Mary Ekah explored the world of childless couples to tell the story of test-tube babies and the stigma associated with their conception. But an advocacy group has stepped up to assist childless couples embrace and overcome the challenges of conception through in-vitro fertilisation
The clinic was cramped by the time they got there. It was not strange to them. They had visited the clinic to see the doctor on several occasions and it was always the same. In the waiting room, many couples sat in bewilderment as they took turns to see the doctor. One thing was common to them: infertility.
Olanike and Joseph Adedeji, who arrived to join the others, had been married for 10 years without a child.
At 34, Olanike was more worried. The thought of several negative results from the past trials occupied her mind and of course the fact that her biological was clicking loudly, increased her fears.
But like the irony of life, just about the time Olanike was contemplating giving up on in-vitro fertilisation (IVF) after six trials, the seventh trial changed her experience. She became pregnant.
Mrs. Ifeoma Emekwue who had twins through IVF, had a similar experience as Olanike.
She said: “I had infertility problems and I went through IVF and today I have my own children. I was not ashamed then and I am not ashamed now because I am a proud mother of two lovely children. We want to also tell people that there is nothing physically or otherwise wrong with children that are born through IVF. They are normal children. A lot of women have gone through a lot of challenges that have even broken their marriages due to their inability to have children, while infidelity abounds every now and then and even men go into polygamous arrangements just to get children. However, there is an alternative in IVF.”
She continued: “From the day I had my babies in 2000, I have never kept quiet about it because I know that many women go through that same experience I went through. While looking for babies, women do a whole lot of things, which are even detrimental to their health.
“So it is just a passion that is driving me not to keep quiet. I have always spoken for and about IVF because I know a lot of marriages would have been broken because of this.”
During her childless sojourn, she recounted: “I went through so much pain that at a point, even though I knew that my husband’s love for me was so strong, I told him to marry another woman who would give him a child because I never wanted to be a stumbling block to him but he said no.
“So when I eventually discovered IVF and it worked, I decided to reach out to a lot of women out there who are going through similar experiences and anguish due to delays in childbearing.”
Now a proud mother of twins, Emekwue said her ordeal in search of babies lasted for six years until a friend introduced her to the Bridge Clinic where she got her IVF procedure done. Luckily for her, she got pregnant after her first trial and had twins. But it has not been the case for many others.
Perhaps, Emekwue may be one of the lucky few. According to experts, the opportunity that IVF creates brings with it significant challenges. They acknowledge that IVF is considered by patients to be the most stressful of all infertility treatments.
They attest that patients rate the stress associated with IVF treatments as more stressful than or almost as stressful as any other major event, such as the death of a family member or separation or divorce. But while general assumptions may be made about stress levels during IVF, the experience for infertile patients is always personal and unique.
To be sure, each couple will have their own unique experience based upon their personality and circumstances. They confirmed that the aspects of IVF that are perceived as most challenging by patients are multifaceted and affect all parts of their lives, ranging from marital, social, physical, emotional and financial to religious. For instance, making out time to go through the treatment can induce pressure, both in terms of commitment on the part of the husband or male partner, to an intense treatment which leads to a disruption in family, work, and social activities, and for some, in the long waiting periods for the treatment.
They also acknowledged that couples may also find themselves stretched financially, paying for the high cost of IVF treatment with a somewhat limited probability of success as well as dealing with the medical staff and the side effects or potential complications of the treatment, which could include hot flashes, headaches, mood swings, injections, sonograms, future health concerns, and decision making about embryos, their disposition and multiple pregnancies.
Nevertheless, 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.
Emekwue said: “In Igbo land where I come from, six years of bareness is long enough for a man to marry another wife and enough time for the relations to give you a hell of a time but that was absent in my case. I just knew that I had to give him a child and that childlessness is not a good thing.”
Since the introduction of IVF treatments in Nigeria over a decade ago, it has come with its prospects and challenges. For example, IVF treatments have remained an elitist programme, in which the educated urban settlers are adequately informed about the method, while the teeming population in rural communities is not well informed about the method.
â€¨As a matter of fact, urban dwellers that do not have enough money or belong to the middle class may not be able to venture into obtaining fertility treatments through IVF. Besides the pressure, a cycle of IVF treatment is quite expensive. A cycle of treatment could cost about N1 million or more and might not necessarily lead to pregnancy. Expectedly, the high cost has kept many from resorting to IVF treatment.
Also, since most of the centres offering the service are concentrated in major Nigerian cities, like Lagos, Abuja, Port Harcourt and few other state capitals, the service in most cases is inaccessible to numerous infertile couples, who live in the hinterland.
According to the Managing Director of Nordica Fertility Centre, Lagos, Dr. Abayomi Ajayi, the reason for the high cost of IVF has to do with the cost of the equipment and facilities offered by the clinics that specialise in the treatment. He noted that the equipment used for the treatment is not locally sourced, but imported and very costly. The cost of maintaining the equipment is also high, while most times electricity is erratic, forcing the clinics to depend on stand-by generators that consume large amounts of diesel daily to provide their own electricity.
