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No respite for infertile couples as treatment cost skyrockets

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When Doris, a 30-year-old civil servant suffered series of successive pregnancy failures, she and her spouse were encouraged to seek specialized pregnancy care service.

Before then, the couple had tried to conceive for more than six years going from one doctor to another until a gynaecologist diagnosed Doris with incompetent (blocked) fallopian tubes and referred her to a fertility specialist.

After series of preliminary tests and investigations, the couple was advised to try Invitro Fertilisation, IVF, but was in for a shock to learn that it would cost between N1 million and N1.5 million for a single cycle of the procedure. This sum, it was gathered, excludes the cost of assessment, tests, drugs and other incidentals.

The couple’s anxiety escalated when it was made clear that for best results, patients undergoing IVF treatment are recommended to budget for a three-IVF cycle plan.

In Nigeria an estimated 90-95 per cent of IVF and other treatment costs are paid out-of-pocket with just a handful of patients having access to some form of financial support plan. Doris and her spouse belong to the out-of-pocket paying group.

The foregoing exemplifies the financial challenge of seeking assisted fertility treatment in Nigeria where raising children is already challenging under the prevailing economic downturn.

Though most infertile couples readily seek at least one type of fertility treatment, high cost is a major hindrance to achieving their dream of parenthood.

Reproductive health officials told Vanguard that for couples that require donor eggs, donor sperms, or donor embryos plus any additional form of third party intervention such as surrogacy or other technically specialized procedure, the cost is often several times more than that of a normal IVF cycle because there are additional charges to contend with.

Vanguard gathered that infertility treatment costs are not fixed across board, rather costs are usually personalised.

It was further learnt that major factors that determine the cost include the patients’ diagnosis, recommended procedure, as well as the location and sophistication of the treatment centre.

Most of the centres are based in Lagos in Ikeja, Surulere, Ikoyi, Victoria Island and the Lekki/Ajah axis. Several other centres are in the Federal Capital Territory, FCT, Abuja, Port Harcourt, and Asaba to mention a few.

Vanguard findings show that the cost of a routine diagnostic test for infertility ranges between N150,000 and N300,000. This may include semen analysis, blood tests for hormone levels, biopsy, genetic testing, etc.

A medical consultation along with an initial assessment may be offered at a one-time cost of around N100,000. A reassessment is often necessary after six months of the initial assessment at additional cost.

One of the ART consultants told Vanguard that the cost of a standard Intrauterine Insemination, IUI, cycle (including cost of drugs), ranges between N300,000 and N500,000 while subsequent/repeated IUI cycle goes for N250,000 and up to N450,000.

He explained that one of the key determinants of the cost is the location of the centre where the procedure is carried out.

Vanguard findings reveal that in Nigeria, the cost of a single IVF cycle in a decent centre or hospital begins from around N1.0 million up to N1.5 million excluding the cost of drugs. For a two-cycle plan, the cost is between N1.6 million and N2.6 million while a three-cycle plan is in the range of N2.1 million up to N3.6 million all excluding the cost of drugs.

If the cost of drugs is factored in, the overall cost could go up by at least an additional N1 million for each category.

Additional costs for other interventions

It was further disclosed by the practitioners that couples that require additional intervention pay extra.

For instance, the cost of opting for one cycle of a combination of IVF plus Intracytoplasmic Sperm Injection, ICSI, (a technically sophisticated procedure for addressing sperm related male-factor infertility) is between N2.0 million and N3.0 million.

Each subsequent cycle of IVF with ICSI combination is between N1.5 million and N2.5 million depending on the treatment centre.

For couples that require donor eggs, cost of a single IVF cycle is between N2.4 million and N3.1 million inclusive of screening of the donor but excluding the cost of drugs.

For two IVF cycles with donor eggs, couples pay from N4.8 million up to N6.0 million, while the cost of a three-cycle IVF plan with donor eggs goes between N5.5 million and N6.7 million inclusive of screening of the donor but excluding the cost of drugs.

Subsequent repeated cycles with donor eggs start from around N2.4 million per cycle with the cost of drugs adding at least N1 million extra to each category.

Vanguard learnt that if donor sperm is required for the IVF cycle, the costs vary, as sperm banks and fertility centres fix their own prices. The procedure per cycle is between N1.3 million and N1.8 million inclusive of insemination and screening of the donor but excludes the cost of drugs.

One frozen embryo transfer (FET) cycle including the cost of drugs ranges between N0.9 million and N1. 6 million depending on the centre and its location.

