Nigeria Records Reverse Medical Tourism as Foreigners Seek IVF, Experts Say

• IVF cheaper in Nigeria despite high treatment costs

• Experts seek regulation, insurance coverage, local production of fertility drugs

Sunday Aborisade in Abuja

Nigeria is increasingly attracting fertility patients from other parts of Africa and the global diaspora for in-vitro fertilisation (IVF) and other assisted reproductive treatments because of the comparatively lower cost of treatment in the country, fertility experts have disclosed.

The experts, who described the development as a form of “reverse medical tourism,” said Nigeria had developed sufficient capacity to provide advanced fertility treatment, despite the high cost of IVF and the country’s dependence on imported drugs and other materials required for the procedures.

They also called for stronger regulation of assisted reproductive technology, increased investment in research and local production of fertility drugs, as well as greater health insurance coverage to enable more Nigerians suffering from infertility to access treatment.

The experts spoke yesterday in Abuja at a joint conference of the Association for Fertility and Reproductive Health (AFRH) and the African Federation of Fertility Societies (AFFS), ahead of the continental fertility conference scheduled to take place in Abuja from September 24 to 26.

President of AFRH, Prof. Preye Fiebai, said Nigeria’s fertility sector had made considerable progress but remained under-recognised, particularly because of inadequate reporting of the number of fertility treatment cycles being carried out in the country.

Fiebai said the country’s large population and growing fertility treatment capacity should make Nigeria a major destination for reproductive health services on the continent.

According to him, “Despite the fact that we have very high fertility rates, we also have extremely high infertility rates.”

He said infertility had been recognised by the World Health Organisation as an ailment requiring appropriate medical attention, but that fertility challenges had not received the same level of attention as communicable diseases and other major health conditions.

Fiebai stated, “Unfortunately, the attention given is not as much as other conditions. And the World Health Organisation recognises infertility as an ailment just like any other disease.

“Every person who is so afflicted is entitled to receive the kind of care that you will receive even if you had cancer. But we pay more attention to communicable diseases amongst others.”

Fiebai said Nigeria had developed from providing basic fertility treatment to offering some of the most advanced reproductive technologies available globally.

He added, “So, we have gone far in the world and Nigeria is not lagging behind. From the most rudimentary forms of treatment, we are also able to provide the most advanced forms of treatment. And this obtains across the whole of Africa.”

The AFRH president, however, identified the high cost of IVF as a major barrier to access, attributing it largely to the country’s dependence on imported drugs and other materials.

He said, “The cost of IVF treatment is still high, because of the cost of providing what you require. The majority of what is utilised is imported. The drugs are imported. We don’t really produce much in Nigeria.”

Fiebai said the country needed increased investment and collaboration to develop local alternatives and reduce dependence on imports.

He disclosed that some institutions were already working towards developing local capacity, citing the Institute for Medical Science in Africa in Abuja as one of the facilities seeking innovative solutions in reproductive health research.

“We need support because it costs a lot of money. We need collaboration, investments, so that these things can be replicated,” he said.

He also blamed poor data reporting in Nigeria’s fertility industry for limiting the country’s ability to attract adequate investment and international recognition.

According to him, if Nigeria reported only a fraction of the IVF procedures being undertaken in the country, international pharmaceutical and medical companies would naturally give greater attention to countries with higher recorded treatment volumes.

Fiebai said, “One of the major challenges we have with regards to the drugs is that the reporting of what is done is very poor.

“So if we do 5,000 IVF cycles in Nigeria, and another country is doing 50,000, I mean, naturally a company would rather go to the one place they are doing 50,000 than 5,000.”

Fiebai stated that Nigeria had a population of more than 250 million people and remained the most populous black African nation, stressing that the country’s fertility treatment capacity should be better documented.

He said despite the high cost of IVF, treatment in Nigeria remained considerably cheaper than in many countries from which patients were coming.

“Despite this high cost, IVF is much cheaper than most of the places where we are coming from. So we still have a lot of reverse medical tourism going on in the country,” he said.

He added, “People are coming from the diaspora to do IVF treatment because it is cheap in Nigeria.”

He said the challenge was that many Nigerians who needed fertility treatment could not afford it because of prevailing socioeconomic conditions.

“But because of our poor socioeconomic situation, many of those who require it and deserve it are not receiving it,” Fiebai said.

He urged the government, health insurance providers and other stakeholders to support Nigerians requiring fertility services.