Ajayi explained that during the importation of the equipment, government agencies collect high import duties on them, increasing the overhead cost and thus making the treatment expensive. He therefore appealed to the federal government to improve electricity situation in the country, while also urging the government to wave import duties on such essential medical equipment.
Emekwue recalled the reaction of her husband when he knew she was going for an IVF procedure. She said: “It was kind of funny. Initially I did not tell him. When my friend introduced me to the Bridge Clinic, I went on my own to find out and then reported back to him so that I would be able to face him with whatever question he was going to ask me about the IVF thing.
“So I went and met with clinic’s director, Dr. Richardson Ajayi and I told him my problem and he assured me that they were going to do something about it. So when I got home to tell my husband, he was really angry. He asked rhetoric questions like, ‘So you went to the hospital without telling me? And you said Dr. Ajayi would like to see me?’ I said yes. He then said, Okay, tell Dr. Ajayi to go and get a rope and tie round my neck to pull me down to the clinic’ and that was it.
“It took a lot of pleas and convictions for him to accept the idea, and to understand why I took the initiative without him. So after a lot of apologies and promises to be a good girl, he eventually agreed.”
Asked how long it took her to become pregnant through the IVF procedure, Emekwue was somewhat taciturn in her response. “During natural conception, are you sure that once you sleep with your husband you get pregnant? Is it not 50/50 chance as well? That is the same way it is with IVF,” she volunteered.
She added: “At the clinic, they do everything they have to do, following up the procedures and you back it up with prayers, and if you are lucky, you get pregnant just like when you sleep with a man. You and your husband may be 100 per cent okay, yet cannot achieve pregnancy over a period of time. That is how it is with IVF treatments too.”
Emekwue revealed however that after the procedures, she waited for just two weeks to go for a pregnancy test. “The lab I went to gave me a report in an envelope to be taken to my doctor. I went there with my husband and the doctor opened the envelope and said, I’m sorry Mrs. Emekwue it is negative.
“But I told him that the report wasn’t true because I was pregnant. It was like a drama, and he said, okay can we go and do another test in his own lab? So we went and had another test; the result was brought and this time it was positive.”
Emekwue was so overwhelmed with the news of her pregnancy to the extent that she started talking about it to any who cared to listen, even though she had been instructed by her doctor not to do so.
According to her, “The doctor told me to come back in two weeks time so that I could run blood and urine tests and I was told not to tell it to anybody. But as soon as I left the clinic, I called the village and everyone that cared that I was pregnant. Not that I wanted to disappoint my doctor or disobey him, but out of happiness I had to tell everyone that mattered to me because it was like I was in another planet really.”
On her husband’s reaction to the news, she said: “We had a problem and he understood that the problem we had was childlessness and there was a solution. It is not as if he is an ignorant person. In fact, my husband is the chief medical lab scientist at the University of Lagos Teaching Hospital (LUTH), so he knows all these things.
“But the problem I had initially with him was going to the clinic in the first place without telling him. So he would not have stopped me from getting an IVF done.”
Despite the joy IVF treatments have brought to several couples, the procedure still has stigma attached to it. Most people feel the behaviour of such children would be abnormal as they grow up in, while some hold the belief that since IVF babies are not natural their lifespan would be shorter.
Emekwue said: “I know there has been stigmatisation of children born through IVF but for me there is nothing to stigmatise, because I have never kept quiet about it right from the day I had the children. So there is nothing like stigmatisation. It is only when you are hiding things that people will start digging to see what you are hiding.
“I am proud of my kids and if you see them, you also would be proud of them. Even my kids know that they were born through an IVF procedure and they are okay with it. I talk about it freely and openly to anybody that wants to hear and even direct those who are interested to where they can find help.”
To help others, Emekwue who had her twins, a boy and a girl, 13 years ago through IVF has started a forum that will assist infertile couples and those who already have children through interaction and sharing their experiences.
She has established a non-governmental organisation called Association for the Prevention of Infertility and the Promotion of Reproductive Health and Rights (ASPIRE) to advocate an end to infidelity, polygamy, divorce arising from childlessness and ultimately to seek an end to childlessness.
“We are starting ASPIRE to enable other people who have had the IVF experience and have gotten children through that process to create awareness for those facing infertility challenges for them to know that there is something called IVF, which they can also benefit from,” she said.
Speaking on the working modalities of ASPIRE, Emekwue added: “It is a support group. Right now we are funding it ourselves but we would look for sponsors and also partner with some professional bodies that are ready to help these women. Some of them who do not know about IVF can be reached, while others who do know about it but cannot afford the procedure can be accommodated as well.
“It is time to stop infidelity, stop polygamy, and divorce because of childlessness. IVF is not a taboo neither is it a disease. I have gone through it and I succeeded. It is by the grace of God anyway and just anyone out there facing the challenge can also become victorious.”