‘IVF awareness and health consciousness are relatively high in Nigeria’

Dr. Abayomi Ajayi is a Consultant Obstetrician and Gynecologist and the Managing Director of Nordica Fertility Centre, Lagos a clinic that specializes in In-Vitro Fertilisation (IVF) and treatment of infertility in couples. The frontline company is a franchise with its headquarters in Denmark. The fertility expert in this interview with IJEOMA THOMAS-ODIA explores the IVF world as well as latest technologies and procedures to achieving perfection in embryo formation.

Having been in the business for eight years, how have you been able to keep abreast and stay relevant?
The field we are is a very dynamic one. New things come up on a yearly basis, so it is important to stay at the cutting edge of what is happening in the world. And we have so many people we are collaborating with all over the world. In other words, what we are trying to do is to make sure that whatever happens out there, we can replicate it here too. There are so many things we are still not doing in Nigeria, so we are trying to close the gap. You will agree with me that there is a wide gap between the health sector in Nigeria and outside the country except for reproductive medicine.

Does it not cost so much to stay abreast with the world on reproductive health?
Of course and that is re-inventing. Every year, in my company, at least three people go abroad to study new courses, even with the state of the economy where the cost of travelling is quite expensive, we still have to because that is the only way we can stay on the cutting edge. So, it is a policy of the company that we need to train ourselves and stand anywhere in the world to defend what we are doing.

With your efforts, to what extent has IVF resonated in the mind of Nigerians?
With the help of the press, too, IVF has become a term even common people are familiar with. In a walk on the streets and even bus conductors can explain properly the concept and it shows the level of awareness. It wasn’t like that 10 years ago and I think we have all done a good job, but we need to go beyond the surface to get to the nitty gritty of it. The health consciousness in Nigeria is very low, today you see people jogging and running around to keep fit which a few years ago you couldn’t find. This shows us one good trend that, if we face something, we can do it well.

If all Nigerians become health conscious, will there be lesser people in need of IVF?
No, it is not possible, because in advanced parts of the world like Demark and Germany, the awareness is higher but they need more IVF than we do. This is because some people are born to be infertile; while some have inherited low sperm count, others inherited endometriosis, polycystic ovaries among other infertility diseases.

Some religious bodies have questioned the morality of IVF, what is your take?
I am a Christian and unfortunately a medical doctor. Mixing religion and medicine together sometimes conflicts. Some things that some churches are holding on to happened over 30 years ago. Science is improving on a daily basis. Literally the problem stems from when life starts? We know that life does not start when the sperm and egg come together because even in the body, naturally when these two meet, doesn’t always result in a baby, so when you say life starts when sperm and egg come together, I think that there is a mistake. Fortunately, because we are learning more about genetics, it is becoming clearer to us that some of the notions we had are not particularly true even though some people have built their religious views. There is no doubt that there are still ethical issues in IVF. What we believe as practitioners is that life only begins when we feel the heartbeat of the baby, which is about five to six weeks.

What is the stand of Nigerian government on IVF?
You know they say he who pays the piper dictates the tune. In Europe, it is easier for their government to regulate because they put their money where their mouth is, but in Nigeria we don’t put in money but we want to put our mouth. We agree that the government has a place but when you purchase your equipment on your own and bear all the costs and all you get is paying tax. Especially when we had to import machines for the procedures, we were charged 65 per cent of the total costs, which is not encouraging.

What are some of those modern trends you are engaged in?
Any technology that is available in the world is found here, too, and so we are doing so many things other clinics don’t do. In the treatment of male infertility, the best treatment you can get in the world is available here. Every clinic can do the Intra Cystrophasmic Sperm Injection (ICSI), we can do Intracytoplasmic Morphorlogically Selected Injection (IMSI) and PISI, and we also do DNA fragmentation. We still believe that the quality of the egg is the most important thing that affects the quality of the embryo, but we now know that the quality of the sperm contributes to 20-40 per cent of the quality of the embryo. Don’t forget that all the doctor can do is get embryo, we cannot get babies.

Since we can know the genes of the embryo, we can tell embryos that can become a baby. About 70-75 per cent of embryos produced in labs all over the world cannot produce babies; this is because God is still God. He has made it normally that a woman cannot produce more than one to two eggs every month but because we use drugs; we can get 15 to 20 eggs and so about 70 per cent of them cannot make babies, otherwise the world will be populated.

Tell us about your first success story in IVF?
It happened in 2004 and the young man just turned 12. Recently as we celebrated him at the office, he says he wants to become a doctor and so we call him Dr. Julian (which is his name). The first set of twins delivered here was in May 2005. The most remarkable for me are the first set of triplets, which came in July 2005. The couple had tried earlier and it didn’t work, the next month we tried again and three eggs fertilized. It is a nice experience knowing of the gift that God has given mankind. They are just as normal as every other baby.

Do babies born from IVF suffer peculiar health challenges?
Babies born from IVF will inherit whatever their parents have except you do the procedure we call Pre-implantation Genetic Diagnosis (PGD) or Pre-implantation Genetic Selection (PGS). If two AS people marry, if we do PGD, we can pick out the embryos that don’t have the sickle cell and we don’t transfer it, so we can prevent disease from there including cancer.