Nigeria has recorded the first successful birth of a baby conceived from frozen egg of a 44 year-old woman, who had suffered infertility for eight years, making it the first in the country and West Africa. The birth and conception of the baby, named Tiwatope, which is the 5001st in the world, was carried out by Nigerian fertility specialists at The Bridge Clinic, a Lagos-based fertility treatment centre, where the mother had her eggs frozen using the vitrification (flash-freezing) process. The birth of the baby on February 16, 2016, effectively puts Nigeria on the global map as regards the practice of oocyte (egg) freezing or cryopreservation, a new offering in the in-vitro fertilization (IVF) process. Prior to the birth of Tiwatope, the new practice seemed to be the exclusive preserve of the developed world of Europe and North America.

1st Test Tube Baby in Black Africa is now 29 years old
On March 17, 1989 history was made at the Lagos University Teaching Hospital when the first test tube Baby in Black Africa (comprising of West, East and Central Africa), conceived through the delicate In-Vitro Fertilisation and Embryo Transfer (IVF-ET) method was born. The bouncing baby boy named, Olushina, Eghosa, Oluwaremilekun, is nature’s gift to the family of Mr & Mrs Pius Oni and the crowning glory of five years of painstaking research endeavours of Professors Osato Giwa-Osagie, an Obstetrician and Gynecologist and Oladapo Ashiru, an Endocrinologist, both of the Lagos University Teaching Hospital, LUTH Idiaraba, Surulere, Lagos.The lad then, thus, became the First TestTube Baby in East, West and Central Africa. Read more at:

Celebrating Milestones

Sunday, January 20, 2008


Dr. Tunde Okewale, consultant obstetrician and Gynaecologist, St. Ives IVF and fertility unit, speaks on Infertility and assisted form of conception, IVF

Q: What is IVF all about?

A: IVF means intro vitro fertilization: that is, the conception and the fertilisation takes place in the test tube. That is why it is called test tube baby. The first recorded success was in the United Kingdom in 1978. And the name of the baby is Louise Brown. A few months later other cases were recorded in India, Canada, America among others.

Test tube baby, the local parlance that IVF is known for, is a form of treatment for infertile couples.The indications for it are where there is low sperm count or no sperm count. Traditionally, it is used for women whose tubes are blocked. As we all know, the tube is necessary for sperm and egg to meet and when there is a blockage, this becomes impossible.IVF bypasses the tube, we bring out the egg and the sperm, fertilize them in the laboratory (the so-called test tube) and after the embryo is formed, we return it to the womb.Over time, the indications have expanded. Initially, it was just for blocked tubes but we use it in cases of unexplained infertility. There are some people that have tried and tried and they cannot just get pregnant.

Q: What are the risk(s) involved?

A: The risks are not much. But the greater risk is failure. This can be very devastating. For one, the cost of treatment is high and when it does not succeed, everybody is upset, including the doctors and the patient. So with this, there is a psychological risk attached. That is why in most IVF hospitals, we have psychology department, where they offer counselling.Also, because the woman needs to have her eggs stimulated, there is the risk of hyper stimulation syndrome whereby sometimes, we have excessive eggs. But they are minimal risks, since the woman will be closely monitored.

Q: Specifically, what has been the success rate in your hospital, St. Ives?

A: We calculate the success rate in two ways: the pregnancy and the take home babies. It is possible to have baby but not take home as in case of still birth. Our success rate so far is 50 per cent. As you are aware, we started the IVF unit in July and we have three on-going pregnancies. Since July, we have three cycles and the pregnancies are about 18 weeks, and we have new ones that have just tested positive, but until the pregnancies grow, we would not make any noise.The success rate varies from hospital to hospital, some 25 per cent to 50 per cent. Over 60 per cent rate was recorded in India. You may ask why?

Q: What are the factors militating against the success rate?

A: The patient selection is important. The older one is, the less one has chances. For any woman above the age of 35 years, the chances are slim. Unfortunately in our environment the women that present themselves for IVF, after testing all other avenues, are in their 40s, most of the time. Another factor is the setup, the incubator, quality control et cetera. The number of embryos that are returned and the more embryos that are returned, the more chances that pregnancy will occur.

Q: How many embryos can one get?

A: When a woman is stimulated you can bring out like 10 eggs. When the egg is fertilized and one gets 10 embryos, you can return all the 10. Everything has its own guidelines. In the United Kingdom, you cannot return more than two embryos. In India and other developed parts of the world the accepted maximum you can return is four. The more you return, the higher the chance.

