Why infertility clinics boom, fertility decreases with age for a woman writes Anthonia Obokoh on fertility options treatment
It is overwhelming. Should I freeze my eggs to use with my future husband? Wait for the right partner and just consider adoption one day? Surrogacy? I had no idea what to do say a 34-year-old Ngozi Udo( not real name) thinking about having her own kids.
“But I still want to wait until I got married so that I could give my child the type of family I dream of. My doctor suggested that in the meantime, I should find out what my options were,” she says.
Around age 19 or 20, I started experiencing extreme pain that I learned was caused by Ovarian cyst abnormal growth in the left side of the uterus. I had to have carryout myomectomies, which is the surgery required to have the cyst removed, that even lead to the loss of the left ovary.
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According to Ngozi, my doctors never told me that the procedures could affect one of my ovaries and could affect my fertility one day as I recently had a scan which reveals that the cyst is now growing on the right ovary. I have to consultant other gynaecologists – this time about three, they told me – that I might have difficulty in getting pregnant “At some point, your uterus will not recover from all of this.”
” I learned that removing one of the ovaries and the other already having a new cyst grow would make it extremely difficult for me to ever have children, and even less likely for me to be able to conceive on my own. That sent me into anxiety mode.
“Now I am 34 and not still married, I have checked online and find out that there are assessments at a clinic that had a great reputation for helping women of my age get pregnant via in vitro fertilization.
“My case might not be far different from what my next neighbour may be facing as I have realised that infertility is a big struggle for grown-up women not minding the age,” she said.
So the questions running through my mind each time I think of my condition is, I could still try to have a baby, whether on my own or via IVF—but I am not ready for the next steps because I have not found someone I wanted to have a child with.
The process is successful.
After some deep vetting and research, Folake Adelusi found another place in Lagos that she liked to have her IVF done. And this time, it is her second attempt, the IVF worked.
According to her, I am expecting my first child in just a few weeks. I and my husband David Adelusi do not know the baby’s gender, because we told the doctor not to tell us, but we have settled on a unisex name. It is been a long journey. I mean, I am in my late 30s, recently married, and having my first baby!
“When I wedded my husband, I was 25. We tried on our own for a little while, but we had to be down-to-earth about the fact that our best chances were through IVF. I did a lot of research, and we came across this went clinic in Lagos.
“The anxiety of not having a child after 11 years of marriage made me and my wife considered and planned for the IVF option. I have been supportive to my wife, though we more than N1m for the cycle and thank God this second one is a success, I am happy that my wife is pregnant,” said David.
Folake added that infertility is not by you getting married early, I will say if you do run into struggles, do not give up. I have been childless for 11 years.
“IVF, egg freezing, surrogates, and adoption can all be stigmatised and overwhelming and expensive. But there are ways to find the funds, from financing to loans. I will say couple should not panic. There are always options.”
In many countries, particularly in Africa, women who are unable to have children suffer stigma. Infertility can from time to time be treated it is far beyond the means of many people as sometimes women face isolation and violence.
This experience shows that as younger women find out they have fertility problems, while some have future fear of getting pregnant more Nigerian families are turning to the In-vitro fertilization (IVF) procedure and the country is seeing more partners agreeing that if a delay in pregnancy will have babies through I.V.F.
Infertility affects 12 percent of all women up to the age of 44, and studies suggest black women may be almost twice as likely to experience infertility as white women.
According to data released by the World Health Organisation, the majority of people who suffer infertility are in developing countries.
WHO estimated that infertility affected up to 10.5 per cent of couples of reproductive age group globally and 20 per cent of couples of the same group in Nigeria.
Available statistics show that there are about 12 million infertile persons in Nigeria, which is almost 10 percent of the total population.
“The fact really is that with advancing age, even In vitro fertilization (IVF) becomes more challenging. The risk of not having a baby after IVF is more than five times higher if the male partner is 41 years old or older,” says Abayomi Ajayi, managing director and chief executive office Nordica Fertility.
