•Fertility experts contradict critics: It is a helping hand, not transaction
By Chioma Obinna
Infertility is one problem that affects large numbers of people and, according to a report by the World Health Organisation (W.H.O.), one in six people (17.5 per cent) are affected globally.
And the Director-General of W.H.O., Dr Tedros Adhanom Ghebreyesus, once said “Infertility does not discriminate”.
A disease of the male or female reproductive system for failing to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse, it can cause significant distress, stigma, and financial hardship, and affects mental and psychosocial well-being.
However, despite Nigeria parading one of the highest fertility rates in the world, the growing concern of increasing cases of infertility has birthed all sorts of abuse and illegal means to have a child.
From Maiduguri to Lagos and Port-Harcourt to Sokoto, baby factories boom and hundreds of fertility clinics are also smiling to the bank.
For instance, contrary to what is obtainable in the developed world where eggs are donated freely under strict regulations, in Nigeria, stories abound about young girls selling their eggs for as little as N50,000.
There are no regulations or standardised guidelines to control the booming sector.
There have been reported claims upon claims about how young girls are forced to sell their eggs for peanut.
Media reports abound on claims of egg selling by girls as young as 16 years of age.
A case in point is the claim made by an actress turned filmmaker, Ogeh Cynthia, about some fertility clinics in Nigeria and how young girls are cashing out from the booming business.
According to her, young women are selling their eggs to fertility clinics in Nigeria for as low as N20,000 to N50,000.
While it has become a common sight, findings by Sunday Vanguard reveal that some fertility clinics that are into illegal selling of eggs do it with uttermost secrecy.
“I was asked not to discuss it with anybody except a friend who will be willing to sell. I have done it two times now,” 20-year-old Celine told Sunday Vanguard.
According to her, she was promised a commission if she could bring eligible donors.
“I recommended two friends and I was paid N50,000. The first time you are brought into the clinic, you will be given a consent form to fill out.
“I was able to donate after three months, and it was quite an experience because it was a little scary and painful. But you know the money will compensate for the discomfort. I had to do it again,” she said without remorse.
However, in some cases, these young girls are coerced into donating.
For instance is the case of Ms. Precious Ikechukwu and Ms. Theresa Obam, ages 19 and 17 years old, who alleged that one of their church members took them for surgical egg retrieval in Lagos without their consent.
They also alleged that one Mrs Adeleke told them that they would be compensated with N80,000 if they provided their menstruation to the hospital and also threatened to kill them if they disclosed the information to anyone.
Also, recently, the House of Representatives mandated it’s Committee on Healthcare Services to commence a probe into the activities of fertility clinics in Nigeria following a motion moved by an All Progressives Congress, APC, lawmaker representing Ikorodu Federal Constituency, Babajimi Benson.
Benson alleged that some desperate Nigerian women are selling their eggs for as low as N100,000 to fertility clinics.
He said due to poor regulations, some clinics in Nigeria were taking advantage of these girls.
The House gave the Committee four weeks to investigate and present a report.
Helping hand
However, experts in the fertility industry have dismissed these allegations describing egg donation as a helping hand and not a transaction as human eggs are unquantifiable.
According to them, the egg retrieval process is simple and harmless if done by a qualified practitioner.
Multiple eggs are retrieved from the donor’s ovaries through a minor surgical procedure and then mixed with sperm in the laboratory to enable fertilisation and form embryos.
The procedure for egg retrieval is usually completed within 30 minutes.
Today, there have been claims of people harvesting eggs from young people, but, unfortunately, there is no standard law or policies to control the process.
investigation by Sunday Vanguard shows that although there is no regulation on egg donation, the National Health Act enacted in 2014 serves as the only legal framework governing egg donation in Nigeria.
Section 53 of the Act criminalises the exchange of human tissue and blood products for money, even allowing for a fine and/or up to a year’s imprisonment for those convicted.
As it is currently, health watchers have described the situation as financially coercive, hence the need for legal protection against the exploitation of these girls.
Regulations
Chelsea Polis of the Guttmacher Institute, a think-tank, estimate that 31 per cent of Nigerian couples fail to conceive a child after 12 months or more of regular sexual intercourse.
Findings also show that one in four Nigerian couples may require assisted reproductive technology (ART) but laws and policies are not in place to meet the growing demands.
However, concerns are mounting among Nigerians, including stakeholders, regarding the lack of regulations in egg donation.
They emphasize the urgent need for laws that protect all parties involved: Donors, recipients, and caregivers.
A clear legal framework is essential to define who can participate in these procedures, establish guidelines for ethical practice, and impose penalties for violations.
Stakeholders are particularly concerned about the vulnerability of young women, especially students, who may be financially disadvantaged and pressured into donating/selling eggs.
Eggs not sold – Experts
Speaking to Sunday Vanguard, a Consultant Obstetrician Gynaecologist and Fertility Specialist at George’s Memorial Medical Centre, Dr Faye Iketubosin, said that egg donation has revolutionised the treatment of older women who have depleted their egg reserves and there are guidelines for egg donors formulated by the Association for Fertility and Reproductive Health (AFRH) as well as the Fertility Support Practitioners Association.
Iketubosin stated: “There are guidelines for reimbursement of expenses donors undertake for participation in fertility treatments and donors are not paid for donating their eggs but they may be reimbursed for reasonable expenses incurred during the donation process, such as travel and medical check-ups”.
He said some younger women who have prematurely depleted their eggs have also benefited immensely from egg donation, adding that the treatments are very successful in Nigeria frequently exceeding 60 per cent.
Dismissing stories of indiscriminate sales of eggs, the expert said egg donors are recruited from registered donor agencies that can screen them and also by clinics that provide assisted conception treatments.
