Dr Sunday Omale Onuh is a consultant gynaecologist and fertility specialist. He is also the medical director and chief executive officer of Deda Hospital, Abuja. In this interview, he spoke on ways people can seek help for infertility, and the need to eschew stigma against those affected, among others.
What is infertility, and what is your assessment of the prevalence in Nigeria?
Infertility is defined as the inability to conceive after one year of regular and unprotected sexual intercourse by a couple. There are two words stressed there. They are ‘regular’ and ‘unprotected’.
I have seen a couple that was married for one year without a child, and when I ask them how many times they met in a week, they said they have met only once since they got married. How can that lead to conception?
There has to be regular and unprotected sex. So this is just a general definition; there are some provisos, like a woman who is above 40, shouldn’t wait for one year before seeking help for infertility.
So the burden of infertility is so much in our society. And it is like it is increasing kind of; increasing because people are coming out. Before, people shied away from even seeking medical help, particularly men. They usually push the women to go for help.
Once there is a problem they say it is from the women. But we now know that the causes of infertility are 50-50 between men and women. That is equal share. About one-third of the causes are from women, one-third are men while the other one-third is a combined problem or unexplained; meaning you have checked and there is no problem, yet there is still a delay in conception.
For this last category of people, conception will take place at some point but you don’t know for how long. That is why we still need to intervene.
Infertility also brings a lot of family and psychological problems for the affected men and women because of the importance attached to having children in our society.
What is your advice to couples when they experience infertility, especially against the backdrop of some people resorting to herbs or ‘spiritual’ treatment?
My advice is that once there is a challenge, it is good to avail yourself to be checked to know where the challenge is coming from. There is an adage that a problem known is a problem half solved.
For instance, if you marry and the man has no sperm cells at all, a condition called Azoospermia, there is no amount of herbal medications you take that will solve the problem.
Or a woman whose two tubes are blocked; there is no amount of meeting with the husband even if it is every day that will lead to conception.
So people should avail themselves of medical tests, and if they test and know the problem, they should receive treatment.
The best place to receive treatment is in a hospital. You need to see a doctor or an expert. Infertility is also a question of age for the woman. As you are getting older, your fertility potential is also decreasing. So why waste all that time when you can access help early.
What is your take on the stigma associated with infertility?
People should note that infertility is not a plague. Anyone who has a delay in conception is not plagued. So we should not increase their problem by taunting them or making jest or making some annoying statements where they are. It is not their making so they need a lot of care and encouraging words.
Men should be supportive of their wives; it is not the time to say ‘I am going to marry another person’. The two of them should face it together because there is a solution at the end of the day.
So my advice to Nigerians is that they should show love to people experiencing infertility because it is a temporary problem.
Nigeria records a high rate of medical tourism for fertility treatments and even common ailments. How can it be stemmed?
Nigeria’s healthcare system has really developed. The private sector is taking the bull by the horn and ensuring that the country improves its standard of care.
There is no need for people to be running abroad for one medical condition or the other unless they are referred there by a specialist. Because are doing great here. Treatments for most of the general conditions that people are running helter-skelter for abroad are here and also cheaper.
How can the government support hospitals in delivering quality assisted reproductive treatments for Nigerians?
The major challenge we have is the high import duties because we are practically a consumer nation. We do not produce most of the things we use, particularly for IVF and even general medical practice.
So one way the government can come in and help the masses is to reduce import duty and also make forex available. If these are reduced, the cost will also go down for the consumer.
The federal government should also include In vitro fertilisation (IVF) and other forms of fertility treatments in the National Health Insurance Scheme. It will make the cost of IVF and other fertility treatments affordable for Nigerians.
Your hospital recently marked its 11th anniversary. How has the journey been, especially for fertility services?
Deda Hospital is a private hospital in Abuja. The hospital has recorded milestones in the last 11 years providing succour for infertile couples, and providing quality health care for Nigerians.
It started in 2012 in Gwarinpa as a small unit with just five staff including myself.
We started basically as an obstetric unit, then In vitro fertilisation (IVF). It then expanded to paediatrics, because the babies being born needed support.
In 2018 we had to move to the present location in Katampe as the former place could no longer accommodate us because of the growing services, and the increase in the number of patients.
Since then we have grown into a multi-specialty hospital. We have opened other departments to improve our functionality and access to our patients.
So, aside from the core obstetrics and gynaecology, we have laparoscopic and hysteroscopic surgeries, moved to minimal access surgery, IVF and genetic testing.
We added other services like cardiology, family medicine (which became an integral part of the hospital), general surgery, pediatric surgery, and urology and recently we added the radiology department.
We are also looking towards expanding to include plastic surgery. When you mention plastic surgery, people think only of cosmetic surgery. Plastic surgery is wide; it has a cosmetic side, a therapeutic side and a treatment side.
I am very passionate about gynaecological plastic surgery such as vagina rejuvenation, vaginoplasty and perineoplasty to help women who suffer an injury during childbirth, among others.