For couples that desire to preserve their embryos, the cost of embryo freezing per quarter (per embryo) at average of N100,000.

Other service charges

Endoscopy is an investigative /diagnostic procedure where a thin, lighted tube (endoscope) is inserted into the uterus to examine it for infections, diseases or any abnormalities.

The most frequently carried out gynecological endoscopy procedures are hysteroscopy and laparoscopy.

The cost of these procedures range from N300, 000 up to N3.0 million depending on the patient’s diagnosis/requirements and location of the fertility clinic or centre.

From findings, average cost of basic fertility treatment in Nigeria including consultation, investigation, counselling tests, drugs and follow up starts from a conservative N1.3 million.

Cost of surrogacy higher

If for any reason, a woman is unable to carry her own pregnancy, a surrogate can do it for her. Surrogacy is the involvement of a third party in the infertility treatment process. There are two types of surrogacy – traditional and gestational.

Traditional surrogacy uses the biological father’s sperm to artificially inseminate the surrogate mother who then carries the baby for the intended parents.

A traditional surrogate shares a genetic connection with the baby she carries.

For gestational surrogacy, IVF is utilised to create an embryo that is then carried by the surrogate, thus the surrogate has no genetic ties with the baby since her eggs are not used. This is the more commonly utilised method.

The average cost of gestational surrogacy varies and could range between N5.0 million and N8.0 million or more depending on whether or not it includes the IVF treatment fees, surrogate fee, diagnostic assessments, drugs, legal fees among other costs.

Overseas option still higher

Further investigation reveals that infertility treatment is even more expensive abroad. In the United Kingdom for instance, similar treatment procedures would attract around N3.0 million excluding the cost of visas, flight tickets, accommodation, feeding and other ancillary charges.

In the United Arab Emirates which has become the hub of medical tourism lately, the same treatment would attract up to N3.3 million; USA N5.5 million; South Africa N2.1 million; India N1.8 million; Germany N2.7 million; Spain N2.8 million; Denmark N2.6 million; Greece N2.3 million and Czech Republic N2.2 million

Practitioners explain the cost

Professor Osato Giwa –Osagie, renowned IVF specialist and Co-pioneer of IVF in Nigeria, says the high cost of IVF treatment in Nigeria is not unconnected with the poor state of the economy as well as infrastructural and manpower challenges in the health sector.

Giwa-Osagie encouraged the setting up of even more fertility centres as well as intensive financial support.

“Most of the things utilised in IVF are imported and some are consumables that are used just once and discarded.

“Getting appropriately trained and qualified personnel like the nurses, embryologists and clinicians is still a challenge.

“The equipment is expensive and most centres have to acquire more than one, sometimes two or even  three equipment of the same kind for just one procedure because of the issue of maintenance locally. All this adds to the cost.”

According to the “Biological and Social Aspects of Human Infertility: A Global Perspective” published in the Oxford Research Encyclopedia: “Progress for lower-cost state-of-the-art infertility treatment options is desirable.

“However, progress will depend on getting policies right, building health systems that work well and ensuring availability of enough trained medical staff.”

Nigeria’s health funding

For Nigeria, this would include an increase in per capita expenditure within the health system to meet WHO recommendation.

Nigeria has been far behind the recommendations and also behind peer group of nations in healthcare funding, a situation that has forced almost all infertility treatment to be on out-of-pocket expense.

In 2018, as stated by the latest available data by the World Bank, the per capita health expenditure for Nigeria was $84.

In comparison, figures for other developing countries are: Algeria $256, Brasil $848, Gabon $218, Ghana $78, India $73, Kenya $88, Mexico $520, Namibia $471, Pakistan $42, Rwanda $58, Senegal $59, South Africa $526, Tunisia $252, and Uganda $43.

Nigeria has never met the Abuja Declaration target of allocating at least 15 percent of the overall national budget to health.

The closest that the country has got to the target was in 2012 when N289, 770 billion or 6.23 percent of the N4, 648,849 billion federal budget was allocated.

In 2001 when the Abuja Declaration was made, the federal health budget was N41, 269 billion which was 4.46 percent of the N894, 214 billion overall federal budget.

The lowest percentage allocation to health since the Declaration was in 2010 when N185, 765 billion (4.20 percent) of the N4, 427,184 billion federal budget was allocated.

In 2021, the federal allocation to health is N604,191 billion, or 4.45 percent of the N13, 588, 027 billion federal 2021 budget.

This is lower than in 2020 when N575, 228 billion or 5.32 percent of the N10, 810.800 billion federal budget was allocated.