“Universal health care can only be achieved by ensuring that everyone has the same level playing field,” he said.

On regulation, Fiebai disclosed that fertility practitioners had continued to engage with the National Assembly on legislation governing assisted reproductive technology.

He recalled that fertility professionals appeared before the National Assembly in 2023, shortly before the end of the legislative session, to make submissions on a proposed Assisted Reproductive Technology Bill.

“We are still on it, and we’ve gone far in trying to redraft what we think is going to help us in providing the proper regulatory framework,” he said.

Fiebai stated that effective regulation would protect patients, practitioners and children born through assisted reproductive procedures.

“So we believe that with proper regulation, the populace will be protected, the practitioners will be protected, and everyone, in fact the child,” he said.

He added that legislation should take into account the rights and long-term welfare of children conceived through assisted reproductive technology.

On abortion, Fiebai said practitioners were expected to operate strictly within the provisions of Nigerian law, stating that voluntary termination of pregnancy remained generally illegal except in circumstances permitted by law.

He said, “There are different views on whether abortion should be offered or not. Right now, it is legal in certain circumstances.

“Generally, when we talk about abortion or voluntary termination of pregnancy, it is illegal in Nigeria. And it is still controversial.

“So, we practise it within the law, and we encourage all our members to do the same.”

Meanwhile, the immediate past president of AFRH, Dr Ibrahim Wada, advocated wider adoption of egg freezing as a means of preserving women’s fertility, particularly as age could significantly affect reproductive capacity.

Wada said women who were not ready to have children earlier in life could preserve their eggs for possible future use.

“On the side of a woman, age is not a helper by the time you get to 40 or thereabouts. So why not preserve your eggs?” he asked.

He said egg freezing was safe and could also become important for people undergoing medical treatment that could damage their reproductive capacity.

“If you take treatment from that sickness, you may injure your ability to produce eggs or even sperm in some cases,” Wada said.

He added that fertility preservation was already available in Nigeria and should be encouraged among people who might require it in the future.

He said, “Preserving your fertility is with us. It is very safe in Nigeria, and I think people should be encouraged. It makes things less complex for the future.”

Chairman of the Local Organising Committee for the forthcoming conference, Dr Sunday Onuh, said the event was designed to demonstrate Africa’s growing capacity in fertility science and treatment.

Onuh said the continent was increasingly attracting patients from outside Africa because of the quality and affordability of fertility services available in some African countries.

He said, “If we take a cue, we are having people coming from outside the continent to Africa to have their fertility treatment, knowing that they can get the same results at cheaper price.”

Onuh added, “So, we’re having a reverse medical tourism in that field. That’s also why we’ve decided to gather together as Africans, inviting the world to propagate the science of fertility treatment and beyond.”

He said the conference was not merely another professional gathering but a deliberate attempt to position Africa as a significant centre of fertility science.

President of the AFFS, Paul La Roux, said the organisers were expecting participants from across Africa and other parts of the world for the Abuja meeting.

Roux said, “We are very happy that we will be having this important fertility conference in Abuja and we are really looking forward to bringing everybody together from all over Africa for this amazing meeting from September 24 to 26.”

Fiebai disclosed that no fewer than 1,000 fertility and reproductive health professionals were expected to participate in the conference, which he said would be the first of its kind to be hosted in Nigeria.

He said the event, themed, “Fertility Frontiers, Global Innovations and Advances in Human Reproduction,” would bring together a broad range of reproductive health professionals.

According to him, AFRH is not limited to medical doctors, but included nurses, embryologists, counsellors, lawyers and other professionals involved in reproductive health.

The conference is also expected to attract representatives of the European Society of Human Reproduction and Endocrinology and the American Society for Reproductive Medicine.

President-elect of the AFFS, Mohamed Khrouf, described the conference as the fulfilment of a long-standing dream of African fertility professionals to build a continental platform for collaboration.

Khrouf said the establishment of the AFFS six years ago had enabled fertility professionals across Africa to develop stronger professional relationships.

“This conference is really the realisation of a dream. When we started the AFFS, it was the first time that Africans came together and formed their own organisation,” he said.

He added that the growing international interest in the Abuja conference demonstrated the increasing relevance of Africa’s fertility sector.

“But this upcoming conference in Abuja is even bigger, and the interesting thing is that the whole world wanted to join us in Africa. So it’s not that we were just inviting them,” he said.