IN-VITRO FERTILISATION AS A MEANS OF FERTILITY TREATMENT IS ONE OF THE BEST THINGS TO HAPPEN TO REPRODUCTIVE HEALTH, BUT THE HIGH COST OF ACCESSING THE TREATMENT AND OTHER CHALLENGES CONSTITUTE MAJOR SETBACK. THIS IS EVEN SO AS ONE OF THE PIONEERS IN THE COUNTRY NORDICA, CELEBRATES A DECADE OF GIVING JOY TO PARENTS, WRITES STEVE DADA
Since the introduction of the assisted conception, In-Vitro Fertilisation (IVF), by Professor Robert Edwards and the birth of the first baby, Louis Brown through IVF in Britain in 1978, the method has come to represent the best means of fertility treatment. IVF has also provided succour to numerous infertile couples around the world that desire a child of their own. Record indicates that over five million children have been born and added to the global population through the assisted conception.
IVF has completely changed the prospects of couples that were unable to have children. Fertilising an egg with sperm outside the body and implanting the resulting embryo into the womb means infertility is no longer a serious barrier to starting a family. The technique sparked a huge ethical debate in 1978, and attracted media attention around the world, but the pioneer of the method insisted on the philosophy that the most important thing in life was having a child and giving joy to couples.
As is the case in other parts of the world where the method has become a norm for assisting childless couples to raise children, Nigeria is not lagging behind as gynaecologists/obstetricians have also embraced the method to bring happiness to families in self-pity for inability to raise biological children.
Since the introduction of the method into Nigeria over a decade ago, it has come with its prospects and challenges. For example, IVF has remained an elitist programme, in which the educated urban settlers are being adequately informed about the method, while the teeming population in the rural community are not well informed about what the method stands for.
Even, the urban dwellers that do not have enough money or belong to the middle-income category may not be able to venture into obtaining fertility treatment through IVF. This is due to the high cost of a circle of IVF treatment. If not during a promotion period by some of the centres offering the treatment, during which they crash the price, not many people could afford the over a million Naira cost for a circle of IVF treatment, which does not transform to pregnancy. High cost has kept many off the demand for IVF service.
Also, to buttress the claim that the method is elitist, most of the centres offering the service are concentrated in major Nigerian cities, like Lagos, Abuja, Port-Harcourt and few other state capitals, which make the service inaccessible to numerous infertile couples who live in the hinter-land.
During the 10th year anniversary celebration of a notable fertility centre, Nordica Fertility Centre, Lagos, last Sunday, the Managing Director of the hospital, Dr. Abayomi Ajayi, in an interview with THISDAY provided answers to some of the questions on the high cost of fertility treatment.
According to him, the equipment used for the treatment are not locally sourced, but imported and very costly. The cost of maintaining the equipment are also high, while most times electricity is erratic forcing them to depend on stand-by generators that consume much diesel daily and therefore forcing them to expend so much on electricity generation.
Besides, Ajayi explained that during the importation of the equipment, government agencies collect high import duties on them, increasing the overhead cost and thereby making the treatment expensive. He therefore appealed to the Federal Government to improve electricity situation in the country, while urging government to also wave import duties on such essential medical equipment.
Infertile couples who had their tears wiped off through IVF treatment provided by Nordica, trooped out in hundreds last Sunday, to celebrate with the hospital on its 10th year anniversary. The popular events place, The Civic Centre, Lagos, which hosted the anniversary, went agog with couples who had benefited from the services of Nordica, in raising their own children went into ecstasy, expressing appreciation to God and the institution that removed their sorrow.
So who patronises Nordica and at what stage should people seek help? Ajayi said: “Well what we say is that infertility is the inability of a couple to conceive after one year of unprotected intercourse if the woman is below 35. If the woman is above 35 then it is six months and should look for help. But now the thing is that some people still leave IVF as the last resort wwhich is not actually making the success rate to be fantastic because the older a woman is the worst the result from treatment.
“Just like how fertility does naturally that fertility decreases with age, the same thing the result of fertility treatment also decreases with age. Therefore that is one of the things we are saying that people even if they are 20 years, there is no other method of treatment apart from IVF.