Q: Are there chances of multiple birth through IVF?

A: Yes, it is possible. But the reason we do not put more than four is that after twins, if you have triplets or more, the risk to the mother increases.The higher the multiple of pregnancies, the higher the risk that the babies would not survive. We can have premature ones among them.

Q: You mentioned something about the cost and we feel it is for the rich in the society

A: The cost really has nothing to do with it. The setup alone is a very high intensive unit and it costs a lot. That is why you would not find many hospitals doing IVF. We are talking about hundreds of thousands of dollars. To have a decent setup, one of the instruments we use, micro-manipulator on its own cost N950,000. The media you will use, that is the culture medium, is also expensive.What has been happening is that the more the number of people that offer themselves for IVF, the more there are clinics and the more the companies that produce the media will come into the country. At present there are none.We have to import all what we need and these cost more.For instance, in India and America there are many clinics and there is a lot of competition. All the disposables that we use are from India. But what we have in St. Ives, our cost is still the cheapest.The reason is, part of the things that inflate the IVF cost are unnecessary investigations before IVF is finally arrived at. IVF is a straightforward technology procedure, but there are so many things that surround it.

Q: What are these investigations?

A: For most infertile couples, when they come to hospital, doctors would write down the list of investigations to conduct. Most of the investigations do not have anything to do with the success of the IVF or not. Most of the investigations would have been done by the patient somewhere else. But we will still tell them to do it. You find out that infertile couples go around doing the same set of tests and everybody pretends as if they are doing something. All these add an extra cost. If you come to St. Ives and you have done some of the investigations in the last one year, we offer you direct, what is necessary for you in the procedure.The media you use for IVF is just for one individual and the person has to pay for it.

Q: On the average, what does it really cost?

A: Let me give you a comparative cost, in the United Kingdom it is $4,000 to $6,000. In America $10,000 to $25,000. In St. Ives, excluding the cost of the drugs, it is N250,000. In other IVF clinics around, it costs about N500,000 to N600,000.The cost of drugs is from N70,000 depending on the drugs.Q: Many of the people that have undergone this treatment do not open up about it. Why is this so?A: Yes, but when we have our first test tube next year; we would want the people to know. Every IVF clinic has the right to celebrate their success. Maybe in the past, they didn't, but I think the level of enlightenment is now making women to come out and say it.

I think the problem in Nigeria is that we need more clinics. There are so many infertile couples around.Nigeria’s case is an unusual one. For instance, in United Kingdom, in 1978, after the first test tube baby, there have been transfer of skills internally and there are thousands of IVF clinics in the United Kingdom now. Nigeria announced it in the 80s, it happened at the Lagos University Teaching Hospital, LUTH. The strange thing is that there is no massive transfer of skills. In fact, LUTH is not offering IVF clinic currently. No teaching hospital in Nigeria offers it apart from the University of Benin, which has just started.You can count the number of IVF clinics on the tips of your fingers. It is over 20 years.

Q: What is the hope of low-income infertile couples?

A: In the United Kingdom, you can either have your IVF privately or go to government hospitals. If LASUTH is offering IVF, the waiting list may be long, but it will be at a reasonable cost.Government has the power and financial capacity to import these equipment. What we try to do for the low-income earners is shared programme. Where an egg of a 48-year old is not okay but needs IVF and can afford it, and there is a 28-year old who also wants IVF, but cannot afford and has good eggs, the 48-year old would pay for the treatment, though they are both unknown to each other. Likewise in the case of sperm donor.

Q: Can a woman who undergoes IVF breast-feed?

A: Yes, the only thing is that fertilization occurs in the laboratory. We return the embryo and it continues to growth.

Q: So what are the causes of infertility?

A: First we need to know how conception occurs. There are five requirements for conception. Good quality and quantity sperm, sperm must enter the vagina at the right time of the month, so the woman must know her fertile period. The womb must be able to accept and keep the pregnancy. Nothing should disturb the pregnancy in the womb like fibroid.

The tubes of the woman must be open, so that the eggs and sperm can meet. And the woman must be producing quality eggs every month.Out of the requirements, you will discover that four concern women and it is only one that concerns men. If you see anybody that is pregnant, you must know that all the five requirements have been fulfilled. These requirements can be linked to causes of infertility like no sperm count or low-sperm count, fibroid, wombs gummed together, quality eggs not produced, damaged tubes and stress. All these can cause infertility.Sometimes, we have unexplained infertility. We check all the five requirements and everything is well, yet pregnancy does not occur.


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