Fertility Procedures Explained:
Assisted reproductive technology or otherwise called ART is a form of technology that is used to help achieve pregnancy in such procedures as fertility medication and artificial insemination [(AI). It may also be called intra-uterine insemination —be it artificial insemination with husband’s sperm or artificial insemination with donor’s sperm], in vitro fertilization (IVF) and surrogacy. ART is a reproductive technology used essentially for infertility treatments.
THE HOSPITAL, via Julianah Akande Fertility Centre is proud to provide reproductive and fertility services to assist couples intending to have children achieve their cherished desires.
Fertility Treatment Involves:
Assessment. In pre-fertility treatment, patients will undergo thorough clinical assessment for intending couples and individuals. During assessment, our very courteous staff will provide reassuring environment whereby patients and clients can provide initial personal information to the assessing doctors and nurses. Such information will include, the person’s history and previous treatments, prior surgery, medical and other relevant information to assist the clinician. Further, the doctor will conduct relevant examinations. In case of the woman, such examination may include, assessment of the entire body and more specifically, areas affecting reproduction such as the thyroid, the abdomen, the uterus (womb) and as the case may be the ovaries. For men, focus of attention will be on the male’s reproductive tract except otherwise so indicated.
The next step will be investigations. Depending on the information that is gathered during the earlier step of history and examination along with evidence of prior tests done, the doctor may order a battery of investigations such as hormone profile and pelvic ultrasound. If appropriate, a hysterosalpingogram(HSG) may be requested. A hysterosalpingogram or HSG is an x-ray procedure for seeing if the fallopian tubes are patent (open). It’s also used to determine if the inside of the womb (uterine cavity) is normal. In the alternative, laparoscopy and dye test (L &DT) may be used to replace HSG. Note should be taken that (L &DT) is a minor surgical procedure that requires anaesthesia.
In men, the main initial test that is required is sperm analysis with culture. Further tests may be ordered by the infertility doctor if necessary.
Non-Surgical Procedure: Depending on the choice and clinical indications for further treatment, the fertility doctor may order medications alone to correct an underlying issue. In some instances, counselling of the couple or counselling of the individual may be all that is required.
Surgical Procedures: If counselling and or medication are not enough, surgery if appropriate, may be advised. Example: if fibroid in uterus is deemed to be interfering with conception in the woman, the doctor may advise its removal. If the fallopian tube is blocked, a surgical manoeuvre may be suggested to unblock it. Also, in men, if varicocele is the problem in the infertile man, a varicocelectomy type of surgery may be suggested. (A varicocele is when veins within the scrotum become enlarged inside scrotum (the bag of skin that holds testicles). Varicocele is said to be responsible up to 65% of infertility in men attending infertility treatment.
If despite the use of surgical and non-surgical means, pregnancy cannot be achieved naturally and depending on the cause, then the fertility doctor may advise any of the following:
Artificial Insemination (AI): Provided the Fallopian tube is opened and the woman is ovulating, AI may resolve the infertility issue. Sperms from the husband (if the sperm is of good quality) or donor as may be appropriate may be used. It may also be that there may not be a need for insemination. This can happen if ovulation is the problem. The fertility doctor may help stimulate the woman’s ovary to ovulate and the couple can have sexual intercourse on the day of calculated ovulation without the need for artificial insemination of sperm. Artificial insemination may also be used where there is painful or difficulty with sex or where the mucus at the neck of the womb is hostile to the man’s sperm.
IVF: IVF is indicated where there is blockage of the Fallopian tubes, severe difficulty with sex, and severe hostility to presence of sperm in the woman, poor ovulation, severe low sperm count and infertility of unknown cause or where there is difficulty in getting pregnant because of aging. There are several methods of IVF. These include direct in-vitro fertilization and embryo transfer, zygote intrafallopian transfer (ZIFT), GIFT or gamete intrafallopian transfer.
