Nigeria’s private hospital in Mokola, Ibadan, saw the tears of a 22-year-old Jane* on a scorching afternoon in October 2019. One week earlier, Jane had begun injecting herself with hormone shots to inspire her ovaries into producing mature eggs, a fraction of the procedure to get her body set for the doctors to extract them.
Jane was in slight discomfort from the examination and experienced painful jolts on her lower tummy where she was prodded with the hormone doses. However, her tears were not due to the bellicose nature of the process. Rather it was the doctor’s behavior, which she indicated – to Al Jazeera condescending and impolite.
Jane remembered and stated that when the doctor arrived into the ward to perform the examination, she asked if it was probable to be attended by a female gynecologist since she was examined by a female in one of her initial visits. The male doctor, offended, stated that no female gynecologist was present in the hospital at that time. He went on to enquire about the specialty of her body, said that he had put eyes on several vaginas before and that he even saw that of a beauty queen and revealed her name.
At this point, Jane began to cry. She was rejected by the doctor who was not keen on examining her again. The doctor asked her to leave and stormed out of the ward.
Jane considered abandoning the extraction completely. However, a nurse convinced her otherwise. Jane stated to Al Jazeera, that the nurse arrived to console her and told her to apologize to the doctor so that she could be done with the process without wasting the drugs. Hence, Jane had to apologize to this man.
Jane was present in the hospital as she was retailing her eggs. In Nigeria, fertility is a raging business with egg harvesting and miscellaneous in vitro fertilization (IVF) processes carried out by privately-owned and government hospitals. A new-fangled body dubbed the Association of Fertility and Reproductive Health (AFRH), listed 23 private clinics in its directory. However, numerous reports propose that there are over 70 fertility clinics in Nigeria. The number is raging and booming every day. However, there is almost no regulation dedicated to these fertility clinics.
Nigeria’s fertility business is mostly about money
Jane had emerged as a graduate from university and accomplished years of service with Nigeria’s compulsory youth corps – the NYSC. Soon after, she began working in a well-paid job as a project manager. However, she was dissatisfied with her job and craved change. She quit after 5 months of being a project manager. Soon enough, Jane burned through her savings, felt dejected, and was unable to find another job.
She grumbled about her quandary to a friend. The friend, who was a medical student, suggested to Jane that she sell her eggs at a fertility clinic. Despite the difference in the monetary aids that depend on the location of the clinics, the general range per cycle of egg donation hangs around between NGN 80,000 (USD 194.41) and NGN 150,000 (USD 364.51) in Nigeria.
Jane visited a clinic to retrieve further information. She stated that it felt like a good deal as she knew how difficult it was to conceive for women. Hence, she felt she was performing a good deal and also receiving compensation for it.
The screening procedure and the eligibility criteria differ from one clinic to another in Nigeria. Jane articulated her experience to Al Jazeera – they collected her blood sample, performed tests for HIV, hepatitis, genotype, and then enquired about her medical history and health. Post these tasks, she was asked to return during her period which was the commencement of her menstrual cycle.
The procedures entailing hormone injections to egg recovery usually took around 13-15 days, reliant on the body’s reception of the stimulating hormones.
Jane explained to Al Jazeera that the doctors in Nigeria injected her with a bunch of jabs. There were mainly 2 types of injections, she stated. Both injections aided Jane’s ovaries to release extra eggs so that in place of 1 egg per month, at least 6 would be produced to increase the probability for the person receiving those eggs.
Jane had to begin taking the jabs at home – daily self-jabbing her lower tummy just below the navel. After 7 days, she came back to the hospital to witness how the eggs were maturing.
When she went to the clinic, the Nigerian doctors stated that she had 7 eggs and that if she could continue for 5-6 more days, they could retrieve double the number to increase the probability.
Around this time, Jane had a cold happenstance with the male doctor.
Even though Jane was almost halfway through the egg retrieval procedure, she walked home from the clinic and intended on quitting the whole endeavor.
However, money was a necessity of the hour then and she knew she couldn’t just quit.
Nigeria’s unemployment rate was at 33.3% last year. This ratio is steadily increasing. Additionally, the roof-breaking inflation rate affects the Nigerian economy and citizens negatively. Against this milieu, the reception of money is a big deal for the Nigerian youth to perform duties that they wouldn’t generally consider –like egg donation.
The process for egg retrieval is generally finished in half an hour, with the patient under sedation. A needle is sent through the posterior vaginal wall, under ultrasound guidance, into the ovaries. The fully grown follicles are then enunciated through the needle into test tubes. This procedure is mimicked for the second ovary. The patient is injected with antibiotics and analgesics later and is allowed to rest until the sedation wears off.
Professor and Consultant in Gynecology & Obstetrics at the University of Ilorin Teaching Hospital (Nigeria), Abdulgafar Abiodun Jimoh, stated that the process entails a possibility of hyperstimulation syndrome.
This is an impediment wherein the excess hormones enlarge the ovaries and the blood vessels adjacent to them leak fluid, causing swelling. Depending on the extremity of the case, this extra fluid can shift into the stomach, lungs, and chest areas. It emerges as extreme discomfort, stomach pain, liver and kidney dysfunction, breathing troubles, and coagulation difficulties.
Nigerian Government regulations for egg donations
It is assessed that a minimum of 1 in 4 Nigerian couples may need assisted reproductive technology (ART) such as in-vitro fertilization. But regulations have not been developed fast enough to adhere to the demands from the raging fertility industry, say experts.
A bill for the creation of a Nigerian Assisted Reproduction Authority to check this practice was offered to the National Assembly and read twice on May 2nd, 2021. The bill was denoted to the Committees on Health and Justice but has not yet been passed as a law.
The National Health Act was ratified in Nigeria in 2014. It is presently the sole legal entity governing egg donation in Nigeria. Section 53 of the Act forbids the exchange of human blood and tissue products for monetary aid, even facilitating fine or 1-year imprisonment for those who are guilty of the crime. However, the interviewee of the Al Jazeera interview was unaware of the particulars of the law.
Nigerian lawyer, Amarachi Nickabugu, stated that there was a great necessity for laws to safeguard the caregiver, recipient, and donor. This is because most women who donate eggs come from the youth of the society and perform this trade from an impoverished and vulnerable place. It is monetarily intimidating and thus essential for legal safeguarding to be in place to prevent the abuse of the endeavor.
(*names have been substituted to safeguard the privacy of the person mentioned in this article)