…Says it can be done at any age if egg donation is considered

By Chioma Obinna

Infertility, according to the World Health Organisation, WHO,  is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. It  affects millions of people worldwide.

The WHO estimates suggest that between 48 million couples and 186 million individuals live with infertility globally.  Thanks to the advancement in medical science which has brought about other ways of achieving pregnancy and ensuring that couples fulfil their dreams of having babies.

While infertility may be caused by a range of abnormalities of the ovaries, uterus, fallopian tubes, and the endocrine system, among others in females, fertility care encompasses the prevention, diagnosis and treatment of infertility.

However, Invitro fertilisation, IVF remains one of  the major techniques that have ensured access to fertility care  for couples in countries like Nigeria where it remains a challenge.

Good Health Weekly spoke to  a renowned embryologist, Ms. Pamela Bazi, on  IVF  multilple births possibilities and challenges among others.

Bazi who is currently the embryologist with the One Wellness Centre, Lagos explained the rationale behind multiple births from Invitro Fertilisation, IVF, saying that, the process itself, does not necessarily lead to multiple births but the transfer of multiple embryos.

Bazi explained that although multiple births are common in those undergoing IVF, the process does not necessarily lead to multiple births but due to multiple transfers of embryos.

Bazi insisted that it could be prevented with single embryo transfer.

Giving more details on the IVF processes, she explained: “It is possible to do IVF at any age if we are considering doing egg donation. Although, we should shed the light on IVF success rate and egg quality. Research has shown that the IVF success rate is related to women’s age. That’s because women’s fertility declines with age.

“We are born with all the eggs we will ever have. During the course of life, this egg supply will inevitably decrease in numbers and quality drastically after the age of 40. Before the age of 35, the eggs of the women are high-quality in addition to their quantity. “These eggs are more competent for fertilisation and embryo development. As women age, the quality and quantity typically decline to make it more difficult but not impossible to achieve a successful pregnancy.”

Ethical

consideration

Continuing on ethical considerations working with embryos and fertility treatments, she said there was a need to respect patient privacy and confidentiality, informed consent, respect for human tissue as well as human life, avoiding harm to the gametes or embryos and responsibility.

Success rates

“IVF can be an effective way for any couple to achieve pregnancy, but success rates can vary widely depending on several factors. One of the most important factors is a woman’s age.

“Women under the age of 35 have the highest success rates because they produce high-quality eggs that are capable of developing into healthy embryos after fertilisation.”

She listed other factors that can impact success rates including the quality of embryos transferred and the complexity of the condition causing infertility.

“To note that the choice of the fertility clinic affects the success rate because it differs from one clinic to another depending on the experience of physicians and the equipment in the embryology laboratory,” Bazi added.

Fertility and cancer

Speaking on the link between fertility and cancer, she said: “In recent years, there have been many debates about the relationship between fertility medication and cancer. But as we all say “break the doubt with certainty”. Studies have shown that the risk of cancer will not increase after fertility treatment.

“It is important to note that patients should discuss their cases with their physicians including the medical history before starting the stimulation, to set up a protocol (dose of fertility drug used and duration) based on the case.”

Challenges

On the importance of an embryologist, Bazi traced some challenges faced by the embryologist to include a high-pressure work environment by working with delicate and precious biological materials as well as advanced equipment, time efficient work as the embryologist must work quickly and accurately at the same time while managing the time-sensitive procedures.

“In addition, he/she must maintain a balance between professionalism and empathy particularly when he is dealing with infertility patients.”

Fulfilment

as an embryologist

Continuing, Bazi added that the most fascinating aspect of being an embryologist is the opportunity to explore how life begins and monitor embryonic development as I’ve never been bored by watching embryos on daily basis. In addition, the fact of helping couples struggling to conceive is satisfactory.

Embryology

field outside Nigeria and in Nigeria

She said: “In fact, infertility is increasing worldwide but the unusual habit here in Nigeria is that women consider going to a fertility specialist and seeking help late in their 40s, the same goes for Nigerian couples knowing that environmental and lifestyle factors here in Nigeria are inconvenient for gametes quality.

Important

factors for couples

“Bazi explained said: “Fertility treatment is overwhelming for the couple. One of the most crucial decisions for them is which fertility clinic to choose. Honestly, many factors they should take into consideration: the fertility physician’s educational/professional background, the equipment of the embryology laboratory (micromanipulator, incubator), the quality of the team, and the environment of the clinic. All of these criteria play a role in building a trusted couple-doctor relationship and making their journey easier.

Role of genetic testing

She said: “Preimplantation genetic testing (PGT) is a technique used to screen embryos for genetic abnormalities before transferring embryos in the uterus during in vitro fertilisation. There are many types of PGT, but the main role of PGT is to avoid the transmission of genetic disorders to the embryos; subsequently, it increases the chance of implantation by transferring genetically normal embryos. Furthermore, PGT can be used to select embryos for certain characteristics such as gender.

Considering using a donor egg or sperm

“As an embryologist, dealing with couples and gametes donors is part of my job. It requires professionalism and respect for confidentiality. Other than that, a consent document should always be signed after explaining the process in detail and being available for their ambiguities and emotional support.

Emotional aspect of working with patients

Working as an embryologist can involve a range of emotional experiences including dealing with the grief and disappointment of patients as well as the joy of successful pregnancies. Managing the emotional aspect of my work requires a combination of emotional resilience by developing a positive mindset despite all the stress and maintaining professional boundaries at the same time by being compassionate with patients.

The field of embryology is constantly evolving, and embryologists must stay up to date with the latest research and technologies. Education and training are critical for a skilled and qualified embryologist to maintain success and satisfy patients’ expectations.

Safety and accuracy of laboratory procedures

Ensuring the accuracy of my procedures is crucial for obtaining reliable results and providing the best service for our patients.

Standard Operating Procedures (SOPs) are the basic guidelines which can help to ensure the consistency and accuracy of procedures. In addition, quality control is essential by regularly monitoring the equipment, temperature and humidity and ensuring the use of quality reagents using a pH meter and gas meter.