You don’t need to have sex to get pregnant
• But is IVF morally right?
By HENRY UMAHI
Saturday, July 12, 2008

•PHOTO: The Sun Publishing Ltd

Although Nigeria could be said to witness a healthy population growth, there are many couples desirous of having children of their own but cannot achieve their hearts’ desire through the natural means of copulation.

Indeed, medics have been churning out frightening estimates in recent times to the effect that baby making is no longer a piece of cake to a growing number of people of productive age in the country.

As someone observed, there is no one who does not know someone having difficulty in achieving pregnancy. So, why are couples not hitting target? Is it that the barber is unskilled or the razor is blunt?

Experts say that as much as seven million couples have fertility challenges, attributing the development to a number of factors, including unsafe abortions by women, stress, dietary preferences, smoking, drinking, tight fitting clothes by men, sexually transmitted diseases, environmental and occupational hazards, late marriage in women and genetic makeup among others.

However, assisted conception and reproduction techniques are addressing the problem. Unlike in the days of yore when people appeased the gods of fertility by killing goats and chickens to make sacrifices, improved sciences are providing succour to infertile couples, particularly In-vitro Fertilisation (IVF).
Despite opposition by moralists it has become increasingly accepted as a method of assisting infertile couples.

According to Dr. Tunde Okewale of Ives Hospital, Lagos, “the first IVF baby was born in 1978 in the UK. The second one was reported in India in 1979 and by 1980, it was reported in Austria while America recorded the first IVF baby in 1982. In 1989, there was a report in Nigeria from LUTH that they had an IVF baby.”

Advent of IVF in Nigeria
Back in the early 1980s, when some gynecologists at the Lagos University Teaching Hospital (LUTH), namely Prof Osato F. Giwa Osagie, Prof Oladapo Ashiru and Prof. Abisogun disclosed that they could assist couples plagued by infertility solve their problems through a process of fertilization outside of the body, otherwise known as In-Vitro Ferticerlisation (IVF), not a few denied them the benefit of the doubt. Even many of their colleagues criticized them and argued that their claims were false. As the matter boiled over, the Federal Government subjected the matter to close scrutiny through two panels it set up for that purpose.

At the end of the day, the medical eggheads got a clean bill of health to the effect that they were not operating in the realm of deceit or fantasy.
Over the years, assisted conception and reproduction techniques have gained a measure of acceptance in the country even as the scope has been expanding. Besides the pioneers, many practitioners have embraced this specialized sphere of medicine just as people are better informed and can actually make informed choices.

Saturday Sun checks revealed that presently there are 14 IVF centres in Nigeria. Seven of them are located in Lagos, three in Abuja, two in Port Harcourt, one in Aba and one in Benin city. Another one will be starting soon in Enugu. Of this number, government is funding two, namely, National Hospital, Abuja and University of Benin Teaching Hospital (UBTH).

IVF is acclaimed as the most effective procedure of assisted conception and reproduction. According to experts, “it is often used when a women’s fallopian tubes are blocked or when a man produces too few sperm. Doctors treat the women with a drug that causes the ovaries to produce multiple eggs. On maturity, the eggs are removed from the woman. They are put in a dish in the laboratory along with the man’s sperm for fertilization. After a couple of days, healthy embargos are implanted in the woman’s uterus.”

IVF is also beneficial to women suffering from Turner’s syndrome, that is woman born without ovaries and who don’t menstruate at all or whose ovaries do not function properly as well as menopausal women. Such women are assisted to achieve pregnancies using donor eggs. Under this circumstance, a donated egg is fertilized with the sperm of the woman’s husband and then implanted into her after her womb had been prepared with special drugs.

One child, multiple parents
With advent of IVF, the whole of parenthood is evolving. It is now possible for a child to have up to five parents, according to Giwa-Osagie, who is the president of the Nigerian Fertility Society (NFS) and founder, Advanced Fertility Centre (AFC).

