‘Infertility not a death sentence’

Dr Abayomi Ajayi is a consultant obstetrician and gynaecologist and Managing Director, Nordica Fertility Centre, Lagos, a clinic that specialises in the treatment of infertility. In this interview with Sade Oguntola, he says that infertility is not a death sentence since medical science can help resolve it. Infertility is on the rise in Nigeria, what are the reasons for this?

Infertility is on the rise in Nigeria for many reasons. It is an issue in women, particularly those that start their families late for several reasons. Basically, with increasing age, fertility declines.

Sexually transmitted infections are also on the rise in both men and women and these are major causes of infertility. Lifestyle issues including alcohol ingestion, cigarette smoking and sedentary lifestyles leading to obesity are also contributors.  Moreover, some infertility cases occur because of unnecessary and /or poorly done surgeries like open fibroid surgeries in women.

Can science restore the joy of motherhood to individuals with conditions that even medical science has written off as barren?

Yes, virtually all forms of infertility can now be treated by one form of assisted reproductive technology or the other.

So, infertility needs not be a death sentence because, with current medical technology, it can be effectively treated and it is not the end of life.

There are new technologies and even newer ones are being developed by the day to help solve the challenge of infertility. They include Intracytoplasmic Morphologically Selected Injection (IMSI) and Pre Implantation Genetic Screening (PGS).

Pre Implantation Genetic Screening (PGS), a technology that helps screen against diseases in the embryo that may manifest later in life, will greatly help improve the outcome of fertility treatment. All these are available in Nigeria and Nordica Fertility Centre has over 2000 babies and counting born from Assisted Reproductive Technology(ART) bringing joy to many families.

What are the common myths on infertility in Nigeria and why do they continue to exist?

One myth, especially in this part of the world, is that only women are responsible for infertility. This is not true. Men contribute up to half of the causes of infertility and a couple need to be evaluated for infertility.

Another myth is that it is caused by spiritual factors. This delays seeking correct, effective medical assistance on time. These myths continue largely because of ignorance. Public enlightenment at such forums like Nordica fertility centre open forum as well as the media can help dispel such myths.

The cost of IVF is a challenge, how best can Nigeria solve this?

Government can help pay for one to two IVF cycles for indigent couples with infertility. Fertility treatment can also be covered by the National Health Insurance. The cost of running IVF services can be eased by government providing adequate public power supply as well as ensuring availability of forex to help in purchasing equipment and medications for assisted reproductive treatment. Also, infertility treatment loans can be provided by banks.

How healthy are babies born through assisted reproductive technology (ART)?

They are very healthy, in fact, probably healthier than the naturally conceived babies because they have come from the best sperms and eggs. With technologies like PGS, several genetic diseases like sickle cell disease can also be prevented in them. In fact, IVF babies are free from about 600 diseases plaguing mankind.

What role do men and women have in putting an end to increasing cases of infertility?

Certainly, many men have Chlamydia, an infection that leaves them unable to father a child and they are never aware of it. So, they need to ensure they practise safe sex. There is also the need for women-friendly policies to allow and encourage them to start their families early when they so desire.

The basic rules of prevention of sexually transmitted infections, that is ABC of safe sex is: A, standing for abstinence from sex; B standing for Be mutually faithful, avoiding multiple sexual partners; and C meaning correct and consistent use of condoms.

Lifestyle modifications like avoiding excessive alcohol ingestion, cigarette or marijuana smoking, regular moderate exercise are also important for good fertility level.

Also, avoiding exposure of the scrotum to excessive temperature, say from laptops and exposures to radiations and chemicals in the work place that could damage sperms, is also key to improve fertility rates in men and women.

Men working in the oil industry, alongside those leaving around facilities with petro-chemical exposures like gas flaring, are more prone to developing low sperm quality.