Dr. Michael Ogunkoya, MD, The Hope Valley Fertility Clinic |
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Saturday 27 October 2018
ANY WOMAN WHO GETS PREGNANT AT THE AGE OF 42 IS MOSTLY THROUGH IVF, SAYS DR. MICHAEL OGUNKOYA, WHILE SPEAKING ON SEX SELECTION: BETWEEN DESIRE AND NECESSITY
“GOD gave us choice so we have the right to choose!”
Henrietta was
telling John, her husband why they needed to have a girl third time around. The
couple already had two boys, Kenneth and Kevin who were 5 and 3 respectively.
Now Henrietta was pregnant again and her belief was that baby No. 3 should be a
girl. But John was being more practical. “Let’s not tempt God. It doesn’t matter whether this child turns out to
be a boy or girl. If God wanted us to be choosing, He would have asked Adam and
Eve to choose,” he
argued.
According to John, God didn’t give Adam and Eve
choice for their children’s gender, rather, in His wisdom, He gave them Cain
and Abel, both boys. We should be thankful that we even have children that are
healthy and normal. Children are the same after all. But Henrietta would have
none of that. “Children
are not the same because there are boys and there are girls. They are different
and we should have both. We already have two sons and that is enough. I want a
daughter and I am willing to do whatever is necessary to get one,” she said with
finality.
The argument continued. The Abahs had a similar
challenge. Like every other couple in this part of the world, Josephine and Joseph Abah looked forward to having children with a balanced
gender bias. Eleven months after their wedding vows, their first child arrived.
It was a boy. Their joy knew no bounds, more so when they live in a parochial
society where male children are given preference. But this joy was short lived.
Few months later, it was discovered that the baby boy had Haemophilia, an
abnormal blood clotting condition more common in males. The Abahs were
devastated.
They tried again for the second child. The second
baby also turned out to be a boy. Alas, he also came down with the same disease
condition. Neither Josephine nor Joseph could explain their predicament. The
search for treatment began. During one hospital visit, they met a doctor who
explained more about the condition and possible treatment. They were told the
disease is sex-linked and prevalent in the family, and that a way out is to try
sex selection principles through assisted reproduction to reduce chances of
having another male child with such condition.
Josephine said, “It dawned on us that even though we are capable of
making children naturally, we can only have healthier children through In-Vitro
Fertilisation, IVF. We went to a very good fertility treatment centre in Lagos.
We did it and we were able to select the preferred sex for our baby.” However,
gender balancing or gender selection has remained an issue, especially in
Nigeria. Many homes have been broken but with the advent of science of gender
selection many homes will be saved. The Hope Valley Fertility Clinic is a major
player in the technique. Thanks to the technique, Josphine now has a baby girl.
Toyin Odoh also
benefited from the wonders of IVF. Diagnosed with Turner ’s syndrome, a
condition that results from a missing or incomplete sex chromosome. For Toyin
and her hubby, Ben, it was like there was not going to be normal children. After two years
of unsuccessful attempts, they turned to fertility clinics. Although, they were
in London, Toyin returned to Nigeria for treatment. The couple’s testimony was
moving.
“I was diagnosed with Turner syndrome and this means
I cannot conceive normally. We have been married for two years and we wish to
have our own children. At first, I read an interview of Dr. Michael Ogunkoya of The Hope Valley Fertility Clinic, Lekki,
Lagos. I called him from London, explained my condition and he invited me over.
I came to Nigeria in April 2009 and he placed me on medication for IVF and one
month later to God’s glory, it was successful. After all my treatments abroad,
it was at The Hope Valley Fertility Clinic, I was treated and conceived. I
thank God for putting smiles in my home and family,” she noted.
Sex selection fact
and myth
A Consultant Gynaecologist & Fertility
Specialist, Dr. Michael Ogunkoya, who
successfully handled the cases enumerated above gave insight into the many
issues surrounding sex selection, as well as increased reports on male
infertility and why multiple births are occurring in older women. An
experienced physician of international and local standing, he explained: “Sex selection
has always been on the agenda for many homes in Africa before now. Even the old
Chinese believed that the male sperm comes from left testis. There have been
other efforts around the world to influence sex of babies. In Nigeria for
instance, some people believe that if some people use some back of trees or
leaves they will have male children.”
Dr. Ogunkoya, who stressed that there have been so
many tales and myths that are completely not true about sex selection, said: “Sex selection
is not all about balancing sex rather the main aim of sex selection is to
reduce and prevent abnormalities.” The
fertility specialist who stated that many IVF babies have been delivered at The
Hope Valley Fertility Clinics said
sex selection has also been successfully achieved. “Apart
from gender balancing, there are other reasons, one of such is to avoid sex
link disorders that are prevalence in some families like colour blindness,
haemophilia and acute haemophilia. Sex selection allows such families who are
prevalent to such disease conditions to decide the gender that suits their
family. Like in the case of Josephine, the couple was able to decide
whether to have a male child or a female child,” he said.
Sperm sorting
Dr. Ogunkoya noted that the only clinically proven
method of sex selection was the MicroSort Sperm Sorting Theory. “The MicroSort
principle is a clinical technique used to sort and separate the two different
types of sperm, X and Y, that is the female and the male sperm. Once the sperm
is sorted out, it can be artificially inseminated (IUI). In this case you,
would need the sperm sorting to be done on the day of ovulation.”
Although it said that sperm cannot be sorted into
the two types 100 per cent accurately, clinical examination has shown success
rates for girls is 90 per cent while male chances of success fall around 75 per
cent. According to him, “For a Nigerian couple that needs the procedure, we are living in a
parochial society where there are much desire for male children. Here, if
somebody has good sperm and wants a male child we collect sperm from him and
freeze it and send to MicroSort abroad in a special container and when it gets
there, they separate the male sperm and female. So separation has always been
on our agenda but it attracts extra cost.”
