IVF: BRINGING JOY INTO THE LIVES OF THE INFERTILES

Bringing joy into the lives of the infertiles

In medical profession, Dr. Adewunmi Adeyemi Bero, the Managing Director of The Roding Medical Centre, Lagos, is a pioneer. The medical practitioner is a solid advocate in new technology to foster the growth and development of medicine. He is making waves both in his practice and as a medical entrepreneur with a technology known as Assisted Conception Technology. With this technology, his organization has brought joy and hope into the lives of barren women and infertile men.

In Vitro Fertilization (IVF)

At the beginning, the IVF method was used to treat tubal blockage. The method is now most commonly used of the assisted reproductive technologies (ART). It is often known as the ‘test tube baby’ procedure, and has helped infertile couples conceive and bear children for well over two decades. It is essentially to stimulate women who cannot ovulate with fertility drugs and injections to produce eggs.

Qualified couples

Couples who qualify for the IVF are men with a normal sperm count and women with blocked tubes. Dr. Bero advocates the method when the cause of infertility is inexplicable and where insemination has failed. (men with low sperm count will benefit from ICSI where just a single sperm is used for IVF)

What Roding does

We look after women and children. When you look after women, infertility is part of it and we want to have a solution to every.Problem a woman comes with. We want to have a solution to every problem a child comes with – that is what we’ve been doing for the past eight years. Men also come. So, we sometime take care of the husbands too.

Challenges

Like any other business you embark on in this country, there is no infrastructure. You have to create your own constant power supply. You have to ensure water runs constantly. Here we open 24 hours and we ensure that there is constant power supply every second. I can tell you that our diesel bill every month is about N700, 000. That money should be profit and not spent it on things like this. What should be your profit you spend to ensure that you have all necessary infrastructures to deliver your services. The other problem is that a lot of our doctors don’t want to stay in Nigeria because they don’t earn good income. So, all of them travel out. The issue is that there is a personnel manpower problem in Nigeria. There were never enough doctors to start up with. So, the ones that are properly trained or are still undergoing training have all left. They are in UK, America, Europe. The ones that are still here are planning to go.

Government subsidy

For instance, I don’t know of any initiative from government that subsidizes the procurement of equipment for hospitals. If you go to a bank that you want to purchase medical equipment, they will tell you the equipment is too specialized. They are more ready to lease generator to you or a vehicle to you than medical equipment and you cannot blame them. So, to buy equipment one has to go and look for money at very huge cost to buy equipment when there should be some subsidy somewhere that encourages outlets to lease their equipment. I know it’s coming because we are getting there gradually.

The National Health Insurance Scheme

That’s a big problem now because there is a new dispensation in the field of medicine that is called ‘The National Health Insurance Scheme’. The health managers are like brokers who go out and collect business. They go to companies to collect business like reaching an agreement with you that for an amount of money in a year, they will manage the health need of your staff and they negotiate the tariff with you. All the companies are finding it cheaper to operate that way because they can actually budget the health needs of their staffs on annual basis so marketing really is becoming unnecessary because you are going to market for these same corporate people. Even individuals too are also learning that it is cheaper for them to go to these managers either as families or use their workplace so that they can assess hospitals and they don’t have to pay from their pockets.

Starting an IVF unit

When setting up a medical center, it’s not only the IVF equipment that you have to consider. You have to consider some other issues like two generators. You don’t need to have a mighty building for an IVF unit. You can even just rent a flat but it’s the infrastructure that matters. Like anything you want to do in Nigeria, you have to provide your own infrastructure which is what increases the cost. You have to sink a borehole. You have to put tanks everywhere just to ensure you can store enough water for your needs. Its not only the equipment you have to take into consideration, sometimes you find out that the money you spend for your infrastructure is even more than the cost of the equipment.

