Within the last three decades or so, there has been a revolution in bringing laughter to infertile couples or to those with challenges in their reproductive health. The beginning of this change was in Scotland in 1978 when Dr. Patrick Steptoe and Dr. Robert Edwards pioneered the technique to conduct fertilisation outside the human body and within a test-tube until it is sufficiently mature within several days for re-implantation in the womb of a woman. This was a dream come through for so many and even though its availability has been democratised over the following 30 years with the procedure becoming common-place even in many Third World countries, the cost has remained astronomical and beyond the reach of the poor couples in many countries. Even worse is the fact that many couples have never even heard of the procedure. The first child delivered by this technique is now a mother herself. In recognition of the pioneering efforts of those medical researchers, Dr. Robert Edwards was awarded the Nobel Prize for medicine in 2010 but Patrick Steptoe, who had also pioneered laparoscopic techniques in the operating room, had died in 1988 and was not therefore eligible to share in the glory. In Nigeria, as in many other nations in the Third World, there is a huge gap between the haves and the have-nots to the extent that only the very rich and those who earn above average incomes are able to fund this procedure. At home, however, the challenges are the same. Newly weds are usually the focus of family discussion with the emphasis laid on getting pregnant as soon as possible after the wedding. In some families, marriage is not consummated until the bride is pregnant. In addition, the woman becomes the butt of jokes in the household with some in-laws even taking it out violently against the new wife. Some women are simply ignored and brand new wives married in their place. The pressure is immense and some have been known to take desperate measures in order to remain in their matrimonial homes. Some years ago, as a medical officer in a private hospital, one young woman confided in me that she allowed an old boyfriend of hers sleep with her with a view to getting pregnant. Her scheme succeeded and she had a baby boy. The husband was jubilant without realising what had transpired. The previously hostile in-laws were none the wiser and everyone essentially congratulated one another for a successful pregnancy and safe delivery. Several years later, she had another son from the legitimate husband and later emigrated to another country. This may now be a potential problem because they emigrated to a country where this disparity could be unearthed should the first son take seriously ill. It leaves me with sadness whenever I remember it. I was still to have another encounter of a bizarre kind. There was the case of another woman at the same hospital. For over five days, she repeatedly complained about lower abdominal pain, fever, a loss of appetite and profound weakness. A pelvic examination revealed a small rat in her vagina in an advanced stage of decomposition! This was inserted in her body by a traditional practitioner. She was admitted based on this finding and she battled for her life for over 15 days or so. She survived but the resulting genital damage was such that she would need a miracle to get pregnant. This is a shocking story and it is not made up. But this is our way Elsewhere on the planet, other people are, of course, more creative with their options and therefore more enterprising. Women who are incapable of child bearing for reasons of age or health are embracing the option of surrogacy. For cultural reasons, our womenfolk see this as a taboo. Others are even hostile to the idea. In spite of it all, they bare the brunt of the attacks within the family, often with associated cruelty. Even where all the omens are favourable, the treatment options employing the various assisted reproduction techniques are generally beyond the financial capacity of the poor. They have no place in the scheme of things and are not even reckoned with or remembered by the various providers. Yet, they also have significant challenges with fertility. It is a genuine problem and it requires a solution. And as we saw with the scourge of malaria two weeks ago, the solution to our own problems always seems to come from other nations, other continents even. Potentially beneficial help seems to be on its way this time from Europe and with the new, cheaper procedure for making eggs available for harvesting and fertilisation, the cost of in vitro fertilisation techniques could crash from about $6,000 to $10,000 depending on where the treatment is being obtained to as little as $265. In Naira terms, that is a reduction from N900,000 to N1.5 million to as little as N42,000. The difference is huge and there is sense in encouraging them by saying that help is on the way. It is a real problem, driving many women into unethical behaviour and even tragedy. Some end up in mental homes and yet others further damage their health while seeking ill-advised therapies based on their level of education and financial strength. Serious public education efforts are required to turn our populace away from harmful practices. As interest continues to grow in improving child and maternal mortality figures, this is perhaps the best possible time to also focus on aspects of reproductive health in ways they have not been discussed before. It is also the time to assure this segment of the population that all hope is not lost. As for those who have given up hope on their marriage or even walked away from it all, life can surely become better. It is only a matter of time and it is my hope that it will not be too late for many who nurse the hope of being joyful mothers. It is not only women who are at fault however, men also play some sad roles in these encounters. I do recall another couple who I was privileged to treat from time to time that had a similar challenge. We discussed the possibility of assisted reproduction using donor semen. The man’s reaction was ballistic; he would not hear of it. He termed the product of such an effort a bastard and other unprintable adjectives. He stopped attending the hospital altogether and within three years, the marriage grounded to a halt. He could simply not reconcile himself to the news from the laboratory that he could not father a child. Such is the tragedy of the present status of many of our countrymen and women. posted on August 25, 2013 at 12:00AM jtnng.blogspot/
Posted on: Sat, 24 Aug 2013 23:14:50 +0000
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