A woman’s wish…….using ART interventions to break infertility barriers

At age five, she had a colostomy surgery due to her inability to release human excreta (bowel blockage) for about three weeks.

A colostomy is an operation that creates an opening for the colon, or large intestine, through the abdomen. A colostomy may be temporary or permanent. It is usually carried out after bowel surgery or injury. Most permanent colostomies are “end colostomies,” while many temporary colostomies bring the side of the colon up to an opening in the abdomen.

Fast forward, Akua Bentsil(not her real name) is now 47 and 21 years into marriage but struggling to conceive.

A medical checkup revealed that she has a medical problem with her uterus and could not produce eggs due to the surgery and some medications she received at a tender age.

“When I was at age 11 and 21 surgeries were carried out again to reverse the colostomy but to no avail, I have been given several medications and injections due to my condition, which prevented me from menstruation, I remember we were about six children who went through colostomy but I was the only survival,” she confessed

The desire for MadamBentsil to have children are dashed, but all is not lost, since there is an alternative by way of Assisted Reproduction Technologies (ART).

In 2017 through careful deliberation and advice from her doctors to have an alternative fertility treatment, sheand her husbandopted for surrogacy to enable them have their own children.

According to her, the 21 years into marriage without her biological children had been frustrating as she faced public ridicule and rejection. 

She disclosed that, a fertility facility in Tema was recommended to her in order to go through the process.

Madam Bentsil said after payment had been made and processes begun to finding a surrogate mother, her husband pulled out of the deal.

According to her, when she confronted her husband he told her, he was no more interested in surrogacy, therefore would not contribute in paying for the process.

“He told me he was not interested in the process, therefore he cannot waste his money and time on surrogacy, but later I found out that my husband has given birth with another woman,” she said.

“I was really hit by the news, as I speak to you I  am very sad, the man I thought was ready to go through this infertility challenge with me, now he has a child and he is not ready to support me,” she cried.

Over the years some couples have suffered infertility challenge and the stigmatizationassociated with it.

According to World Health Organisation (WHO) Infertility is a disease which affects both male and female reproductive system defined by the failure to achieve a pregnancy after a year or more of regular unprotected sex.

Infertility affects millions of people of reproductive age worldwide and has an impact on their families and communities. Estimates suggest that between 48 million couples and 186 million individuals live with infertility globally.

In the male reproductive system, infertility is most commonly caused by problems in the ejection of semen, absence or low levels of sperm, or abnormal shape (morphology) and movement (motility) of the sperm.

In the female reproductive system, infertility may be caused by a range of abnormalities of the ovaries, uterus, fallopian tubes, and the endocrine system, among others

WHO Assisted Reproduction Technologies (ART) have been available for more than three decades, with more than 5 million children born worldwide from ART interventions such as in vitro fertilization (IVF),

Dr Kingsley AssahAgyei, a Medical Director,  Pro Vita Specialist Hospital (Fertility Centre ) throws more light on Assisted Reproduction Technologies (ART), especially surrogacy.

According to him In Vitro Fertilization (IVF) is a process by which sperm is added to the egg or (ovum) to fertilize it in test tube. This means that the female ovary is stimulated with special medication to mature the eggs or ovary (induced ovulation) then the eggs are harvested or retrieved.

He said, then,  the male sperm is washed and added to the eggs to fertilize them in a test tube, after which it is cultured in a special medium for one to two days to mature the embryo in an incubator which would then be ready for transfer into the womb in the third or fifth day.

He said types of IVF include, Natural IVF, Intracytoplasmic sperm injection(ICSI), Donor protocol, Donor Egg, Donor sperm, surrogate, Artificial Insemination among.

Dr Agyei said surrogacy is an arrangement often supported by a legal agreement whereby a woman agrees to bear a child to term and deliver through IVF procedure (Embryo transfer or artificial insemination) in Ghana for couples only, for a person or persons in other parts of the world.

Surrogacy can be done through agency surrogacy, Individual surrogacy (professional or volunteer)

He said Gestational or carrier which (embryotransfer) and Traditional (artificial insemination) are the types of surrogate mothers, adding that the most common of them is the gestational surrogate mothers.

“With Gestational surrogates, IVF technique has made it easier to gather eggs from the mother, fertilize them with sperm from the father, and place the embryo into the uterus of a gestational surrogate.

He said with a close supervision, the surrogate would carry the baby till she puts to birth. He said traditional surrogate is whereby the woman is artificially inseminated with the father’s sperms.

Dr Agyei said couples decide to go for surrogacy due  to infertility challenges such aMedical problems with their  uterus, conditions that make pregnancy impossible or risky for you, such as severe heart disease, male-low sperm count, urethral stricture, female-Endometriosis, pelvic inflammatorydisease(PID),Bad Obstetric History, fibroids (Uterine),no uterus/poor uterus development, uterine abnormalities, Vasectomy, very short penis, age-usually above 40years, (egg quality at this age drops drastically).

He advised couples to seek early medical treatment when after a year into marriage without any sign of successful pregnancy.

“Medically, technology has improved and there are so much health practitioners can offer especially with issues of infertility and other health related matters, there is no need to go through the tress of infertility,” he said.

BY AGNES OPOKU SARPONG