Vanguard News Nigeria

Health

86% of COVID-19 infections in Africa go unnoticed – WHO

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About 86 per cent of all coronavirus infections in Africa go unnoticed, the World Health Organization reported on Thursday.

The WHO puts the number of all infections on the continent at 59 million, over seven times more than the eight million reported cases.

It said: “The high number of unreported cases can be explained by the fact that health facilities have so far focused on testing people. People with symptoms of the disease has led to extensive under-reporting.”

Matshidiso Moeti, WHO Regional Director for Africa, said with limited testing, the continent is flying blind in far too many communities.

“By comparison, the United States, with about a third of the population, had conducted more than 550 million tests.

“While Britain, with less than 10 per cent of Africa’s population, had conducted more than 280 million tests.”

Read Also: https://newstrends.ng/2021/10/15/blasphemy-drama-as-abduljabar-tackles-his-lawyers-in-court/

Read Also: https://newstrends.ng/2021/10/15/be-like-jakande-nigerians-slam-sanwo-olu-over-costly-lagos-estates/

Read Also: https://newstrends.ng/2021/10/15/former-us-president-bill-clinton-hospitalised-for-infection/

In total, more than 8.4 million coronavirus cases have been recorded in Africa, including 214,000 deaths.

According to WHO data, less than half of the African countries that received vaccines have fully vaccinated an average of about two per cent of their population.

dpa/NAN. “By comparison, the United States, with about a third of the population, had conducted more than 550 million tests.

“While Britain, with less than 10 per cent of Africa’s population, had conducted more than 280 million tests.”

In total, more than 8.4 million coronavirus cases have been recorded in Africa, including 214,000 deaths.

According to WHO data, less than half of the African countries that received vaccines have fully vaccinated an average of about two per cent of their population.

dpa/NAN.

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Entertainment

BBNaija winner, Whitemoney hospitalized in Lagos

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Winner of the 2021 Big Brother Naija, BBNaija, reality TV show, WhiteMoney, has been hospitalized.

 

WhiteMoney was hospitalized on Tuesday morning.

 

Although the cause of his illness was not revealed, he was sighted on drips.

 

Alongside an Instagram video of the 29-year old receiving treatment was a caption that read, ”Good morning, break in transmission. We will be back shortly.”

BBNaija finalists have been going for media rounds since their exit from the house. His tight schedule may be responsible for his breakdown.

 

WhiteMoney emerged winner of the ‘Shine ya Eye edition’ ahead of Liquorose, Pere, Cross, Angel and Emmanuel on the final day of the show.

 

He walked away with N30million in cash and prizes adding up to N60million.

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Health

FG stopped residency payment after strike suspension – NARD

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FRESH crisis may be brewing between the Nigerian Association of Resident Doctors and the Federal Government as the association accused the government of already deviating from the understanding reached before it suspended its strike last week.

This was as the association also accused the government of causing confusion among its members and suspending the payment of the Medical Residency Training Funds

The National President of NARD, Dr Dare Ishaya, disclosed this in an interview with The PUNCH in Abuja on Monday.

But the Minister of Labour and Employment, Chris Ngige, said there was no truth in the claim

The PUNCH had reported last week that the association, after interventions by the Nigerian Medical Association, suspended its industrial action with the aim of holding a meeting of the National Executive Committee to review the activities of the Federal Government six weeks after.

The NARD commenced its industrial action on August 2, 2021.

Sources familiar with the matter told our correspondent on Monday that since the association suspended its industrial action, the Federal Government stopped the payment of the medical residency training fund which it commenced before the strike was suspended.

“They paid 20 centres before we suspended the strike and they promised they would pay everything immediately we suspend the strike and the salary arrears.

“But the moment we suspended the strike, till now, we have not heard anything from them. Thirty-four centres have not been paid (medical residency training fund) and salary arrears, even the one for August and September have not been paid,” one of the sources said.

The National President of NARD, Ishaya, confirmed the development.

However, Ngige confirmed the aspect of non-payment of salaries, saying the case was still in court while government was working towards an out-of-court settlement.

He said the striking doctors would not be paid for the months they did not work.

On the residency fund, the minister said the payment was suspended because some individuals who were not resident doctors were paid.

The minister said, “Do you pay somebody who didn’t work in August, September? The truth of the matter is that the August and September salary is a matter that is still in court. So, when we go to court, we will try to see if we can do out-of-court settlement. But for now, nothing like payment.

Punch

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