By Bilesanmi Olalekan
Dr. Tunde Okewale, the medical director of St. Ives Specialist Hospital, Ikeja, Lagos, explains the causes of infertility and how invitro fertilization (IVF) is helping couples to have their own children.
Analysts say the rate of infertility is on the increase in the country. Do you share the perspective?
I think to an extent it is true. About 25 percent of couples in their fertile age group are the sufferers and the incidence is on the increase because of urbanization, pollution, stress, chemical exposure, career orientation, late settlement in life, etc.
Whilst about 40 percent of the infertile couples will get pregnant by themselves, by changes in their lifestyles and by the standard gynecological treatments, up to 60 percent will however require some form of assisted conception techniques such as intra uterine insemination (IUI), invitro fertilization (IVF) or intra cytoplasmic sperm injection (ICSI) to achieve pregnancy. Here we are committed to providing state-of-the-art assisted reproductive techniques.
You started in Nigeria a little over ten years ago but your success rate in IVF gives the impression you have been here for ages?
May be because we adopt a success-oriented approach towards infertility. We focus on solution, getting babies for infertile couples rather than the problems like doing endless investigations and tests. We do not waste time, money and effort by concentrating on a long list of useless and fanciful tests and investigations that do not affect the treatment or the outcome of the IVF procedures. Apart from basic infertility tests which are necessary in the initial evaluation, extended investigations and tests do not get women pregnant and usually do not help much in deciding the best treatment for couples. Couples that come to infertility doctors for help want to have babies, not extended investigations and having to wait too long in achieving their objective.
It is bad enough being infertile but going through tests that add no value to the outcome of the procedure drains the couples emotionally and financially. Keeping the treatment complex however helps some clinics to justify the abnormally high fees they charge. We focus on IVF treatment protocols that are easy, simple, safe, less stressful and with a high pregnancy rate because we are confident of the fact that IVF technology is better at solving infertility problem rather than a long list unnecessary diagnostic tests.
Who really are those qualified to go for IVF?
They are people whose fallopian tubes are absent or blocked due to surgery, ectopic pregnancy or infection. Endometriosis reduces sperm count and motility.
And those who have tried all other treatments such as ovulation induction and intra uterine insemination that have proven unsuccessful. Also in this category are people with unexplained infertility, patients who have failed to get pregnant in spite of all routine treatment for infertility, patients who want to get pregnant by the procedures of embryo and egg donation, and lastly those ones in advanced female age from 38 years.
What are the procedures?
IVF treatment involves the administration of fertility drugs, monitoring of the cycle, collection of eggs, mixing eggs and sperm together outside the woman body in a culture or test tube. Any resulting embryo are left to grow and the best embryo 2-3 are then transferred into the woman’s womb. Any remaining embryo of good quality may be frozen for future use.
Some are of the opinion that there should be a regulatory body to control the activities in the IVF sector.
I think it is a welcome development. However I think we should be careful about those who regulate it. For example, in this country, a donor can produce more than two, three embryos while it is frowned upon in Europe. America is not so strict, the same thing in Italy. So, all these must be looked into properly and that is why I am of the opinion that those who will be in charge of the regulation should be those practising themselves. In other climes, it is the IVF sector that regulates it.
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