•MD Nordica Fertility Center
Getting pregnant for some couples is as easy as getting started. But so many people are not that lucky. There are many couples battling infertility presently. Many have spent time, money and emotions and the results have not fared better. However, Dr Abayomi Ajayi, the MD of Nordica Fertility Center in this programme held for expectant couples answered a lot of questions about infertility and how patients can help themselves and their doctors.
Dr Abayomi Ajayi is synonymous with treating fertility problems. He has said time and over again that the only thing he knows how to do is being a gynaecologist and he is very good at it. He at all times provides soft-landing for patients and he did the same on Sunday, November 14 2021, while he was answering many infertility-related questions.
City People’s Brands Editor, DAMILARE SALAMI 08155134152 followed proceedings and right here, he brings you excerpts, especially for young couples and those who are having problems with getting pregnant. This edition focuses majorly on the female gender, the next edition shall focus on the male gender, read on.
Please doctor, I’ve been trying to get pregnant for more than 10 years without any success. I’ve been having my menses regularly and all my fertility test results are good. I’ve had 3 failed IVF, I am 33 years, what can I do differently to have my own child?
I pray that you have your own child, your age is good, you are 33 and if you’ve had three failed cycles, we need to look at both the sperm and the eggs. What most practitioners do is that we focus only on the eggs, leaving the sperm out but we know that the early development of the embryo is mainly dependent on the quality and the genetic composition of the sperm. So, that is something that we might need to have a look at.
Can blocked fallopian tubes be opened and can someone with first-year multiple fibroids conceive naturally?
Well, if you have a blocked fallopian tube, it is unlikely for you to conceive naturally. Once your fallopian tubes are actually blocked, then the best you could do is IVF. When you say your tubes are blocked, my question is how did you find out? But if you have done the necessary tests and you discover that they are indeed blocked, then the only thing you can do is IVF.
Can a woman diagnosed with low ovarian reserve get treatment for quality eggs, can she get pregnant naturally at 44 without donor eggs?
That’s a very tricky question, when you have a low ovarian reserve, especially at 44; yes it’s possible to be pregnant without donor eggs but what we must look at is the probability. If you have not been pregnant before, I will ask you not to wait for this to happen from the blues. It is better that you do it actively and if you need to have donor eggs. I know that’s a very emotive decision to make but for so many people, the chances that they will have a baby with their eggs at that age are very slim. You know it is said that when you are over 41 and get pregnant, the chances that you will have a miscarriage is higher than that of having a live baby. So, those are some of the questions that must be answered and some of the things that you might need to provide answers to. But if you want
Good day sir, I was diagnosed with adenomyosis a few years ago, I had a laparoscopy done four years ago and had been recently diagnosed with uterine fibroids. My question is can I still conceive naturally, I am 42 years old.
The first thing we need to say is that it all depends on the kinds of treatments you have had. When we state endometriosis and adenomyosis, they tend to go hand in hand and they are probably the same condition in different locations. If you’ve had laparoscopy a few years ago, well, I don’t know what was done and what was not. But it is not also unusual for you to have fibroids with adenomyosis and endometriosis. So, at 42 you can still conceive but you will have to make some decisions but that will be with a good IVF doctor to help you out in other for you to go through but definitely, you can still have a child of your own.
Doctor, can a patient with endometriosis do IVF?
The answer is yes. Any people with endometriosis will be required to do IVF. However, whilst it is not an absolute indication for IVF, endometriosis will probably require IVF, so you can do IVF.
I’m 44 years old, not married and not sexually active, would love to have a baby between 2022 and 2023. I want to know what my options are. Does Nordica run a sperm bank, do I opt for artificial insemination or hope that I get pregnant naturally etc. what are my choices since I’m working with a tight budget?
Let’s take it one at a time. Do we run a sperm bank? Yes. If you are 44, your chances of natural conception are there but they are less than 5 percent. And at that age, I must state categorically that your chances of having a miscarriage when you are using your eggs are higher than having a live baby. Artificial insemination is not an option for you. It’s either you are doing an IVF at 44 and be willing to answer the big question of where the eggs are going to be coming from. Of course, your chances are much bigger if you use donor eggs at this age because of miscarriages due to chromosomal errors. So with a tight budget, you will still have some time to gather more finances because that will help you where you are going to be making your decisions. I must tell you that inter-uterine insemination is not an option for you at that age.
