Infertility is a big problem globally and in Nigeria, it has become a big issue. So bad has it become that it has broken many homes and shattered many marriages. However, it is not a problem without a solution. Infertility has been with us since time immemorial and different ages have solved the problem differently. In this era of digital technology, Infertility is gradually becoming easier to solve, however, not without some cost.
Below Fertility Expert, Dr Abayomi Ajayi opens us up
to the many solutions available to battle this threat to marriage and family.
City People’s Publisher, Dr SEYE KEHINDE hosted him a few weeks ago on the
popular City People Instagram Live Chat and DAMILARE SALAMI brings you the
excerpts, enjoy.
Before a couple can say they have infertility
challenge, how far would they have gone for them to say we have a challenge on
our hands?
Thank you. We
are going to look at this statistically. When 100 couples decide to have a
child in a month and they don’t have any problem, about 25 per cent of them will
be successful. If in six months, about 55 per cent of them will be successful
and in one year about 85 per cent of them will have a child. So for us to say
that a couple has infertility challenge, they must have tried for at least one
year before subjecting them to various tests. But we have had to modify that
definition of infertility because of women who are over 35 years because we
know that there is something called the physiological clock that ticks for
women of over 35 years. For them we say after six months we must begin to
investigate why they are not pregnant but if you are less than 35, after one
year will be appropriate for investigations.
So sir, what will be the most appropriate definition
of infertility now since it’s been reviewed over and over again?
Well, it’s still the same that is, the ability of a
couple not to have a child after one year of unprotected regular sex. Regular
means they have sex 2-3 times in a week and unprotected means they have sex
without the use of any contraceptives. But the modification is the age of 35.
If she’s 35 and above, after six months you can start ringing the alarm bell.
Sir, is it possible for a 55-year-old woman to have
a child?
Sure, it is possible for a 55-year-old woman to
conceive especially if she’s using IVF. The good thing is that you use any
technology but you can as well abuse it. For a woman, if you are healthy and
have a uterus, you can use IVF. There was a couple that holds the record of
being the oldest to produce an IVF baby in India, the woman was about 70 years
when she had her babies. While they were celebrating the birth of the babies,
the husband who was 72 had a heart attack and was taken to the ICU, two days
after, the wife also joined him at the ICU. The technology can be used even if
you are 80 years and healthy but the question is in whose interest? When a
woman is going to have a child at 70 and she probably lives till she’s 90, the
problem is the quality of life that she has produced. When you are 50 and you
have a toddler with you, you understand the amount of energy you need to train
a child but when you are 70, it is a lot of hard work. People talk about the
quality of lifestyle of a child being trained by a woman of 70 years.
What will be your message and advice for the women
reading this right now?
Well, my message is always simple and that is that
there is hope if you want to have a child. The time when infertility used to be
a big problem is gone. All you need to do now is follow your doctor’s advice,
do the right thing and God will be with you.
Are we also making progress with IVF technology in
terms of bringing down the cost because a lot of women are actually scared of
how much they are going to spend on IVF so I want to know if we are making
progress in that regard.
Thank you. That’s also a very good question but I
will say to you Dr Seye without being tricky that is there a way we can bring
down the cost of iPhone in Nigeria? We don’t manufacture it so we are not
really in control. Most of the things we use for IVF, if we do it properly are
imported. You want to have good quality like what is obtainable in the UK or The US and you want it cheap, somebody must be paying for it. It’s either there is
a subsidy or insurance. The dollar has a big bearing on the kind of service
we render. An IVF clinic is not a place that light can go off for two minutes
and we know what electricity is like in Nigeria. There are some clinics like
mine where we have three generators. We also have a transformer dedicated to
the clinic and we have inverters too and these are some of the facilities
people don’t bother about in the UK or US. We are also at the mercy of foreign
exchange and it’s not easy for people who want to measure up to the standard
you have all over the world. What I tell people is that if you have a business
that the success rate is about 40 per cent if you cut corners, your success rate
becomes 20 per cent and somebody who can get pregnant once will now have to do
it three times before getting pregnant. So it’s like penny wise pound foolish.
It was a better business for me when a dollar was N165 than what it is right
now.
Sir, I don’t know how to define this but these days
people tend to have just one or two children unlike in those days when they
have as many as they want. Is there a medical reason for this?
