CREATING FAMILIES

Nigeria 2019 | HEALTH | FOCUS: REPRODUCTIVE MEDICINE

Nigeria's population growth is booming, but as in all countries, a significant number of couples are unable to conceive, creating a growing market for fertility clinics.

Nigeria is home to one of the fastest-growing populations in the world. By 2050, UN projections estimate the number of Nigerians to double to about 400 million, making it the third-most populous country behind India and China. Yet, the high birth rate does not mean the country is free of common infertility issues, which continue to prevent couples from starting families.

Slightly above global averages, between 25 and 31% of Nigerian couples face difficulty in conceiving after 12 months of unprotected sex, the standard definition of infertility used by world health organizations. While the average Nigerian woman gives birth to five-fix children in her lifetime, and societal norms place a high value on a woman's ability to reproduce, naturally occurring infertility problems are increasing demand for assisted reproductive technologies (ART), creating a growing domestic market for fertility clinics.

Whether the cause of infertility stems from the male or female in a couple, difficulty in achieving a successful pregnancy is a particularly sensitive topic in Nigerian culture, where couples tend to face communal pressure to create families, according to Dr. Faye Iketubosin, president of the country's Association for Fertility and Reproductive Health (AFRH).
“In cultures such as ours, childless couples suffer discrimination, stigma, and social isolation," Iketubosin said. “To this group of people, any form of access to effective treatment is a priority."

Considering the stakes, it should be no surprise that about 70 fertility clinics are operating in Nigeria, with the majority offering reproductive services such as in-vitro fertilization (IVF), the most widely used procedure in treating fertility or genetic problems and assist conception. IVF is a process in which mature eggs are taken from a woman's ovaries and fertilized by sperm in a laboratory before being re-implanted into the host mother's uterus, where the child grows and develops just as in natural conception.

One of Nigeria's leading IVF providers is the Nordica Fertility Centre, with multiple locations in Lagos, Abuja, and Asaba. The clinic provides world-class reproductive medicine and health services, for clients within Nigeria as well as from neighboring countries. Nordica offers IVF treatments for about USD4,000, which can be out of reach for many Nigerians, but state health initiatives have worked to reduce fertility treatment costs, making Nigeria one of the least expensive countries for couples seeking reproductive assistance in the region.

Public-funded training for doctors and research projects are aiming to assist couples seeking fertility treatment in Nigeria and have become particularly popular among the nation's large diaspora, who might live in countries where comparable services are offered at higher prices with negligible difference in service standards and laboratory technology.
According to Iketubosin, most Nigerian fertility medical professionals currently receive their training abroad, due to the lack of educational opportunities within the country, but his association is working with government officials to provide more professional development facilities for the growing industry. In a speech he delivered at an International Federation of Fertility Societies workshop in 2018, Iketubosin said less than 500 doctors were working in reproductive services in Nigeria, a number that is insufficient to accommodate growing national demand, and steps would need to be taken to bridge the service gap.
Industry analysts expect the number of fertility clinics to continue increasing in Nigeria, and therefore, have called on state officials to implement strict regulations on medical facilities to ensure quality of service and compliance with international standards. The push to implement national ethical and regulatory guidelines comes at a critical time, as more Nigerian medical personnel undergo training to work in fertility clinics, which are increasingly providing high-end services at competitive prices, such as egg-freezing for women under 40 years of age.

The growing popularity of reproductive medicine could become a positive development for Nigerian couples facing difficulties in achieving natural pregnancy. As infertility has long been a taboo in the country, the success of science-based interventions could diminish the role of traditional healers, who use a mix of superstition and herbs to exploit couples in need. Such deceptions have not only caused much of the distrust surrounding fertility treatments, but also serious harm to some of their patients. The development of well-regulated fertility services in Nigeria will bring lasting improvements to the contraceptive health field.