assessment on them and everything is ok, but
that is not so because the basic test can only identify a certain percentage of
the problem.
“For somebody that is 45, the first thing to look at is the age. If we look
at it from the point of view, you know we said it is the eggs that become
babies. For such woman, even if she is still menstruating regularly, the
problem lies with age which cannot be detected by regular tests. We are not
going to look at whether she is ovulating or not, we are not looking at the
stock ovaries, even then such person has normal function, we know it cannot be
true. You have to interpret your tests holistically, so it is like a 60 year
old woman now has an ovary function test that says normal, it cannot be. You
have to look at the whole person to make your decision”, he stated.
Mrs Ranti Ajayi, the Clinic Manager, explains further. “When they come in
and they are told they need donor eggs, they do not readily agree. Well it is a
normal thing that every woman wants to have her own child biologically but when
the reality on ground says it is not feasible, they just have to use donor
eggs.
“Some will not accept, even when you give the options – to use donor eggs,
adopt a child or buy one as they do now. With donor eggs, most of the time the
child looks like the father. We look at the attributes of the mother before
choosing a donor egg. Even then, other things are taken into consideration.”
Recalling how, in 2003, the vision of setting up Nordica Fertility Centre,
Lagos was conceived, Ajayi said the primary aim was to courageously combat the
plague of infertility by providing true “comfort centres” where the pain of
childless couples could be soothed both emotionally and medically.
“Our first Centre opened on the 14th of April, 2003 at Victoria Garden City,
Lekki Lagos. But owing to our desire to be close to our clients and the
fact that we were also rapidly expanding, we moved to Ikoyi, Lagos in January
2008. The Yaba Clinic opened its doors in October 2003
and the our bid to make our clients the centre
of their world, another Clinic opened in Asaba in November
2009 and the newest Centre in Asokoro Abuja was commissioned in
November 2012.
“The lack of information about fertility options coupled with the
stigmatisation associated with childlessness has contributed to the reason why
a lot of people do not explore the possibility of assisted conception. This
should not be seen as a taboo but seen as a means to an end. “In 11 or so years
of existence, God helping us, we have been able to assist in the conception of
several hundreds of babies and we are still counting,” Ajayi noted.
In its lifetime, Nordica Lagos has set a number of firsts. With all
modesty, it is the first IVF clinic to have a baby from laser assisted
hatching and remains the only fertility clinic currently using the
Intracytoplasmic Morphologically selected sperm Injection, IMSI, in addressing
male related infertility issues. It is also one of the few clinics in Nigeria to utilise
acupuncture for IVF treatment and to carry out Pre-Implantation Genetic
Diagnosis and egg freezing”.
Source: Vanguard