He explains: “Traditionally, when we say somebody’s parents, we mean his biological father and mother. But with progress in assisted conception, one cannot assume that his father or mother is his biological father or mother. This is because a pregnancy could result from a donated sperm. Whoever produced the sperm is the biological father. So, the child has two fathers.

“On the other hand, if a woman conceives from donated egg (Oocyte), the owner of the egg is the biological mother. The person carrying the pregnancy is the carrying mother because she can even carry it for someone who can now be the adopting mother. So, one can have different types of parents.

Who owns the baby?
Osagie continues: “Again, there is the issue of who owns the baby, who owns the embargo? The person who owns the garment (sperm or egg) doesn’t necessarily own the baby. These have to be discussed and agreed. Some people are aware that these issues arise, they knew what they are getting into and how best they can be solved in their society.

“But usually the person that comes out to say that he/she is the parent of a child is the one the law accepts. In Nigeria, you are unlikely going to have a controversy over such an issue because when people conceive from artificial insemination they don’t broadcast it. In any case, the donor and the recipient are not supposed to know each other. So the person who carries the pregnancy is the mother as far as everybody is concerned and her partner is the father. That’s how we have solved it in Nigeria.”

Ethical issues/right of child
Mrs. Nkasi Idoko-Johnson, a social worker admits, that improved sciences leaves in its wake issues bothering on ethnics, right of child etc.

According to her, unlike in the past when child bearing or rearing was a matter for married couples only, today single parenthood have become an issue. More worrisome is the fact that lesbians and homosexuals are now having children of their own in strictly female-female and male-male relationships respectively. Of course, this is against established or acceptable societal norms. But in all this, the right of the child is not considered. Take this: how would a child feel when he grows to discover that both parents are same sex.

Chequebook babies
IVF is not a two a penny venture. It is expensive and time consuming. In other words, it is not for the poor, so to say. According to the first female embryologist in West Africa, Mrs. Bobo Kayode, “Drugs and IVF cost between three and five thousand pounds in United Kingdom and from $10, 000 to $15, 000 in the United States of America. In Nigeria, it could run from about N650,000 to N750,000 per cycle. If we are going to do an ICSI (intracytospemic sperm injection), we will be talking about N750, 000 to N1 million depending on the patient’s response to the drugs and the entire procedure.”
She, however, volunteered that “not all patients require IVF or ISCI. Insemination costs between N20, 000 and N60,000 depending on the cycles and number of procedures required per cycle”.

She added: “At our own clinic, Omni Medical Centre, we have pioneered what we call the low-cost IVF in Nigeria. It is a course of treatment whereby those who cannot afford the full course treatment are taken through the minimal drug stimulatory regime that would at least encourage their follicles to be developed and produce ocytes that would enable us to proceed with the treatment.”
She put the minimum cost of that procedure between N280,000 and N320,000.

No warranty
However, a cycle of IVF might be repeated before or if at all pregnancy can be achieved. That is to say, it is not a “sure banker” as pool stakers would say. On the other, IVF may produce multiple births as it happened at AFC in Lagos sometime ago where a couple got a set of twins– a boy and a girl– two for the price of one. So, it is different tales for different folks. While some women who conceive and deliver without hassles sell or throw their babies into canals or dump sites others pay through their noses to have same, sometimes without luck.

Reducing costs
Fertility management experts are of the view that the cost of IVF in country could be reduced with the support and assistance of government by way of subsiding drugs and duty waver on imported equipment as well as development of social infrastructure, such as power supply as the fertility centres depend almost solely on energy converts and generators. Another way of reducing overhead costs, they maintained, is through collaborative initiatives, such as bulk purchase of drugs as a group and use of same personnel embryologists etc in labs instead of keeping private staff in this area.

Fraudsters on the prowl
Like in virtually every field of endeavour in Nigeria, fraudsters are prancing about the Advanced Reproduction Technology (ART) stage, milking couples who are desperate to savour the indescribable joy of parenthood. Such fake fertility centres make unsubstantiated claims just to wood wink unsuspecting members of public.

