World Fertility Day – Myths around eggs storage in IVF

On Tuesday, November 2, First Lady Margaret Kenyatta will be the chief guest at the World Fertility Day conference at the Nairobi Serena Hotel.

Cecilia Mwangi, the chairlady of Fertility Kenya, a medical health NGO that seeks to raise awareness around infertility, is hosting the event.

Ms Mwangi says that, “Having children is the greatest gift life has given us; and Fertility Kenya implements awareness and activities that give hope and avenues to folks who struggle but still plan for parenthood.”

Eve visited Westwood building that houses the Myra IVF to speak to In-Vitro Fertilisation (IVF) expert Sarita Sukhija, who has practised and treated over 5,000 patients in India, Spain, Cleveland and the US. Sukhija has set up an IVF centre here in Kenya, where she says “approximately 20 per cent of couples have delays or actual difficulties in matters of conception.”

Dr Sukhija says the most common myth in the African setting is that the woman is to blame for infertility.

“When in fact half of the cases of infertility are to do with the man, issues of spermatozoon mobility or motility,” she says

She believes that it is important for couples to know this, to avoid ‘blaming the woman’ and other unhelpful shaming approaches, the marrying of ‘more fertile women’, and so on, when there are actual, affordable solutions.

Sukhija takes us through the menu of services available in cases of male and female infertility.

“All professional clinics and centres start with a gynaecological consultation in cases of repeated miscarriages, that may wreck a marriage, and after ultrasounds, there are solutions of IVF, IUI, PGS, PGD, TESA and PESA.”

The medical techniques involved include Intracytoplasmic Sperm Injection (ICSI), blastocyst culture and Laser Assisted Hatching, and there are donation programmes of eggs, sperms or even embryos, as well as ‘fertility preservation’ of the same that involves egg and semen freezing, as well as Embryo Cryopreservation.

In cases of male infertility, there are treatments of Testicular Sperm Aspiration (TESA), Testicular Sperm Extraction (TESE) and PESA – Percutaneous Epididymal Sperm Aspiration.

Genetic Testing services are either Pre-implantation genetic screening (PGS) or else Pre-implantation Genetic Diagnosis (PGD), and for women, surgical procedures like Operative Hysteroscopy and Operative Laparoscopy for cysts and the unblocking of fallopian tubes are recommended.

Sukhija notes that, lately, more and more women, especially in business and corporate world, are putting off having children in order to advance their start-ups or climb up the career ladder.

The risk being, of course, that the longer one puts off having children, the more the quality and number of eggs in her fertility cycle declines. Ideally, a woman should have a baby in her twenties, or latest mid-thirties, for an optimum offspring. The solution, according to Sukhija, is egg freezing.

“The success rates of having successful pregnancy decrease with each year, which is mainly because of ageing of eggs and the abnormal embryos that result in non- implantation or miscarriage as a result of abnormal chromosomes,” Sukhija explains.

“To prevent the failures and transferring abnormal embryos, we do PGS (Preimplantation Genetic Screening) in which we can do the biopsy of embryos, send them for testing to look for abnormal embryos then select and transfer only normal embryos with maximum potential so as to give the woman in late 30s/40s best chance to carry a pregnancy.”

Sukhija observes that in Kenya, many women marry late, or get divorced then have second marriages - which obviously pushes them into their late thirties or early forties for the trying of babies.

“In such females,” she says, “bilateral tubal blockages are quite common, often because of pelvic infections, then fibroids are quite common.”

“This is often the issue. So we first advise to have IVF! We freeze the embryos for use at later date (to prevent eggs from aging due to delay), and then advise fibroids removal. And after a six months healing time for the uterus, a patient returns for the transfer of the embryo (to her uterus), and we wait for successful pregnancy to take place.”

“Success rates of IVF beyond the age of 35 are not great all over the world even in the best of centres,” she adds. This is attributed mainly to the egg quality as well as quantity. The number of eggs and quality decreases as a woman crosses the age of 35.

“This is what we call as biological clock ticking, and there is no way one can increase the eggs in ovaries as every woman is born with particular set number of eggs, which go on decreasing as the woman ages.”

Thus the rate of having a successful pregnancy decreases inversely with each passing year, which is mainly because of ageing of the eggs that result in non- implantation or miscarriage, as a result of abnormal chromosomes.

The obvious answer then, for women in their twenties or early thirties these days, who are putting off having babies – whether deliberately or inadvertently – is to freeze their eggs.

“A single woman, in her early thirties, realises that as her career is picking, her eggs are deteriorating, but still has hope of marriage in the future. We can store her frozen eggs, and maybe when she gets married later on, or even decides to be a single mother, she can come back and get her baby,” Sukhija says.

On World Fertility Day this Tuesday, Fertility Kenya has organised a procession parade from 10am at Harambee Avenue and will proceed to Serena Hotel, where the conference will be.

“We need to raise awareness and stop the societal stigmatisation around issues of infertility that affect women deeply, but are also a great concern to men,” says Mwangi.