LACK OF REGULATION IN FERTILITY MEDICINE

 There is need for appropriate legislation to regulate the sector

While the demand for In Vitro Fertilization (IVF), commonly known as ‘test-tube conception’, remains high, especially among the elite, there is still a dearth of regulation for Assisted Reproductive Technology (ART) in the country. For inexplicable reasons, this important health subsector has for long been overlooked by the government and experts in the field who should set standards. Yet, from human egg harvesting, in vitro fertilisation itself, up to advertorials on ART success rates, many practitioners in Nigeria are having a field day without much monitoring: all at the expense of patients who crave for these all-important public and social health services.  

It is estimated that one in four Nigerian couples have one or more forms of fertility issues. Meanwhile, pressure from society on childbearing pushes many of these couples to seek artificial reproductive assistance. However, laws and policies are not being developed fast enough to meet the demands of this growing industry, a loophole that has now been taken advantage of by quacks and even some otherwise known fertility clinics. The Managing Director, Nordica Fertility Centre, Abayomi Ajayi once raised the alarm about the absence of regulation in the sector and the implications for healthcare in Nigeria. “More than 60 per cent of people offering IVF service in the country do not have the facilities but due to the perceived financial benefits and patronage, doctors and health workers who know little or nothing about IVF have continued to take advantage of couples in need by offering services. I am calling for the strengthening of regulations in this area of medicine,” he said.  

There are several reports of substandard services to couples seeking in-vitro fertilisation with some not only disappointed with failed outcomes but also having serious health concerns relating to their procedures. There have also been reports of some fertility clinics in the country harvesting eggs of young girls in exchange for money. Others have had to pay huge amounts so they can get young, and in many cases, underage girls, to carry their unborn babies. Some simply buy these babies under the arrangement of fraudulent ART centres. In many cases, underage victims are coerced into trading their eggs monthly even though the World Health Organisation (WHO) has said no one female should have her eggs harvested more than twice a year. The health body has also stated that egg harvesting, just like blood donation, must not be traded for financial gains.  

A Bill for the establishment of a Nigerian Assisted Reproduction Authority to regulate this practice was presented before the National Assembly and read for the second time on 2nd May 2012. It was referred to the committees on health and justice in both chambers at the time. Almost 13 years after, the bill has not been passed into law. Although some practitioners kicked against the bill at the time saying it was a ‘copy and paste’ from East Africa, the onus is on the legislators and stakeholders to repurpose the bill to address local challenges. Except Lagos which has passed a law on IVF, the remaining states are yet to enact any legislation to regulate fertility medicine. 

We are aware that some practitioners in Nigeria have formed the Association for Fertility and Reproductive Health (AFRH) to produce ethical guidelines that would govern the practice of assisted conception. But they cannot enforce these guidelines. Legislations from the National Assembly and the state houses of assembly are therefore required to enact appropriate legislation that will properly regulate the sector. In the Nigerian society, fertility is not just about health, it is a serious social issue that requires every attention it deserves.