Spiritual and medical conflict

There is a conflict between spiritual and some aspects of medicine. The conflict essentially causes we waste of many years because when you look at the woman, her fertile years are not long. When she starts approaching 40, she begins to have fertility problems because she will not be ovulating as regularly or if she ovulates, the eggs will not be of good quality. Medical solution is minor if you are in the right place, and take the right course with prayers. All will work together.
IVF awareness We reach out to couples let them know that there are places that can make them pregnant. Like I said, there will be more IVF units. The whole idea is just that the more units we have, the more awareness we create. The more you have couples coming out early to seek medical intervention for their problems rather than other types of intervention. We all go to the same medical conferences. It is basically the same attitude, the approach may be slightly different but the service is the same. The only thing we are trying to do is to make it cheaper for young couples to come into the programme with us.

Success rate

The success rate of IVF is between 20 and 35 percent. That is in most units across board. May be If you are in America where there is no electricity supply problem, no environmental pollution where younger couples can come into the programme early because they can afford it, you will get success rate of 35% in some units. But here in this part of the world, you tend to see older couples and there is a problem of infrastructure even in spite of that, the pregnancies are there.

THE ABC OF IVF (II) - Everything you need to know about test tube treatment

In Vitro Fertilisation (IVF): This is the procedure classically known as the test tube baby technique. There are five stages to IVF as follows:

1. Down regulation:
So called because the woman is given drugs (such as Buserelin or Naferelin) which shut down her ovaries so her cycle can be carefully controlled. This will put her into a temporary menopause.

You can have an injection of the drug once a day in your buttock or thigh. They can be given by a nurse or your partner – or you can do it yourself. If you are squeamish about needles you can use a nasal spray to inhale the drug several times a day but this is more expensive than injections. You do this for two to three weeks. But be warned – you will feel as if you have PMT to a factor of ten.

2. Egg production:
You then add a second injection of drug called human menopausal gonadrotophin (HMG), a hormone highly purified after being taken from pregnant women’s urine, or FSH. This stimulates the ovaries to produce several egg-containing follicles rather than the one that would happen naturally. During this process you will be carefully monitored by ultrasound and will feel quite bloated but not as bad-tempered as in Stage One.

3. Egg collection:
When the follicles reach the right size and maturity you will be given an injection of human chorionic gonadatrophin (HCG). This mimics the surge in hormone which normally triggers ovulation. Thirty-five hours later the eggs are collected, either by laparoscopy or via the vagina, before they have the chance to move down the Fallopian tubes naturally.

The operation is carried out under general anesthetic or vaginally under sedation and may leave you feeling sore. The more eggs that are collected, the more painful it can be but it increases the likelihood of success.

4. Fertilisation:
At the same time the eggs are collected, the man has to provide a sperm sample. The eggs and top-quality sperm (200,000 sperm per egg) are placed in a glass dish by an embryologist. If successful, fertilization will take place within 24 to 48 hours and throughout this period you will be feeling tearful and anxious.

5. Embryo transfer:
The two best quality (fertilized eggs) are put back into the womb via a catheter. You may be offered progesterone to increase your chances of getting pregnant.

This experience is an emotional rollercoaster. You and your partner will have an anxious two-week wait to find out whether the embryos have become implanted and you are pregnant.

Unfortunately, hormone levels caused by the drugs can make you feel pregnant even if you are not. So if you are unsuccessful the arrival of your period can be even more devastating than normal. Success rates on average are 25 per cent per cycle.

Intracytoplasmic Sperm Injection (ICSI): This is a way of fertilizing eggs by injecting a single healthy sperm into an egg by using a glass needle that is one-fourteenth of the thickness of a human hair.

As with IVF, the woman takes a course of drugs before collection of the egg. ICSI is used where the man has a low sperm count or fertilization is a problem. It costs (£5,000) about N700,000 which includes IVF treatment and the drugs you need.

FOR MORE ARTICLES ON IVF, CLICK ON http://www.invitrofertilisation.blogspot.com