Patients' Preference for Number of Embryos Transferred During IVF/ICSI a Nigerian Experience

Background: The Human Fertilization and Embryology Authority is considering limiting the number of embryos that can be transferred to single embryo per cycle as has been done in several European countries; with the aim of reducing the rate of multiple pregnancies and its attendant complications following in vitro fertilization (IVF) / Intracytoplasmic sperm injection (ICSI). Objective: To determine the number of embryos patients' attending a fertility clinic in Nigeria; would prefer transferred during IVF/ICSI. Materials and Methods: Fifty four consecutive female patients who underwent IVF/ICSI procedures between May 2006 and April 2007 at the Port Harcourt Fertility Centre; Rivers State were interviewed using structured questionnaires. They were informed of all the obstetric and perinatal complications of multiple pregnancies and the advantages and trend towards single embryo transfer and then asked to choose the number of embryos (one; two or three) they would prefer transferred assuming similar implantation rates. Each respondent was allowed to give reason(s) for their choice. Design: Prospective; descriptive study. Results: Fifty one (94.4) of the respondents preferred the transfer of multiple (2 or 3) embryos. Only three (5.6) patients opted for single embryo transfer. Majority of the patients (31 or 60.8) preferred multiple embryo transfer because of their desire for twins while twenty (39.2) cited cost of IVF as their reason. Fifteen (29.4) patients saw multiple pregnancies as a compensation for their long periods of infertility. Conclusion: With the desire for twins and high poverty level in Nigeria; a policy of single embryo transfer might be difficult to implement. Health economic studies would be required to determine if the accumulative cost of taking care of twins/triplets is less; equal or outweighs the cost of several single embryo transfers

Cancer of the Cervix at the University of Benin Teaching Hospital (UBTH); Benin City; Nigeria; in the Last Decade of the Last Millennium

Objective: To evaluate the incidence and clinical presentation of cervical cancer in a Nigerian tertiary health institution. Methods: A review of retrieved retrospective data relating to patients managed for cancer of the cervix at the University of Benin Teaching Hospital (UBTH); Benin City between January 1991 and December; 2000 was done and is presented as frequency tables. Results: Cancer of the cervix constituted 72.9of all gynaecological malignancies seen at the University of Benin Teaching Hospital (UBTH) and accounted for 4.8of all new gynaecological admissions. The mean age at presentation was 49.1+5.7 years; with a peak age of 41 years to 50 years. Commonest presenting feature was abnormal vaginal bleeding while the modal stage at presentation was IIIB. The squamous cell variety was commonly encountered. Conclusion: Cancer of the cervix is of Public health importance in Benin City; Nigeria. Late presentations render curative protocols ineffective. Public enlightenment targeting sexually active women in the lower socio economic strata to boost uptake of screening services should be undertaken