‘With Technology, No Woman is Barren’

IMSI machine

Although it is said that no woman is barren biblically, the reality of today’s world is that some couples are experiencing difficulties achieving pregnancy. However, with the help of science, fertility doctors are resolving the problem of infertility among couples. Godwin Haruna writes

Since the birth of the first tube baby, Louise Joy Brown, more than 35 years ago, the science of assisting infertile couples had been revolutionised across the world. Since that novel birth at Oldham General Hospital in Britain on July 25, 1978, more than 5 million babies have been conceived around the world through in vitro fertilization (IVF) otherwise called assisted reproduction therapy (ART).

However, despite advances in medical technology, the Nigerian society still stigmatises women who cannot conceive. And, as medicine has found out, the fault line is not necessarily with the woman alone since the male factor in infertility is also rising. Although Brown’s mother could not conceive because of blocked fallopian tubes, just like many women seeking conception today, the male-induced infertility is also a factor inhibiting couples from having babies of their own. Speaking on male infertility with THISDAY recently, Managing Director of Nordica Fertility Centre, Dr. Abayomi Ajayi said besides hormonal imbalances, many things could be responsible.

Ajayi stated that there are male lifestyle choices such as diet and alcohol that have impacted on their fertility negatively. However, be that as it may, he said new technologies have emerged in medicine to deal effectively with male-factor infertility: “Intracytoplasmic Morphologically Selected sperm Injection (IMSI) is the latest advancement in the treatment of male infertility.”

He added that apart from making clinicians get a better look at the sperms, the procedure has also significantly reduced miscarriages by as much as 75 per cent. He stated that IMSI has not only come to resolve male-factor infertility, but it has helped more couples to complete pregnancies.

He said before now, the Intracytoplasmic sperm injection otherwise called ICSI was the procedure used to resolve problems of abnormally low counts or absence of sperm in the ejaculate. He said ICSI was developed to assist couples who have abnormal sperm parametres and couples who have had difficulties achieving fertilisation after conventional IVF.

Ajayi stated that with the centre’s acquisition of the IMSI technology, dealing with male-induced infertility has become a lot easier. “In IMSI, sperms are magnified more than 6,000 times in order to be able to select the best sperms. Pregnancy rates approach 60 per cent and rates of miscarriages reduced by 75 per cent,” he said.

He said the advantages of IMSI over the old procedure are quite numerous. According to him, the medical procedure is especially indicated in severe derangement in sperm parametres and other indications such as men with very low sperm count less than two million and with less than 20 per cent motility.

“For men whose partners have had recurrent abortions in the first trimester (to exclude the contribution of damaged sperms). For couples experiencing infertility, with the man having low rate of spermatozoa with normal nucleus and the women having had two failed cycles. For couples, in which case the men are above 50 years or elderly men with low sperm count. Also, for couples in which case there is no fertilisation during previous cycle either through IVF/ICSI or for couples, who inspite of having a good number of eggs, have poor fertilisation,” Ajayi stated.

The gynaecologist disclosed that IMSI is the latest advancement in the treatment of male infertility and is presently exclusive to Nordica Centre in Lagos in all of West Africa.

Ajayi noted that before a couple could be enrolled for any of the treatments, they would have to undergo what he called a proper evaluation. He said it is always advisable to start seeking help early enough for couples that desire assisted conception because the procedure could be difficult with age.

In this regard, he counselled that a new couple living together and seeking pregnancy for upwards of 12 months and above without achieving their objective, should seek the assistance of a qualified medical personnel. He said age could have an adverse effect on the females much more easily than their male counterparts and therefore, seeking help before they advance in age, is highly encouraged.

He also spoke about another procedure he called Pesa and Tesa concerning male infertility and who there are recommended for: “Whenever there is any difficulty producing sperms, surgical retrieval is considered with the view of carrying out a cycle of ICSI with retrieved sperm. Tesa and Pesa are both sperm collection techniques, which are performed usually under local anaesthesia.

“Men with azoospermia (absence of sperm in the ejaculate) due to a blockage preventing sperm from entering the semen, that is, obstructive azoospermia. Men with azoospermia, due to failure of sperm production by the testicles (non-obstructive azoospermia). Approximately 50 per cent of people in this category have sperm producing ‘islands’ in their testicles, which may be identified by biopsy.”

He stated that the procedure of Pesa (percutaneous sperm aspiration) is done whereby a fine needle is inserted through the scrotum into the epididymis and sperm is obtained by gentle suction. After collection, he added, each sample is examined under a microscope to confirm the presence of sperm.

Under the Tesa (testicular sperm aspiration), a fine needle is inserted into the testis, and tissue sample are obtained by gentle suction and examined under the microscope. He said if no sperm is present; a small testicular biopsy is taken through a small incision in the scrotum and the testis. Immature sperm can then be extracted from the tissue and added that after the procedure, a firm scrotal support is recommended, as well as regular pain killers, like paracetamol.
“The surgically retrieved sperm are immature and not capable of fertilising by conventional means except by ICSI. This retrieval is usually done to coincide with the female partner’s egg collection,” Ajayi said.

He still fancies the IMSI as the latest advancement that could resolve male infertility with appreciable success stories using the procedure.

Nordica Centre celebrated its 10th anniversary recently and the managing director was asked his experience over the years? “We give thanks to God, who in the first place, is the creator of lives. It’s been rough practicing this genre of medicine here because of the obvious challenges of energy and other infrastructure, but we are happy we have assisted in making many lives. We have had over 1000 deliveries in our facilities and the babies are doing well with their parents. So, in all, we are happy doing what we are doing here because we complete families,” he said with a chuckle on his reclining chair.

More importantly, Ajayi said they opened up branches in Port Harcourt, Asaba and Abuja due to patients’ demand. He stated that the facility is faring well in all the branches and their ultimate objective is to complete families using available modern technologies.

He advised couples seeking conception to arm themselves very well with medical knowledge on the subject matter. He said with the appropriate information, they would be able to achieve their utmost desires of having babies of their own. He said with the assistance of technology, no woman could be barren, with a caveat though: “Beware where you seek help”.

FACTS FILE
First test tube baby born 25 July 1978
Over 5 million babies born since then
Over 1000 born at Nordica
Male-induced infertility on the rise
Couples should seek help early
60 per cent pregnancy rates with IMSI
IMSI has reduced miscarriages by 75 per cent