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A senior gynecologist with the Bridge Clinic in Kaduna, Dr. Ifeju Omojuwa, in this interview said that IVF technology has taken infertility treatment to a new level in Nigeria, explaining that the ability to fertilize the egg and sperm outside the body alone has overcome problems that women have in fertility. Excerpt:-
Can you expatiate more on what IVF entails and briefly tell us the essence of Bridge Clinic forum?
In Vitro Fertilization (IVF) is basically an advance form of fertility treatment. The conventional fertility treatment looks at the problem, like women that do not menstruate, men with low sperm count, we try to treat but the IVF technology has taken treatment to a higher level, whereby what we do is just to get the egg and the sperm, once we get them we do what we call In vitro fertilization, that is we fertilize them outside the body, in the laboratory.
Now the ability to do that alone has overcome a lot of problems that women have in fertility in the past that could not allow the egg and the sperm to meet either because of blocked tube, low sperm count or fibroid.
Now technologies have overcome those obstacles and allowed couples achieve fertilization. Basically the final process of the IVF after fertilizing, the embryo is taken from the laboratory and passed into the womb of the woman.
The actual essence of the clinic is that the Bridge offers advance fertility. This forum allows us to explain these to our partners or stakeholders, those we feel can benefit from our services.
This forum allows them to hear from us directly because it involves advanced scientific techniques, which would enable them understand and make right decision in accessing IVF.
Is the process of passing the embryo into the womb via operation?
Not exactly, because the patient just lays down on the couch and we pass the embryo through the neck of the womb, it is just a 20 minutes procedure; in fact, a lot of our clients come from the office for the insertion and go back same day. The ability to do this alone has provided potential solution to over 90 percent of the causes of infertility in our environment.
Before the attainment of IVF, many couples simply go through ineffective treatment. Ineffective because at our level of development we just know that scientifically, most treatment for low sperm count is not effective.
Some men have undergone five or even 10 years treatment for low sperm count, taking different treatment, hoping the sperm count will increase.
The same goes for blocked tubes, once the fallopian tubes are blocked, it is either you open them up or you look for a solution that can by-pass the tube.
To open them up, people have to do tuber surgery, which the specialist themselves know better than anybody that most of the tuber surgery does not improve fertility.
Can low sperm count be treated?
Low sperm count, let me put it in this context, there are people that will say they treat low sperm count, but most times the treatment is not effective. The other problem is our culture because most people with the problem do not like to discuss it and so it is not given the necessary attention it deserves.
People just speculate on the causes of infertility especially when neighbours are unable to give birth five years after marriage, so for many people, information is based on confirmed reports or suspicion which affects the country.
In actual fact a lot of men are battling with low sperm count and using options that are not effective.
Then finally they come to a place like Bridge clinic and we show them what this technology can do. This technology does not increase the sperm count, but what it does, because of the equipment and the science we have is to take that low sperm count even if it is only two sperm available, and we achieve fertilization and pregnancy.
What are the factors responsible for low sperm count, blocked tube and infertility problems generally?
Over the years, we know that infertility in women is common because most women in their younger days might have had pelvic infections for various reasons including unprotected s*xual intercourse.
These pelvic infections may have not been properly treated. Once they don’t have pain and discharge, they feel they are safe not knowing that the damage is being done until they get married and have difficulty in bearing children.
These women then go for an X-Ray and it shows that their womb is blocked.
Another reason is tuber blockage which is quick disappearing because nowadays a lot of young women once they suffer abdominal pain, they take antibiotic even without diagnosis, that alone tends to reduce the severity and the duration of that infection. So without knowing it, many young girls escape tuber blockage.
These days more men are now coming out because they are aware of the availability of the technology, unlike before when a couple cannot get pregnant, people automatically assume it is the woman’s problem, because the men kept quiet, we now see that in actual fact, most of the times men are the ones with the problem.
As for the causes of low sperm count, s*xually transmitted diseases like gonorrhea is very common in men, it blocks the spermatic cord and there will be no way for the sperm to pass out, that is what we call obstructive to sperm.
Some men during their childhood treat testis infection in which case one testis becomes damaged known as testicular infection, these often times continuous unnoticed for years , and these men eventually find out that they cannot impregnate a woman.
For some men, low sperm count may be due to genetic disorder, you know the garment or sperms are the reproductive cells, so they contain the exact genetic components. So those that have genetic problems, it can affect their garment and it will not be effective in reproduction.
Technically, if a man’s genetic constitution is not alright, nature will not allow him to reproduce. So men with fairly low sperm counts should check their chromosomes, to check for genetic abnormalities in their chromosomes and seek treatment.
What is the duration of the IVF treatment and is it possible for a woman who accessed IVF to have a miscarriage?
After a successful treatment, that is, positive pregnancy test and confirmation with ultrasound scan, there is a period between the positive pregnancy test and the time that the baby is detected by ultra-sound scan, roughly about two weeks. What we tell our clients is that once we do an ultra-sound scan and we see the pregnancy in the womb and we see the heartbeat of the fetus, at that point, we discharge them to go and do ante-natal at any hospital of their choice and what we tell them is from that moment in time, any outcome of the pregnancy is the same as whether they had it naturally and whatever happens to the pregnancy has no bearing with the IVF.
So if anyone has miscarriage, it is not because it is due to the IVF, the miscarriage would have happened anyway.
What is the cost implication of an IVF treatment?
The simple and direct IVF treatment will cost about N900,000 that is, talking of a woman that is young with full parameters. We also have women that are older who have to use more drugs, some can’t even use their own eggs, in that case, the treatment can go up to N1.5 million, but when we are talking of costing, we put it in proper context.
One is that when people talk of the money they should put it in context vis a vis the technology they have at their finger tips. There are many people who say they are treating infertility, but use low technology, collect stipends from people without result.
How many women have conceived as a result of your services since the inception of Bridge Clinic?
We have about 50 per cent pregnancy rate of our clients who are presently doing antenatal. Our oldest client is about 50 years old and we are monitoring them and waiting for their first delivery, you know we came to Kaduna in April 2011.
Soon we will have our first batch of IVF deliveries. My advice to couples with infertility is that there is hope for them. The hope message is not just on wishful thinking, but based on the fact that we have the science, the equipment and the skills. We have sophisticated equipments in which some are even first of its kind in Nigeria.
To the less privileged, they must understand and put into context the equipments and set up we have here for advance fertility in the Bridge clinic, Kaduna is the first in the north.
We are partnering with teaching hospitals whereby the processes can be broken down by transferring some of the processes to the teaching hospitals so that it will be cheaper for them.
Everything we have here are also present in the teaching hospital except for the laboratory which is the central core of an IVF central service. So all the other aspects can be done in the teaching hospital so that when they are ready for egg collection and embryo transfer, they can come to us but quality standard has to be maintained, which is quite expensive.
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