Regarding this nicked act, Prof. Ashiru, Medical Director of Medical Art Centre in Lagos, said: “I have to warn that there are some people out there that are not really practicing advanced technology be careful.”

To checkmate the quacks and false claims being bandied about, Giwa Osagie disclosed, “the Nigeria Fertility society is trying to draft guidelines which will be sent to government to assist it in regulating this area of medicine”.

Adultery by other means?
When a man impregnates another person’s wife, is it not adultery? Is a child born into a relationship involving unmarried partners not a product of fornication? If the answer is yes, what then is the spiritual implication of using donated sperm and eggs to produce babies? Is it adultery/fornication by other means?

For Dr. Success Ibeakanma, General Overseer of The Master’s Royal Choice Revival Ministries, Alakpere-Ketu, Lagos, “It is not really adultery for a man to donate his sperm for the purpose of making a woman who is not his wife pregnant but it is a form of hypocrisy”.

He said:” When you allow your wife to use another man’s sperm to get pregnant because you have medical problems, you want to give false impression that you are the biological father of the child. It is a form of hypocrisy. However is not adultery per se because it is not the process of fertilization that God described as adultery. Adultery is about a relation, it does not matter whether sperm is released or not, or whether a child results form the relationship or not.

“My concern as a minister is the product of the procedure–IVF. In most cases, you don’t know who is donating the sperm or egg because of the confidentiality involved. You know, a child inherits some traits from the biological parents, so what happens if the donor had some unwholesome traits or genetic makeup? I think adoption is even better for a couple having fertility problem than masked deceit”.
Rev. Joseph Abba, presiding pastor of Glorious Tabernacle of God Mission, Iba, Lagos described the use of donated sperm as an inglorious act. According to him, “It is wrong to donate sperm. One can donate blood to save life but not sperm to create life. Infact, it is adultery. One may see it as a way of helping another but it is spiritually wrong”.

Rev. Abba therefore admonished those who may have been involved in such practise to return to God having strayed and ask for forgiveness. Without mincing words, Apostle Paul Adenuga of Faith Revival Apostolic Church (FRAC), Idimu, Lagos, declared sperm donation as “ungodly”. In his view, “it is against the law of God, it is not the natural way of procreation. I pity this generation because people are embracing evil in the name of advancement in science. It is not the will of God of people to do such things. It is not the will of God for people to do such things. The son of men have really gone overboard. Not having children is not the end of the world, it is not a do or die thing to have children. Full salvation should be the ultimate desire for children of the living God. Children gotten through such unnatural means will be a problem to their so-called parents and society. Any product of such procedure or process is sin personified, sin walking on two legs”.

To buttress his position, Apostle Adenuga quoted Romans1:21-32, stressing that the world is in endless crises because of such acts. He therefore urged the sperm donors and users to desist from such acts as a matter of urgency and surrender themselves to the holy urgency and surrender themselves to the holy spirit for cleansing.

Sperm, egg for sale
Efforts by Saturday Sun to ascertain the average cost of sperm and egg met a brick wall. According to Kayode, “people don’t sell sperm or egg. Sperm and egg donors don’t get paid but get a token to cover their expenses. Other egg donors do egg sharing whereby they give out supernumery eggs to those that pay for part of their procedure”. But what is the difference between six and half a dozen?

Adoption
For couples who do not have purses deep enough to finance the assisted conception project as it were or those who have tried without success as well as those who not approve of IVF for whatever reason, adoption remains a viable option. It is an age-old practice but which people prefer to wrap in secrecy. As Giwa-Osagie puts it, “In Nigeria of today, people don’t easily admit that they have adopted children yet we know that adoption is going on. It is unlike European society where if you adopt you have to declare it and proper date kept so that 20 or more years later he could be traced if need arise. But in Nigeria, I don’t know of anybody who have had a child through donor sperm for instance and who declares it publicly”.

However, it is doubtful if the supply and demand can meet equilibrium. Perhaps, this explains why illegal trading in babies is booming in many parts of the country.