ANY ALTERNATIVE TO IVF?

Dr Nathaniel Adewole Consultant Obstetrician & Gynaecologist, University of Abuja Teaching Hospital, Gwagwalada - FCT. 0803 803 9182 nadewole2013@gmail.com, tambari@dailytrust.com I have been married for five years without getting pregnant even once. I have visited hospitals. I did HSG twice when I was told that my tubes were blocked. The last doctor I met took me to the theatre for what he called Laparoscopy, and I was still told the same thing that the two tubes were blocked. I was informed that the only option available is IVF. But the cost mentioned is beyond my reach. Is there no other alternative? Laparoscopy and dye test popularly called Lap & Dye is used to confirm whether tubes were blocked as seen in HSG or not. Also it helps to assess other reproductive organs and look for adhesions. During laparoscopy, in case of bilateral tubal blockage, the tubes will also be assessed to know the possibility of tubal surgery.

In time past, prior to the onset of in vitro fertilization, IVF, tubal surgery was the mainstay of managing tubal factor infertility. In well selected cases, success rate varies from 10 to 25 percent. But with the advent of IVF, the role of tubal surgery is minimal now. Salpingostomy, tubal anastomoses are possible tubal surgeries. These are done better under microscopic view by well experienced tubal surgeons.

Despite the advent of IVF, tubal surgery still has a role in our own environment like in this case of yours because of the exorbitant cost of the procedure which makes it difficult to assess by the average Nigerian. You may need to see a gynaecologist who is versed in tubal surgery. You will need to be assessed to know whether surgical intervention will be feasible or not. It is important to collect the Lap & Dye report.

Let me use this opportunity to appeal to the federal government to make the IVF available at Federal Teaching and Specialist Hospitals at affordable cost. This will help put smile on the faces of a lot of couples in this country.