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Influence of the awareness of COVID-19 pandemic on assisted reproductive technology clinic in Africa, South of the Sahara


Obstetrics & Gynecology International Journal
Abayomi B Ajayi,1 Tola Ajayi,1 Bamgboye M Afolabi,2 Victor D Ajayi,1 Ifeoluwa Oyetunji,1 Adedamilola Atiba,1 Folashade Adeyemo,1 Nnena Okoro,1 Roselyn Obasa,1 Vivian Berenibara,1 Adepeju Osanaiye,1 Toluwanimi Balogun,1 Grace Bisi-Akinlabi,1 Oluwatomi Balogun,1 Chukwudi Eze,1 Oluwole Obasanya,1 Oluseyi Abawunmi1

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Abstract

Introduction: COVID-19 pandemic has taken the world by storm and consequently, various reproductive medicine societies had since issued guidelines based on best judgement for the safety of IVF patients and attending health staffs
Objective: The objective of this study was to assess the opinions of IVF staff in sub-Sahara Africa on the awareness of COVID-19 on Assisted Reproductive Technology. The study also evaluated some of the measures that can mitigate the effects of the virus in IVF clinics.
Methodology: Different cadre of staff of Nordica Fertility Center (NFC) in Lagos, Nigeria was interviewed. The interview was conducted with various cadres of staff such as the Medical Director (MD), Clinicians/Gynecologists, Clinic Manager, Nurses, Embryologists, Counsellor, Business Developing Unit, Client Liaison Officers and Accounts Officer. Their responses were collated, and the key points were documented. Each staff in face mask was visited by one interviewer who observed all government-recommended sanitary precautions including wearing a facemask and maintaining social distance between her and the interviewee.
Result: The response of the MD on the fate of IVF clinic in Africa within the next 6 months to 1 year of the Covid-19 pandemic was that the overall economy is a major determinant of the ability of clients to pay for IVF services. Infertile women would still want to have children but “how would they pay for the services?” since ART is not subsidized by the government but mostly paid as out-of-pocket expense in this part of the world. The main points were that IVF clinic are not immune to the economy and vaccine may or may not favor IVF, reasons being;
(i)    The virus is about 5 months old hence still much to be discovered
(ii)    There is no solid evidence that the virus affects reproduction
(iii)    No evidence of mother-to-child transmission and
(iv)    The virus can survive in cold environment therefore, it could survive cryopreservation.
The embryologist was of the opinion that IVF clinics in Africa need to understand the virus more to decide whether:
(i)    Attend to COVID-19 patients or not and if so, how best to care for them
(ii)    Better prepare modalities of cryopreservation such as
a)    Appropriate equipment
b)    Batching gametes together with HIV or Hepatitis patients
c)    In same or separate equipment and
d)    Getting special cryo-tanks for Covid-19 patients.
Embryologist agreed that clinics will be able to perform other adjunct fertility treatment such as Pre-implantation Genetic Diagnosis (PGD), dependent on clinics’ ability to have separate equipment for Covid19-positive and negative patients.
Conclusion: Concerning COVID-19 and ART, Africa is not left behind in experiencing the effects from concerns for the survival of privately owned clinics to measures and safeguards the health and safety of patients, staff and the unborn babies. As of now, no-one is sure of patients that are symptomatic and those not symptomatic, as testing in the country, just like in most parts of the world, are still inadequate. When a vaccine is available, it may be mandatory for every to get a shot. The main points of other cadres of staff are discussed.

Keywords

COVID-19, Economy, Cryopreservation, Vaccine, Pre-implantation Genetic Diagnosis, Adjunct Fertility Treatment

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