Abayomi Ajayi, a consultant obstetrician and gynaecologist, is the CEO of Nordica Fertility Centre, which specialises in In-Vitro Fertilisation. For over 15 years, he has used the various innovations available in Assisted Reproductive Technology to help couples that have difficulties making babies. Ajayi, in this interview with Mary Ekah, unravels the myth behind IVF services, his journey into the fertility business and Fertility Preservation, Nordica’s very latest procedure used in assisting conception
Can you tell us how the fertility business started in Nordica?
Nordica started in 2003 as a result of the fact that we saw the need to help people with infertility problem because then, people who were into the services of In-Vitro Fertilisation (IVF) were very scarce at that time in Nigeria. At that time, many people thought it was not possible to do IVF in the country because of the facilities were not there to support the service and so it was quite a challenge trying to make things like IVF work in this kind of environment. So, we started because we saw that probably, the greatest need for people with infertility was IVF. The commonest reason why people were infertile was either blocked tube or low sperm count and these are only amendable with IVF. So it was necessary that we had IVF at that point in time, we started in 2003 and since then we have not looked back.
It has been 13 years now, so how successful has it been?
It has been obviously successful and now we have four centres in three major cities in Nigeria. We only hope to do better than we are doing now. We have had over 1500 babies and we are still having babies.
What has been the challenges trying to get things done, especially in Nigeria where a lot of people are skeptical about IVF?
The challenges have been in different stages. From when we started, the challenges we had were quite different from what we have now. Then, we needed to be able to master the process and then transfer the technology to Nigeria, because from the word go, we wanted to transfer the technology to Nigeria and I can say with all confidence that we berthed only for three months when we started and since then we have been working and people have been coming to us. What we wanted was for us to transfer the technology because what we had in mind in starting, was to be able to offer Nigerians the kind of services they get when they travelled abroad and that is what we have been benchmarking since then, while giving it a Nigerian face. Also, ensuring that the quality of the service you get was same thing you get anywhere in world and that is what we have been trying to achieve in the last 13 years.
What do you have to say about the stigma that comes with what many Nigerians tagged ‘test tube babies’?
I would say that it has been improving. You know, generally when human beings do not understand anything, they stigmatise it and term it witchcraft but the more we understand, the more we see the science behind it. So I think the more people get to understand IVF, the better their acceptance, which will mean there will be less stigma. This is not only peculiar to Nigeria; it’s all over the world. And one of the things we are still trying to let people know now is that babies born through IVF are very normal children. You know, initially they used to call them test tube babies and for some people they thought probably these babies are not normal but today the good news is that we have over five million babies all over the world born through IVF and they are not different from those who are conceived and born naturally.
A lot of people still have negative views about IVF, so in what ways have you been trying to convince them that it is okay to have babies through IVF?
It’s really not to convince them but to educate them because most of the people who have this notion about IVF do not understand exactly what it is about. Initially when we started, they said we were playing God and all sorts, but now we are beginning to hear less of that because they are beginning to understand more and more about how IVF works. And if you don’t believe in God, when you come and do IVF, you will know that there is God. Why I am saying that is because you could do the same treatment for two different people and then one will succeed while the other will not succeed. Now you can’t tell if it is the doctor that made it not to succeed, if nothing else, you would say there is God factor in it.
Talking about the success of IVF, how many times must one use the treatment before it can be successful?
There is no prescribed number of times that you must go through it, of course why you go through IVF is because you want to have a child, but what we advice is that if you are less than 35, prepare your mind for two cycles. About 40 per cent of such people will be successful from the first procedure but for people above that age to be successful, they probably need like three cycles. Though that does not mean you may not succeed in the first cycle, but we understand the fact that before people decide to do IVF, they have been used to some kind of hopelessness, and suddenly you see the light at the end of the tunnel and when it fails, you just conclude what is the need.
So that is why counseling is so vital in IVF to prepare people’s minds on the probability of a failure in the first attempt and for them to accept it when they fail in the first instance, so that they don’t just give up hope completely after the first trial. Another thing that we advice people is to do IVF on time so that the success rate for them will be in the neighbourhood of 40 per cent because as the woman grows older, the success rate decreases.
