Tolani Alonge (not real name), a final year student of the Federal Government College of Education, Oshiele, Abeokuta, was offered just tablets of paracetamol after donating seven ova in March 2021. For the service rendered, she was also paid N80,000 and nothing more at a private fertility clinic in Ogun State.
While some argued that the fee was too small compared to the service she rendered to the fertility clinic, a critical analysis into the exercise in Nigeria shows a more grave concern.
Fertility egg donation is not the end in itself but a means to an actual end, which is in vitro fertilization (IVF). IVF is an advanced form of Assisted Reproductive Technology (ART) that helps infertile women and couples conceive. Through IVF, eggs are manually fertilized using a sperm sample from a woman’s partner or donor. The National Health Act of 2014 does not criminalize egg donation and it is also silent on ovum trading. Therefore, the practice is prone to ethical abuse. Section 51 of the Act only states that the “removal of tissues from living persons must be done in a hospital authorised for that purpose and under the supervision of a specialist”.
Past investigations have revealed that many young females in secondary and tertiary institutions in Nigeria embark on egg donations in order to make quick money. The case is the same with Tolani, who spoke with FIJ in late March. With the high rate of poverty and unemployment in Nigeria, the quest to make money has a high tendency of leading Nigerian youth to quack doctors that may cause them serious health consequences.
In many developed countries such as the United States, New Zealand and Australia, there are laws guiding IVF and other assisted reproductive techniques but these are non-existent in Nigeria. In the US, for instance, it is legal for a woman to donate eggs either anonymously or not. She can also receive between $30,000 to $50,000 as compensation. The donor is required to sign a contract that ensures she does not have any legal rights or responsibilities to any resulting children or embryos. Although the woman who receives the egg will not be a genetic relation of the child, legal documents will record her as the birth mother.
In New Zealand, Canada and France, monetary compensation is outrighly banned.
Like the advanced countries, if there were specific regulations in Nigeria regarding egg donation/IVF, this will inhibit the baby factory phenomenon and menace of human trafficking. These laws must define who can be involved in the techniques and the guidelines for practice as well as stipulate punishments for those that violate the rules of the practice.
While speaking with FIJ, Dr. Olusesan Makinde, a Nigerian researcher and physician, expressed worry over the lack of a database in Nigeria to track the successes of IVF.
“The problem here is that there is no legal framework to distinguish what is permitted or not around the practice of egg donation in Nigeria,” he said.
“Some young Nigerians even sell their eggs while in some countries only a family member is allowed to donate eggs. If there were laws to regulate this practice, then we would be able to know the successes recorded over the years on egg donations and IVF.”
Over 4 million children have been born globally through IVF and Nigeria is not left out of this practice, largely managed by the private sector. IVF has been practised in Nigeria for over 20 years, therefore, the country cannot shy away from the reality of regulating egg donation and IVF.
Studies have suggested that the prevalence of infertility in Nigeria is about 25%, with one in four women of the age bracket experiencing delays in conception. This shows Nigeria suffers a high prevalence rate of infertility whilst it is well-known that Nigerian families place high premium on child bearing in Nigeria.
BEFORE THE ABSENCE OF REGULATION HAUNTS OUR WOMEN
Nigeria is constantly experiencing brain drain, as many of the specialist doctors leave the country in search of greener pasture. In the latest news, the National Association of Resident Doctors (NARD) is currently on strike over concerns over wages among other demands. While the country gives low priority to the health sector, the implication is that the remaining medical practitioners working back home would be largely unmotivated and some may be more interested in the business side of the profession over professionalism.
Tolani told FIJ that the fertility clinic, where most Nigerian undergraduates donate their eggs, barely conducts any screening before the retrieval process is conducted. Whereas, in standard practice, screening processes such as drug, blood, and infectious diseases testings must be conducted before determining whether a potential donor is fit. The screening process must be thorough in order to reduce the risk of congenital anomalies and genetic diseases.
An egg donor usually takes series of fertility drugs that stimulate the ovaries to produce several eggs at once. This is known as hyperstimulation.
At the final stage where the donor is put under sedation and her doctor uses an ultrasound-guided needle inserted into each mature follicle to retrieve eggs (known as the retrieval stage), some women may experience bleeding when the doctor inserts the needle into their ovaries. The process may sometimes cause damage to the bowel or bladder.
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