By Jemi Ekunkunbor
Fertility specialist, Dr. Abayomi Ajayi is a Consultant Obstetrician and Gynaecologist. The Managing Director, Nordica Fertility Centre, has through his clinic, pioneered the Intracytoplasmic Morphologically Selected Injection (IMSI) in Nigeria.
In this encounter at his Ikoyi clinic, he talks about the nagging issue of rise in male fertility and states what role the religion can play in the treatment of infertility.
We have noticed in recent times that the population of infertile men is on the rise. What could be responsible for this shift?
Increasing rate of infertility in men is a world wide thing now. We really don’t know why it is so. There are so many factors we are looking at. We are looking at the environment, we are looking at genetic factors, but people are saying that the problem is more in the environment because the environment is becoming more and more estrogenized. Industrialisation is producing all kinds of harmful gasses, etc. We are doing all kinds of things and it’s affecting the man. There was a study done in Denmark and it was shown that over 40% of their men don’t have good sperm quality. So the situation is becoming an epidemic. It seems men are going into extinction.
What treatment does your clinic offer?
The latest technology that is available in the world is available here. We are doing a lot of things that many other clinics are not doing in the treatment of male infertility. Everybody does what we call ICSI (intra cytoplasmic sperm injection). We not only do this, we also do IMSI (intracytoplasmic morphologically selected sperm injection), and PICSI (physiological ICSI).
In the past, we believed that the egg is the most important thing that determines the quality of the embryo. But we now know that the quality of the sperm, contributes 20-40% to the quality of the embryo. Don’t forget that all the doctor can do is get embryos. We can’t get babies. So the thing for the doctor is to be able to get an embryo that is able to become a baby. And because now, we are able to know the genes of the baby, we can tell you which embryo that can become a baby and which one that cannot become a baby; because we now know also that about 70-75% of embryos produced in labs all over the world cannot become a baby because God is still God. He has made it in such a way that normally, a woman should not give you more than one or two eggs every month, but because we use drugs, we can get 15-20. About 70% of that cannot become babies!
Do you have stigma issues with parents whose babies came through IVF?
Yes, but not as strong as it used to be because, people are now seeing more babies born through IVF. So, now they see them as normal babies that they are. It was so bad before that people who had babies through IVF, when they see you in a super-market, they just avoid you so that people won’t see them with you. Today, we now have mothers who can stand in front of the camera and tell you they had their babies through IVF.
What can men and women do in advance if you feel that time is running out?
You can freeze your eggs because we know that fertility decreases with age, and so does the quality and quantity of the eggs. So if Mr. Right is not forthcoming, take the man on the left and put him on the right until you get Mr Right.
For men, they continue to produce sperm for a very long time though the quality decreases after 45, and the chances of congenital abnormality like dawn syndrome increases. And that is why, we are doing some of the things that we are doing now because we now know that your DNA fragmentation increases when you are over 45 which leads to miscarriages and all those kinds of things. We can screen for that when a man is advancing in age. So for the man, and with technology, as long as he produces sperm, he can continue to have babies.
Some people do not subscribe to what you do because of their religious views. What is the place of religion in medicine and how can one complement the other.
The two can work together but each should just know their limits. Where I think religion comes in, is in a situation where a a man is losing hope, There is nothing you can do for a man whose hope is gone, and that is where religion comes in to give hope. Religion should not try to treat. Let medicine do its own work and religion keeps the man’s hope alive, and then, the two can work together. There is nothing that you do that you don’t need to pray even if you are using medicine, you need prayer. You use your medicine and then pray.
What would a woman who feels time is running out on her do when medicine is offering her an opportunity to have a child without committing fornication which the church frowns at? How can religion and medicine work together in this kind of situation?
What I believe is that each person has the responsibility to take decisions that will affect his or her life. As a Christian, I am not one for single parenthood but reality is telling me that there is single parenthood; a woman doesn’t have a husband, she has a good job, if she was wants treatment, that is fantastic! I give her because I know what that will do to her psyche. They say health is not only the absence of diseases, but, a state of well being psychological, financial, spiritual etc. So for that woman to be well and healthy, you need to give her what she needs as long as her peace is not disturbing another person’s peace.
What service is currently trending in your clinic?
It is the PGD (pre-implantation genetic diagnosis) that I mentioned before. That is what we are developing now because this is rather new in the world. Again we just went from day three biopsy to day 5 biopsy which is the latest in the world. That is where we are really concentrating on in the last couple of months.
Is there any government policy in place that can hinder a patient from determining the sex he or she wants?
No we do not have any such policy not when the patient is paying from her pocket.