Additional Methods: To address the low sperm count or azoospermia (no sperm, not no semen) in men, there is TESSA (testicular sperm aspiration) which is one of the newer methods of treating male infertility. Such sperms may be used to achieve fertilization during the process of intracytoplasmic sperm injection (ICSI). A good sperm may also be selected during sperm ejaculation without resorting to TESSA.
Julianah Akande Fertility Center (JAF Centre)
Patients presenting at infertility centres may have endured a lot of humiliation, borne expensive investigations and have anxiety. Distressed, some may even be at the point of giving up trying to conceive.
At JAF Centre, we pride ourselves in helping to meet the needs of our clients.
Infertility causes a lot of pain and suffering. We understand that for a fact.
Our focus is to achieve result. We believe that with good results and client satisfaction, financial rewards and more patient referrals will follow. We put our customers first. We are open and thorough in our approach to problem solving.
In keeping with what we have explained above, our dedicated team provides:
Assessment: We undertake initial history and examination. If investigation is required, we will advise you accordingly.
Counselling: We make sure we direct you to the appropriate treatment or no treatment at all as may be suitable and appropriate in your situation. Counselling may be all you need to be pregnant.
Surgery: We provide surgical interventions as may be necessary. We work with urologists (to correct disorders in men). For women clients, our in-house gynaecologist will direct and perform the necessary operations.
IUI / AI: If your condition can be solved by AI, we will not advise you to try expensive IVF. We work with diligent laboratory staff to help navigate and select the most suitable donors and or select the most appropriate sperm that may lead to fertilization.
Sex Selection: Our embryologists are trained and have long years of experience. They will work through the sperms to help select the desirable gender.
IVF: In our IVF programme, we use different protocols to achieve our results. As may be necessary, we may use a combination of oral contraceptive pill to induce vaginal bleeding before we commence “downregulation” of the brain with gonadotrophin agonists or antagonists and then Follicle stimulating hormone. Depending on the patient needs and the time of the menstrual period that she presented, amongst these protocols that we may use are:
Short protocol: Starting on day 1-2 of the menstrual bleeding day: This may last from 10-14days before egg recovery and fertilization with partner’s/husband’s sperm or donor sperm as the case may be.
Long Protocol: Staring on Day 21 of the previous menstrual period, this may last even anything from 2-3weeks before egg recovery and fertilization.
Monitoring. We use a combination of blood tests as appropriate ( FSH, Estrogen, Progesterone, Luteinizing hormone to assess and monitor our patients) along with ultrasound scanning to monitor our client from time of assessment to time of confirmed pregnancy.
Egg Recovery: When we are certain that the follicles/eggs are sufficiently matured enough, we give an injection HCG (human chorionic gonadotrophin) 30-36hours before egg recovery in readiness for fertilization.
Embryo Transfer: After incubation of the fertilized egg for 3-5days, we transfer about 2-3 embryos into the carrier (genetic mother or surrogate).
Pregnancy test is done 14 days after the embryo transfer to confirm pregnancy.
After the embryo transfer we expect and hope for implantation of the embryo in the carrier. To help achieve successful pregnancy the carrier and pregnancy is supported with hormones.
Surrogacy: We work with reputable agencies that helps manage issues relating to surrogacy. Surrogacy, to quote, Human Fertilization and Embryology (UK), is when another woman carries and gives birth to a baby for the couple who want to have a child. We do not by our self arrange surrogates as this is going to be a contract between intending mother/parents and the carrier. If you wish to use a surrogate, we will direct you accordingly. However, we may help with the legal framework that is involved.
Gamete Donation: Where the individuals desiring a child for one reason or the other cannot produce an egg or sperm, we may help organize for egg or sperm donation. The donors will sign a contract and be thoroughly screened for certain diseases such as HIV, Sickle Cell Disease, hepatitis and so forth.
Fees: Our fees are reasonable, negotiable and competitive. Payment in local currency is acceptable.
For more information or to organize a visit, please contact us on +2348188343865, +2348073188087 or +2348108652639 or use our contact page to send us a message.