Explaining how the separation is done he said: “The principle
of MicroSort is based on the fact that the female sperm has a bigger DNA and
attracts more dye to the DNA, when you now put the sperm on a conveyor belt, on
either side you will now put an anti- dye which will now attract DNA. The anti-dye
will therefore attract the sperm that has more dye to the female sperm to the
side. So female sperm tends to aggregates more to the side of the conveyor belt
while the male sperm remains at the centre. The sperm has a head, neck and a
tail. This head is where the DNA is. The female sperm DNA is fatter, and sluggish
in movement, and because the female sperm is fatter the DNA is more and that of
the male sperm is slimmer but faster.”
Male sperm vs
female sperm
“When the sperm is poured on the conveyor belt, and
the anti-dye, on either side, you put an anti-dye; the dye will stain the head
of the DNA because the DNA attracts the dye. So the head of the female will
attract more dye because it is a bigger DNA. The sperm is moving along the
conveyor belt and the anti-dye both sides will sort of, attract the dye like a
magnet and iron. If you put a magnet here and an iron is moving there, it will
attract the iron because the magnet is there. If you put the sperm with the dye
on their head and an anti-dye on the same axis, but all along the conveyor
belt, you find more dye by the side than the centre. And because of the dye on
the head of the sperm, it will attract more dye.
“At the edge of the conveyor belt you find more
female sperm at the periphery while the anti-dye is at the centre where you
find the male sperm. They have used the mere fact that the male sperm contained
less DNA and less dye than the female sperm which contained more DNA and more
dye in separating them since the anti-dye attract and the female sperm to the
side. So the principle is therefore separating the female sperm and male sperm.
At a distance, you discover that many of the sperm at the side will be female
and many of the sperm at the centre will be male. And it is the only objective
demonstrating method of sex selection known. It is still under research. It is
still not available. So for some reasons when you separate such sperms, the
person who wants female will take and the person who also wants the female will
use the female”
However, due to extra costs, most clients opt for
another method of sex selection which is a bit more scientific. “It is the
fact that some people make love around the time of their ovulation. This
involves timing of intercourse. The idea is based on the fact that female sperm
are larger and slower and Male sperm is faster but more fragile. So a few days
before ovulation favours the larger but slower female sperm while sex at the
time of ovulation favours the faster male sperm.” However, Dr. Ogunkoya counseled that this method
requires careful counting and ovulation testing to determine exactly when the
ovulation will occur. The fertility expert who noted that the recipe for
success is not just simple but a combination of so many factors which includes
diligence, hard work and transparency to patients emphasized on factors such as
regular updating of equipment, training and retraining of staff.
Desire for male
children
According to Dr. Ogunkoya, “There is more
desire for male babies, but statistically most IVF babies tend to be male a
ratio of about 8 to 2 or 4 to 1. We cannot tell you precisely the basis for
that. In our practice, we have sort of noted that there must be a factor within
the concept of Assisted Reproduction which imposes that. We are yet to find out
the science behind it. Somehow, the process of IVF relies on the fact that
sperm should be able to fertilise the egg to make embryo. It is usually that
the sperm that is moving faster to get to the eggs should make the embryo. We
still don’t know. A lot of efforts have to be put into it. May be we should
start marking sperm to know which one makes the embryo. It is also possible to
actively influence sex by selecting them”
Explaining the advent of multiple births in old
women, he notes; “During
the process of IVF we normally transfer more than three embryos back to the
woman’s womb although these days, you only need to transfer less than three
embryos. In some cases one and the idea is that most European communities
rather not have multiple pregnancies and deliveries because of the social preferences.
In Africa, we like multiple births and in fact we celebrate them. The tendency
therefore is that if you go to such countries today, if you have 10 embryos,
the highest they can transfer is two. And if you probably have twins before and
you do IVF again, and the eggs are beautiful, they will probably transfer only
one egg. There is the advocacy for two embryo transfer or one in some
countries. But in Nigeria we still transfer up four embryos for reasons that we
welcome triplets. If the three or four embryos are implanted properly that may
result to triplets or quadruplets. So there is propondence of multiple births
in Assisted Reproduction than in non-assisted births.”
Male infertility
“Yes as a woman gets older, the eggs become older as
in fewer quality and quantity because as she gets older at age 13, the eggs
that are being released are of a better quality than the eggs later in life.
That is the law of natural selection. But to a man is the same but that of a
man is to a lesser extent because the sperm of a man of 20 years is definitely
better than that of a man of 30 years. As a man’s age advances, the sperm gets
poorer. It is easy to say that more men are getting problems of infertility but
all is enough awareness. The apparent increase of male problems is created out
of increase awareness. If there is any increase at all, it could be traced to
environmental problems and nutrition. Increase awareness, a lot of people now
know where to go for their problems, there is no true increase in male infertility
it is increase in awareness. Women are now being encouraged to come forward and
the women are also being encouraged to bring their husbands along for necessary
tests.
Multiple births
In
Africa people do not talk about their pregnancy and a lot of people do not talk
about achieving pregnancy through IVF. They prefer to keep it secret. Anybody
who gets pregnant at the age of 42 is mostly through IVF but I am not saying
that at 42 women cannot get pregnant on their own. But in reality, after age
45, it is really difficult for women to get pregnant on their own apart from
assisted reproductive system. If they introduce two to three eggs and most
times the result came out to be multiple births and for somebody at that age,
will want to have three or more children at a time and forget about having
more.
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