Of course, that is what happens normally in natural reproduction. What IVF is always trying to do, is what happens naturally like when the sperm and the egg come together in the womb and that is what IVF is always trying to do. I must say that the success rate of IVF is a little better than what nature can offer but the good thing is that in nature, you don’t have to pay, so people can continue to try but in IVF you have to pay and so you need to limit the number of cycles you go and that is why it is very important also for the patient to be able to choose good and reliable centres, so they don’t waste their money and time.
How affordable is IVF?
IVF is not expensive but it is not cheap as well. I always tell people that if you can buy a tokunbo car, you can do IVF and if you go on our roads you can see a lot of cars there. The only thing is that we need to prioritise things.
What differentiate you from other fertility centres in Nigeria?
Many things stand us out. When we started, we had our first baby from assisted hatching and I would say that we have been playing on technology and our main strength is in the technology we have been able to acquire over the years. Whatever is the latest in the world, we try to bring to Nordica.
Also, I would say that some of the things we do with genetics, I don’t think any other person does it in Nigeria and this is so because of our affiliation with many other fertility centres abroad, and as a result, we are able to do a lot of things. From 2003, we have been able to decode the human gene, so we are able to analyse all the genes in the human body and since then, there have been a lot of successes.
The most important thing to everybody who wants to have a baby is that you want to have a healthy baby and genes transfer all the quality for a healthy baby. Most times, children inherit diseases even from their parents, but now with IVF, we prevent diseases from being transmitted apart from the fact that we can choose characteristics, which include the sex of the baby.
Genetics in IVF is extending the frontier of IVF not only for infertility now but also even for people who are fertile but want to prevent transmitting diseases to their children or want a particular sex. Another thing we have been able to do is fertility preservation. Like I said earlier, the higher the age of a woman, the less the chances of getting pregnant, so when we use genetics, we can nullify the effect of the age by choosing only the embryos that are viable.
Can the female egg be viable at any age?
That usually is one big problem and like I said earlier, fertility in women decreases with age. As the woman grows older, the ability for her egg to become baby decreases. There is a rough guide that when you are below 35 that is when you are at your peak but from 35 you start declining and at above 40 it become more difficult for a woman to become pregnant with her own egg.
Very few people get pregnant after 43 using their own eggs. That is why we emphasis on people to do IVF before age catches up on them. This where preserved fertility comes in, especially where women are career oriented and wouldn’t get married till when they are approaching 40 or even above 40. So now it is possible for you to store your eggs at the age of 30 and the good thing is that, even if you are above 40 by the time you are ready to use them, they will still look as fresh as when you were 30 and that might prevent you from using donor’s egg but if you were unfortunate to do that, when it get to that age, you just might have to use donors’ eggs.
What would be your advice to couples out there who have not taken the option of IVF or any other assisted reproductive method?
I would advice them that there is hope when you are faced with infertility and that there are so many people that can help them solve the problem even in Nigeria. It is now left for them to gather a lot of information before they make the move. Fertility treatment should not be dictated by price but you must know exactly what you are doing. I am not saying go to the most expensive, but compare the ones you have on ground before you decide on which one to patronise.
More so, in a country like Nigeria, where everything is paid out of pocket, you need to be wise with how you spend your money because money is a resource that is also limited. Not only money, you are also spending your time and your emotions, so it is important for you to be sure that you are going to a place where you can be helped. It is only because your friend said, but go there, ask question and like they say in Nigeria, ‘shine your eyes’, once you do that, I am sure you would get solution.
Another thing is that we should also know that infertility is a medical problem and like every medical problem, should be taken to the hospital whilst I am not saying that prayers have no effects, even the Bible says, faith without work is dead. So while we are praying, let us be doing the things that God has revealed to us because it is God that made it possible for us to be able to do IVF. We should embrace technology and still pray because what I see is that every child is a miracle from God – whether the child was conceived through IVF or naturally, so we should be ready to receive our miracle.
Apart from running Nordica, do you do any other thing?
This is full time ministry, so I am fully occupied with Nordica but then I am involved with a couple of non-profit organisations like Endometriosis Support Group of Nigeria, Fertility Treatment Support Foundation and now I am developing a new case for educational foundations because I suddenly discovered that the educational system in Nigeria is in trouble, so I think I am more of a charity-oriented person if I’m not doing medical work. I’m married with four children, I have a grandchild, and so my family also is enough to occupy me fully. I love music and sometimes I dance.