What are the causes of failed IVF because I have done it 5 times now?
A few weeks ago, I had a session on Facebook titled why IVF cycles fail. I will ask that you go and check that up. There you will learn about a few reasons why IVF cycles might fail. If you have done it five times, you really need to take stocks on what can be done better, that’s always the thing. The first thing is that you will tell me what your age is because sometimes, the wrong decisions are the commonest reasons people do IVF for such a long time. The second thing we always say is that if IVF cycles fail, we need to look at the quality of the embryo; because 70-80 percent of the time, the quality of the embryo contributes to IVF Cycle failure. Another thing to look at is what your endometrium is like because no matter the quality of the embryo, it is going to rest on the endometrium and if the endometrium is not comfortable for it to rest on, you are not going to have a successful cycle. It is also important to know what your medical history is. Have you had a myomectomy in the past, do you have what we call scars or additions in your uterus, etc. those are some of the things we need to look at before we finally look at the interaction between the uterus and the embryo.
Dr please advise on what to do, I did HSG and the result says blocked tubes with fluids with TTC for 10 years.
I guess the best thing to do is IVF but before then, they might also consider cramping your tubes to avoid backflow of the fluids from the tubes to the uterus. That can be done laparoscopically. Please this is something that needs to be done actively, so take the necessary steps as soon as possible in other for you to be able to achieve your dream of parenthood.
Please doctor, I had a baby 9 years ago and ever since I have been trying to get pregnant for the last 8 years but all efforts have proven abortive. I am just 46 can I still get pregnant again?
When it comes to reproduction, you cannot say that you are just 46 because it is a little bit on the other side. For general wellbeing, you can say just but not reproduction. Yes, nobody can say that you can never get pregnant again but to get pregnant spontaneously at 46, your chances are less than 5 percent every month. So, it is something you need to see a doctor about. Age in reproduction is something we have been emphasizing and if you are really motivated, you need to make a decision about the source of the eggs but that’s a conversation you need to have with your doctor.
What causes OHSS in IVF and how do you prevent them?
Wonderful question; Ovarian Hyper Stimulation Syndrome is an exaggerated response to excess hormones. It usually occurs in women taking injectable hormone medications to stimulate the development of eggs in the ovaries. OHSS causes the ovaries to swell and become painful. It is something that used to be very common in IVF but now, it’s really getting less and less common because we now have a hand on how to prevent it. I can tell you that for almost 8-10 years, I have not seen any real OHSS case unlike what we used to experience like once in three years. What causes OHSS is that some people are predisposed to this especially people that have PCOS. Young people are more predisposed, they overreact to drugs for stimulation so they produce too many eggs. How can we prevent this? That’s the most important thing that we need to focus on now. This is the reason we seeing many IVF centres now embracing the antagonist protocol instead of the agonist protocol; so that if you produce too many eggs, they have the opportunity for your trigger. I can prevent using HCG during your cycle, your chances of having OHSS is zero.
Can fibroids be treated without surgery?
Oh yes, now it is very possible for us to treat fibroids without surgery and there are so many alternatives available now even in Nigeria. There’s what we call embolisation and of course HIFU. With HIFU we mean High Intensity Focused Ultrasound. That thing is so simple and after all the tests, the day of the treatment is so easy and almost ridiculously simple. You just lie down for 2 hours and rest for another 2 hours and then you are ready to go home once everything goes right. The most important thing is that you just know and do the things that are required before you get to lie on the bed. Once you have done the prior preparations and we see that you are qualified for the procedure, it’s all easy pieces. You can treat fibroids without surgery now.
I had fibroid surgery three years ago and since then my menses has not been coming, I only stain my clothes. I have also been trying to get pregnant since then but no results…
Yes, this can happen after fibroids surgery especially when the doctor has to cut through unto the inner linen of the uterus, what we call the endometrium. Sometimes you now have what we called scarred tissues that might prevent you from seeing your menses. Not only does it prevent this, it also disturbs you from getting pregnant because once the endometrium is scarred, then there is a problem in you trying to either retain or get pregnant. I think you can start by you going to a centre where they can do hysteroscopy to assess what the scar looks like to know how much of the endometrium has been affected by the scar and whether there is anything that can be done to help you so that you can be able to conceive.