Society of Gynaecology and Obstetrics of Nigeria, and the Association for Fertility and Reproductive Health have raised concerns over the proliferation of fertility clinics by unregistered practitioners.
They noted that such can inflict irreversible damage on women, especially the elderly who might fall victim.
Recent findings by PUNCH Healthwise showed that due to increased demand for assisted reproductive techniques by persons who desire to have children, fertility clinics are springing up in cities at an alarming rate.
However, leaders of the association, in separate interviews with PUNCH Healthwise, warned that people visiting unlicensed fertility doctors stand the risk of medical complications, financial exploitation, permanent infertility, and even death.
Although a report by the World Bank stated that the fertility rate in Nigeria stands at about 5.4 births per woman in 2018, indicating a high fertility rate, newer studies and reports have shown an increase in infertility rates.
For instance, the World Health Organisation in 2023 stated that about 17.5 per cent of the adult population, representing one in six people, worldwide experience infertility.
The Centres for Disease Control and Prevention also warned that globally, the infertility rate is on the rise.
The CDC defined infertility as the inability to conceive after one year of unprotected sex.
Additionally, according to the Nigeria Demographic and Health Survey conducted in 2018, about 25 per cent of married women in Nigeria are experiencing primary infertility, while 16 per cent are experiencing secondary infertility.
The report noted that these figures highlight the significant prevalence of infertility issues in Nigeria.
However, infertility can be treated with medicine, surgery, intrauterine insemination or assisted reproductive technology, experts say.
The CDC further stated that ART includes all fertility treatments in which either eggs or embryos are handled outside the body, with In vitro fertilization being the main type of ART.
A study, “Unmet need for Assisted Reproductive Technology in Nigerian Tertiary Hospitals, by Nnagbo Johnpaul et al, shed light on an increased demand for IVF services globally and an increasing trend in the demand for such services in Nigeria.
PUNCH Healthwise reports that due to this high demand, many fertility clinics and quacks have proliferated in Nigeria with bogus claims of having the ability to make women get pregnant with ease.
A study by Ijeoma Ezeoma et al on the ‘Perception of Key Ethical Issues in Assisted Reproductive Technology by Providers and Clients in Nigeria’ reports that ART is a highly complex technology that requires experience and should not be done by non-experts and ill-equipped practitioners.
It further noted that IVF providers practice sex selection and multiple embryo transfers leading to multiple pregnancies.
As a result, SOGON and AFRH warned against unethical practices and called for government regulation and ethical guidelines for the practice.
Speaking with PUNCH Healthwise, The second Vice President, Society of Gynaecology and Obstetrics of Nigeria, Prof Chris Aimakhu, condemned the proliferation of fertility clinics by unlicensed practitioners.
He further decried the increasing exploitation of persons with infertility issues seeking a cure through ART.
The don revealed that more than 50 per cent of IVF centres are not run by gynaecologists but by embryologists.
He said, “Are these things being done by medical practitioners, some of them, yes but some of them, no. More than 50 per cent of IVF centres are not run by gynaecologists. The people who do the work are embryologists, who bring the egg and sperm together. However, there are not many embryologists, so they go from one hospital to the other.
“Not many people who do these techniques received training for them. Some just went to India, spent one or two weeks there, got the certification, returned to the country and started doing things, and that is why there is a need for standardisation of the practice.
“Lagos State SOGON, together with the AFRH has an ethical guideline for all these techniques.”
Aimakhu reiterated the need for a national regulation to curb the proliferation of IVF clinics.
He added, “We need a lot of regulations, we have talked about it in SOGON and AFRH and we are bringing out guidelines on many of these things. But these guidelines are for the doctors and obstetricians in particular because patients don’t get to know about the guidelines.”
Aimakhu also noted that older women seeking children are mostly victims of exploitation by the quacks.
He explained, “A few women who visit the quacks get pregnant. Some who are aged, carry multiple children because so many eggs were transferred. However, the problem comes when this is done for elderly women.
“What do you do when you put a new engine in an old car? It may work, it may not! So a lot of people, who undergo this technique, especially in their advanced age, may not be able to carry the pregnancy to term because of old age sicknesses and other underlying illnesses that can lead to complications. Babies of pregnant older women tend to have congenital malformations and genetic problems.”
On his part, the President, Association for Fertility and Reproductive Health, Professor Preye Fiebai, said women receiving assisted reproductive care from quacks stand the risk of having complications, financial exploitation and death.
“Death can result from inappropriate treatment by quacks. Many complications can result from drug therapy and surgery. Fertility may be permanently compromised from such complications,” he warned.
The don advised individuals who desire to have children to be proactive and preserve their fertility before the commencement of reproductive endeavours.
The AFRH president counselled adolescents and young adults on the need to embrace healthy lifestyles and practices that would promote good reproductive health.
He said, “Couples who are unable to conceive after one year of regular unprotected sexual intercourse are considered to be subfertile and should seek care from a qualified medical practitioner.
“Couples who are advanced in age (Women above 35 years) need to be attended to with more urgency and would benefit from seeking care from a qualified gynaecologist.
“Couples who need advanced treatment would need to visit a certified fertility specialist.”
He maintained that fertility experts must first be qualified obstetricians and gynaecologists.
Fiebai said the regulation of hospitals and health facilities, including fertility clinics is the responsibility of the state ministries of health but that only Lagos State has a regulation for ART practice.
He pointed out that the AFRH has practice guidelines its members are expected to adhere to and still self-regulate the practice of its members.
The don revealed that the West African College of Surgeons and National Postgraduate Medical College of Nigeria issue certificates to those who have advanced training in infertility and assisted reproductive technology.
He urged couples seeking ART to check for the AFRH certification issued to AFRH-registered clinics.
The fertility specialist, however, urged state governments to regulate the practice of ART and also monitor the activities of fertility clinics and professionals in their domain.
“The National Assembly had proposed a bill to regulate ART in the past and it got past the second reading to a Public Hearing in 2023. It was, however, defective and will hopefully, be revised and re-presented. “AFRH was mandated to work with the Federal Ministry of Health and other stakeholders to fine-tune the bill. We are currently working on it. The National Health Act of 2014 is a regulatory document on all aspects of health including fertility medicine.” Fiebai added.