“So when such people are sported, when the doctors detect them. That is why we are saying if you try for one year and it is not happening then you see a doctor specifically a gynaecologist. We are not saying see a fertility centre straight off but see a gynaecologist who can act as a gatekeeper see the ones that need to go to fertility specialist and the ones he can handle. So that is what we are saying to people.
“If I tell you that I am doing anything to make it affordable then I am lying because it is beyond me. The only thing I can do is just this small thing - give a few people free treatment. The cost of IVF is beyond my determination because we have to buy the things that we need, the consumables that we need, which are imported. It is as ridiculous as even up to the water that we use in laboratory to clean the things we use there, we have to bring them in. So the gloves we bring from Germany because it has to be powder free. So it is a lot of things that go into IVF.
“Unlike other parts of the world, you cannot accept, for example, that electricity goes off and we know what the power situation is in Nigeria. So a lot of cost goes into IVF. So for cost to go down a lot of things need to happen and that is why I said it is beyond me. If you want cost to go down, power has to be constant, government has to make it duty free or lower the import duty for the medical equipment, loan facilities have to be available. So it is not a one-man thing.
“It is either we come together as a body and say fine how can we bring all these equipment in and then we bring it together or government comes and say come on we realize that you guys are doing a good job now we are exempting you from doing this when you are bringing this in. I do not agree that IVF is not affordable, because what I say is that if you can buy a Tokunbo car in Nigeria you can do IVF depending on where you are going.
“If you are below 35 and you are doing your treatment in Nordica, I can conveniently tell you that if you do two cycles you are almost certain that you are going to carry a baby home. That is one of the problems that we have that sometimes people do only one cycle and they are off. So people also take a reverse, they go and start doing Intra-uterine insemination (IUI) somewhere after failure of one IVF cycle, and they need IVF. IUI is a fertility treatment that uses a catheter to place a number of washed sperm directly into the uterus.
“But we know that this reaction to failure is a worldwide phenomenon that is why for us in Nordica we place emphasis on the counseling part of it to say okay when this cycle fails we know that you are distraught, we know that you are disillusioned and therefore you need people to be with you, you need people to counsel you. But you know in Nigeria sometimes you are offering the service and the person is telling you ‘doctor I don’t need any counseling I will get over it.’ That is one of the problems that we have. But anybody who has an issue needs a counselor; you do not need to pretend that you are strong. Take all the help that you can get and leave the rest to God.
“As part of the activities marking the event, the hospital provided free fertility treatment to three infertile couples selected out of the 12 couples that participated and made the final, in a raffle draw earlier conducted from the numerous entries from the six geo-political zones of the country,” Ajayi said.
Some of the couples, who did not want their names in print expressed appreciation to the hospital for turning their sorrow to joy. A couple said for over 10 years they went to different places seeking conception to raise a baby to no avail, until they got to Nordica, where “God used the hospital to get them two children (twins).”
Another family said their happiness knows no bound and that they will ever be grateful to the hospital for making it possible for them to have biological children. They said God has been merciful to given that they conceived in the first cycle of treatment, whereas some will go through several circles before pregnancy.
Ajayi, in a welcome address, traced the history of the hospital, saying, in 2003, the vision of setting up Nordica Fertility Centre, Lagos was conceived, with the primary aim 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.
“Thus, we opened our first centre on April 14, 2003, at Victoria Garden City, Lekki, Lagos, but owing to our desire to be closer to our clients and the fact that we were also rapidly expanding, we moved to Ikoyi, Lagos in January, 2008,” he said.
Ajayi said the hospital has since grown from strength to strength, having opened the Yaba clinic in October 2003, and in its bid to make its clients the centre of its world, had opened more clinics in other parts of the country, like the Asaba, Delta State clinic was opened in November 2009, while the Federal Capital Territory, Abuja clinic was opened in November 2012.
He said the hospital today offers services ranging from comprehensive gynaecological assistant, sperm donation, IVF, artificial insemination, ovulation induction, cycle monitoring, intra-uterine insemination, intracytoplasmic sperm injection (ICSI).
He said: “In the hospital’s ten 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. With our first baby delivered on September 14, 2004, we have continued to set a number of firsts,” he noted.