Fertility decreases with age. Couples should seek treatment – Prof Ashiru, Secretary-general, International Fertility Societies
Q&A: The State of Fertility Care in Nigeria
Q: There is no law regulating fertility clinics in Nigeria, yet demand is high. What is your take?
A: That statement is not entirely accurate. In Nigeria, fertility clinics operate under established professional guidelines. The Association for Fertility and Reproductive Health (AFRH) has provided robust guidelines for Assisted Reproductive Technology since 2012. These standards are comparable to those of leading international societies like the American and European reproductive medicine bodies.
Q: Is formal legislation needed?
A: The discipline of all doctors falls under the Medical and Dental Council of Nigeria. However, many countries enact a broader enabling law to empower these professional guidelines. I understand a health reform bill is under consideration. Importantly, Lagos State has already taken action. They adopted the AFRH guidelines and established a monitoring committee in 2019. This committee inspects and regulates IVF clinics, which has significantly improved quality within the state.
Q: Most clinic visitors seem wealthy. Is treatment only for the rich? What hope is there for the average Nigerian?
A: Access is not only for the rich. Opportunities exist for others through grants from well-wishers, religious organizations, and foundations. However, infertility treatment is inherently costly. The drugs, media, and infrastructure for treatments like IVF are all imported. This makes them vulnerable to currency devaluation.
When we started IVF in the 1980s, one cycle cost about N3,000. Today, the average cost in Nigeria is about N2 million. This sum is far above the average income. That is why supportive organizations are crucial. For instance, the OARS Foundation, which we started in 2005, helps less privileged individuals have babies.
Q: With a high fertility rate in Nigeria, why are infertility clinics booming?
A: I am not sure data supports a high fertility rate. In reality, infertility is a global issue. Worldwide, an estimated 15% of couples have trouble conceiving. In the past, about 90% of Nigerians needing high-tech treatment travelled abroad. Today, they can receive it here. In fact, Nigeria has now become a destination for medical tourism in infertility treatment. This shift is a credit to Nigerian fertility practitioners and the AFRH.
Q: What are the changing alternatives for parenting, and how do Nigerians view them?
A: A lot has changed. June is now World Infertility Awareness Month. This global effort increases awareness, debunks myths, and presents options. The goal is to improve lives through scientific knowledge.
In Africa specifically, we work to de-stigmatize infertility. We emphasize that many causes are preventable. Education focuses on STDs, occupational hazards, and environmental factors. The range of treatment options has also expanded dramatically. These options now include everything from ovulation induction to IVF, donor programs, surrogacy, and genetic diagnosis.
Q: What is the infertility ratio between males and females in Nigeria?
A: We now believe the ratio is 50:50. This means half of infertility cases stem from male factors. Therefore, we recommend couples try for one year (or six months if over 35) without conception before consulting a doctor.
Q: As an expert, what cases seem most difficult to handle?
A: Today, we can address almost all cases. Couples need a customized assessment and the ideal treatment option. Ultimately, we provide the medical treatment, but we believe the outcome is in God’s hands.
Q: What are the common causes of infertility?
A: The most typical cause is sexually transmitted infections, like gonorrhea and chlamydia. These scar the reproductive tubes. Unfortunately, chlamydia often shows no early signs, causing irreversible damage by the time symptoms appear.
Other major causes include:
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Environmental Toxins: Industrial hazards like paints, petrochemicals, and pesticides.
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Dietary Factors: Heavy metals from consuming large fish and stockfish.
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Lifestyle: Driving barefooted can also expose one to toxins.
For these reasons, we recommend couples undergo detoxification to clear accumulated toxins before attempting conception.
Q: How many Nigerian children have been born via ART?
A: Nigeria started a national data registry in 2014. Before that, we participated in international monitoring. The estimated number of babies born in Nigeria through ART is about 12,000.
Q: How old is too old to have a baby?
A: Scientifically, an adult womb can carry an embryo at many ages. The main limitation is the physiological stress of pregnancy, especially from age 55 and above. Nevertheless, there are reports of women delivering after 60.
Q: What should men and women avoid to prevent fertility issues?
A: Key avoidances include:
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Sexually transmitted infections.
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Environmental toxins (paint, pesticides, insecticides).
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Alcohol, smoking, and substance abuse.
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Large fish and stockfish high in mercury.
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Harmful cosmetics.
Instead, maintain a nutritious diet, exercise regularly, and prioritize a healthy lifestyle.
Q: What about people already exposed to harmful substances?
A: Complete avoidance in our modern world is impossible. These toxins affect fertility and can cause cancer. Therefore, a yearly comprehensive body detoxification is mandatory for good health, fertility, and longevity.
Q: How does detoxification improve fertility?
A: A comprehensive detox cleanses the intestines, liver, kidneys, and lungs. It removes heavy metals and pathogens using advanced technologies. According to the principles of modern Mayr medicine, this process renews the body’s mitochondria—the cellular powerhouses. The result is a regenerated, invigorated body that is more conducive to conception, as practiced at the Mart-life Detox Clinic.
