‘70% of gynaecology consultation in UCH due to infertility’

A fertility expert, Dr Gbolahan Obajimi says 70 per cent of gynaecology consultation in University College Hospital (UCH), Ibadan is for infertility and urged an expanded access to affordable assisted reproduction in the country.

Dr Obajimi spoke at the Nigerian Medical Association Oyo chapter Continue Medical Education series, with the theme ‘Expanding Access to Assisted Reproduction: Getting More for Less’.

The medical expert said that there is an increasing unmet need for assisted reproduction with the growing population of infertile patients, government’s inability to meet this need and increased awareness about medical science solutions to infertility.

Dr Obajimi said although infertility is on the rise due to factors such as late marriage, girl child education and abnormalities in semen quality, generally, conception will not occur in two out of every 10 couples within a year despite regular unprotected sexual intercourse.

He added: “One in 10 couples will still not get pregnant, no matter how much they try to get pregnant within two years, except with some assistance.”

Obajimi, a consultant obstetrician and gynaecologist said the likelihood of spontaneous live birth in infertile couples is strongly influenced by the female age, duration of infertility, previous pregnancies and cause of infertility.

The expert, however, said that the goal of assisted reproduction is to produce a child but its sore point remains the methods that may be employed to achieve this goal since the society views the act of reproduction as a private, natural and conjugal act between two people.

“Treatment with available technology does everything but meets these criteria. Nevertheless, the right to procreate is a liberty that must be held sacred by all and sundry.

“As care providers, we must respect this right. It is, therefore, our responsibility to use the available reproductive technologies in a responsible and responsive manner.”

Dr Obajimi, however, said that affordability, pricing transparency, customer service and poor quality control were some parameters that must be tackled to expand access to assisted reproduction to teeming Nigerian couples.

To expand access to assisted reproduction at an affordable price, he suggested that Nigeria should adopt the ‘hub and spoke’ model of care currently employed in advanced fertility and cancer care in the UK.

According to him, “the drive for financial gains at the expense of good clinical outcomes has led to the rapid proliferation of assisted reproductive technology (ART) centres in Nigeria.

“There is an unmet need for advanced fertility treatment in Nigeria, hence the need to be innovative and consider the ‘hub and spoke’ arrangement. Collaboration and not isolation seems to be the right way to expanding access to ART.”

The hub and spoke model ensure greater efficiency, better treatment outcome; ease of treatment, cost-sharing, increased accessibility and decrease the financial burden on the patients while increasing synergy between practitioners.