In vitro fertilization (IVF) is a complex series of procedures used to treat fertility or genetic problems and assist with the conception of a child. During IVF, mature eggs are collected (retrieved) from your ovaries and fertilized by sperm in a lab. Then the fertilized egg (embryo) or eggs are implanted in your uterus. One cycle of IVF takes about two weeks.
“Fertility decreases with age for a woman and also for a man although in different ways and to different degrees. One of the most important factors that determine fertility is age” said Ajayi.
Ajayi further explained that as a man, you are probably aware that women’s fertility declines after the age of 35, but do you also know that your age can affect your ability to become a parent, too?
“While less is known about male fertility and age, there is increasing evidence that the older a man becomes, the more his fertility diminishes.
You cannot change your age, but with knowledge and proper education, it is possible to improve your chances of successfully fathering a child,” he said.
Meanwhile, according to United Nations projections, the current fertility rate for Nigeria in 2021 is 5.212 births per woman; a 1.31 percent decline from 2020The fertility rate for Nigeria in 2019 was 5.349 births per woman, a 1.26 percent decline from 2018. The fertility rate for Nigeria in 2018 was 5.417 births per woman, a 1.19 percent decline from 2017.
There is a delay in the diagnosis of infertility despite its high prevalence rate has remained a major challenge in the management of the condition, experts say.
Fertility experts also say that research on the conditions of diagnosis on polycystic ovary syndrome (PCOS), endometriosis, fibroid has remained largely underfunded in Nigeria, noting that some women suffer pelvic pain for as long as 10 years before getting the right diagnosis.
“However, in as much as success and failure rates exist, it means there are also risks in carrying out IVF. One of such risks is that it increases the chance of multiple births if more than one embryo is implanted in the uterus. A pregnancy with multiple foetuses carries a higher risk of early labour and low-birth-weight than a pregnancy with a single foetus does” said Ajayi.
Ajayi added that another risk is that while the rate of miscarriage for women who conceive using IVF with fresh embryos is similar to those women who conceive naturally — about 15 to 25 percent — the rate increases with maternal age. Use of frozen embryos during IVF, however, may slightly increase the risk of miscarriage.
“Stress is another risk in the use of IVF as it can be financially, physically and emotionally draining. However, support from counsellors, family and friends can help couples through the ups and downs of infertility treatment,” he said.
Cost of IVF in Nigeria
For Advanced assisted reproductive technology (ART), BusinessDay gathered that the cost of the procedure is competitive in Nigeria in comparison with other countries.
“A single cycle IVF treatment ranges between N1.2m and N2m,” says Oladapo Ashiru, a professor of Anatomy and Consultant Reproductive Endocrinologist.
“The IUI cost between N200,000 and N500,000; that is not IVF. The IVF that involves stimulation can cost you over $10,000, which is about N3.6m.
“In Nigeria, because of low manpower and low cost of rent among others, the cost of proper IVF is between N1.2m and N2m if you go to a centre where they do the right thing. Once it is less than that, you have to be careful of what is going on,” he said.
Globally, the IVF market is expected to reach $27 billion by 2022, according to a report by Grand View Research, Inc, a U.S.-based market research and consulting company.
Facilities in Nigeria, experts say, have reduced medical tourism for IVF purposes. Clinics in the country have introduced newer techniques, which can offer a better success rate at an affordable cost.
Conceiving a child could be frustrating when you don’t get a positive result, but struggling to conceive doesn’t always mean the end of the road. While struggling to have a child, a healthy balanced diet is important. Foods rich in antioxidants may promote optimal fertility health.
Ajay said eating healthily and exercising is a good start. It is well known that obesity can contribute to infertility in men, and eating a healthy diet and being more active can reverse some fertility problems associated with obesity.
“Lifestyle changes help. Severe stress, alcohol, smoking and the use of hard drugs can all affect your sperm count. If any of these habits are part of your lifestyle, working toward changing them could increase your chances of remaining fertile as you age.
“Fertility specialists are not only beneficial to women. If you and your partner are having difficulty conceiving, a specialist can help you combat age-related fertility issues,” he advised.