Iketubosin further explained that egg donation treatment is one of the options available to women with specific fertility challenges, saying women are not coerced into accepting any form of treatment as they enter into treatments after giving informed consent.
Debunking stories of selling and buying of eggs in a chat with Sunday Vanguard, the President of AFRH, Professor Preye Fiebai, said human eggs cannot be unquantifiable and cannot be sold.
Fiebai, who is also a Professor of Obstetrics and Gynaecology at the University of Port Harcourt and an Honorary Consultant to the University Teaching Hospital, maintained that the procedure is voluntary, done under normal circumstances and not that anybody is buying eggs.
“There have been a lot of stories about how they are collecting the eggs and selling them or exporting them abroad and stuff like that. This collecting of eggs is not like you just go in and you can easily get eggs from a person. The person who is going to bring those eggs will have to undergo stimulation with drugs, usually injections, for a period ranging from 10 to 14 days before you can collect these eggs.”
Describing the pre-operative screening and egg retrieval process of egg donation, he said the donors undergo medical assessment and blood tests to ensure they’re healthy and infection-free.
According to him, the donors are informed about the egg collection procedure and eggs are retrieved through the vagina using a needle after stimulation medication is complete.
The professor said it is a safe procedure done in a medical facility by qualified personnel.
Fiebai explained further that the procedure should not cause harm if it is done by a properly trained person.
“After the procedure, within 30 minutes, or as long as one hour, the person who is donating should be able to go and continue her life as a normal because she is not going to undergo embryo transfer, and the kind of drugs that are given should not put her at risk”, he said.
The professor however added that the only risk is that some people may over-respond to stimulation and, when that happens, the treatment should be discontinued.
“But that’s the whole essence of the monitoring.”
Frequency of donation
Continuing, Fiebai said there is no evidence that frequent donation harms healthy women, but it’s generally discouraged to donate more than three times in a lifetime.
“It only makes sense that one does not overdo something and, generally, we do not advise anybody who is donating eggs to do it more than three times in a lifetime, if you donate eggs three times you shouldn’t donate again and if you donate this month under normal circumstances you shouldn’t go back the next month and go and start donating again and then go back the following month”, he said.
“The body needs to recover a bit before the person considers donating again.
“Sometimes, the ladies who donate eggs are compensated for the time and inconvenience that they go through in carrying out the procedure. But in no way can anybody conclude that that is payment for eggs”..
According to him, if anyone should put a figure it should be in millions.
“It is unquantifiable. Just like saying you want to buy someone’s kidney. It is not what you can purchase. Of course, there is a black market and there are people who are doing other sorts of things”, the professor stated.
“But under normal circumstances, we should not be talking about selling. It’s not a simple thing.”
Legality of egg donation
Fiebai said it was not illegal to donate eggs, explaining that these eggs are used for other women who are not able to either produce eggs or for various reasons.
He said the National Health Act emphasises that organ and tissue donation should not be done for financial reasons but like a person can donate blood, kidneys, and parts of the body if it is going to benefit somebody else.
The professor said no law says a person cannot donate eggs.
Fiebai disclosed that Lagos is the only state in Nigeria that has guidelines that regulate the practice of ART and the donation of eggs is just one part of the whole spectrum of it.
He expressed hope that the National Assembly’s move to pass a Bill to regulate ART when passed into law, the country will now have national guidelines or national laws that would be implemented.
The professor also disclosed that the Federal Ministry of Health is also working on guidelines for tissue and organ donation, and it also includes eggs and other things.
Also, in a chat with Sunday Vanguard, Chairman & Chief Medical Director, Medical ART Centre and President of the Academy of Medicine Specialties of Nigeria, Prof Oladapo Ashiru, said according to stipulated rules, donors must be over 21 – 34 years old, willing, and motivated to help infertile couples.
Ashiru said selling eggs is illegal, but donation is ethical and compensated.
The professor, who is also the Secretary-General of the International Federation of Fertility Societies and foundation President of the African Federation of Fertility Societies, explained that in countries like America, people who are in university who cannot pay their tuition donate eggs to pay their fees and it varies from university to university.
“Egg donations in a country like America, we are talking about $8000 for the person, of course, egg donation in somewhere like North Africa, we are talking between 100 to 200. It varies, as long as the two parties are satisfied with what they are getting”, he said.
Ashiru warned against women donating more than three times as it could lead to scar tissue on the ovaries.
According to him, people should not for any reason attempt to donate more than three times in their lifetime.
“With three egg donations, you will be giving about 15 to 20 eggs at each attempt making it a total of 60 eggs out of the 500 eggs you are going to produce and that is an indication that it is enough”, Ashiru said.
He warned that unlike men who can produce sperm all through lifetime, women are born with 400 to 500 eggs and these eggs decline as they get older.
The professor, who further called for increased access to fertility treatment, disclosed that fertility was declining all over the world and, by 2060, countries would find it difficult to replace their ageing population.
“IVF is one of the tools that enable everybody to have access to fertility by giving infertility treatments”, Ashiru explained.
“Of course, some of these patients can no longer produce eggs anymore for various reasons.
“And because egg production declines with age, by the time somebody is in her age 40, the eggs have declined and by the time you are 45, there is virtually little or no egg. “We want to provide them with donor eggs but it is not an easy thing. It is a difficult thing to do but they want to go through it.”
Concerns
While egg donation offers hope for infertile couples, the lack of regulations in Nigeria raises concerns about exploitation. Establishing clear guidelines will ensure the safety and well-being of both donors and recipients, stakeholders advised. (Vanguard Report0
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