I guess it’s the reality check. I’m sure you know
how much it costs to send children to primary and secondary schools now unlike
when we were going to school when our fathers could afford to send 10 of us to
school at the same time. You must be very wealthy to have four children in a
private secondary school now. That is one of the things that is affecting the
number of children that we are having these days. There, different groups, some
don’t want to have many children because of the quality of life they intend to
give those children while some cannot have many children because of a
medical challenge.
Sir how do you cope with a lot of women who are
supposed to fulfil the tips that you roll out but cannot meet up because of the
conditions of the society. What advice do you have for them?
Yes, thank you so much, that’s why we talked about
other options. For example, if Mr Right is not forthcoming, you can freeze your
egg. We know that that’s the ideal world but sometimes things happen so you
just have to be aware of the options that are available
And the older women, how do they also cope?
Yea, the older women are an interesting group
because they pay out of pocket. Majority of the women who can afford IVF are
probably past 35-38 years so they are a large group in Nigeria and all over the
world. And sometimes we have to ask some of them to use donor eggs and that’s
where the problem always lies because it is not an easy pill for any of them to
swallow initially and that’s why we have counsellors to help them through this
stage because it is always very difficult to go through this. We also have a
very important group people; when I say that, they marvel that people can do
this in Nigeria, there are some people who have gone through this and are
always willing to hold the hands of others and help them go through this stormy
period; so we have this support group sometimes speak with couples over the phone
when it’s difficult for a couple to make the decision and sometimes they don’t
meet and they later become very good friends. Just as I said earlier, the most
important thing to do in IVF treatment is the quality of decisions that a
couple make.
Sir, is it possible for you to mention the options
that are available again, a lot of people are interested in it?
For the majority of the people who are older, they might
have to use donor eggs especially if you are above 43. The 2018 IVF result in
the UK was released a few weeks ago and it showed that if you are above 43, the
chance of having your own baby using your own eggs is less than 5 per cent and
you see some people who are 45 and they say they want to use their eggs, most
of the time this will fail and we just have to tell them that they have to use
donor eggs. But we also know that this is not what we will tell them and they
do immediately. We still have to talk to them and make them understand why they
have to use donor eggs and some of them will only agree have they have had a
series of failed cycles. And one thing the people are always afraid of is what
the baby will look like when they use donor eggs and that is one interesting
question I really cannot answer. But what I usually tell them is that there is a
nurturing part of rearing children and there is a nature part. The nature part
is what the woman might probably not be contributing to in the process because
we are going to be using the sperm of the husband and donor eggs. The truth is
that children tend to look after the people that take care of them; how that
happens I don’t know but what I realise is that when a man marries a woman,
they begin to look alike after a while and they were never related. So, this
‘look’ thing, I don’t have all the answers to it and that is what I tell my
patients but I can tell you from experience that some children from donor eggs
look like their parents and I have been doing this for more than 17 years. So
it’s the fear of the unknown and a worthy fear indeed but that’s why clinics
have counsellors to help them and as I said earlier, support groups also. And
sometimes it’s the sperm, and that is even more difficult when you have to use
the donor sperm because sometimes even when you have succeeded, you see some
men reacting negatively to their wives because they used donor sperm. They are
dear to the child but to the wife, they start behaving funnily. What we try to
do in my clinic is that we try to form a large family so we don’t leave our
patients alone and that’s why you see that we have a lot of pictures because
when you have a problem, we try to see how we can come in. It’s a phase and we
try to see how we can make the husband come around and understand that the
child is his and nobody is ever going to take it away from him. It’s easier
when you put it into words but some people will just never say it but it’s
always a problem when you don’t just express it. We’ve talked about surrogacy
as well where a woman carries the baby for you. Then we can also do sex
selection where we determine the sex of the child for the couple depending on
their choice. For people who have AS Genotype and married to another person who
has AS Genotype, we can help them do the genotype selection so that their baby
will not be SS. There are so many things that are fictions many years ago but
are now realities with the help of technology and that was why I mentioned
iPhone earlier because anything that has to do with technology is usually
pricey until after sometimes when it becomes commonplace and then it probably
becomes cheaper. So those are some of the things that we can do.
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