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

Experience with conscious sedation for oocyte retrieval in Nigeria

Conscious sedation is the most common method of pain relief used during ultrasound-directed transvaginal follicle aspiration (UDFA) for in-vitro fertilisation/embryo transfer (IVF /ET). It is associated with minimal risks and facilitates early discharge following UDFA. The aim of this study was to assess clients' pain experience; acceptance of conscious sedation and correlates of pain during oocyte retrieval for in vitro fertilisation (IVF) at The Bridge Clinic; Port Harcourt. It was a crosssectional survey conducted between May 1 and October 31 2004. Pain was assessed using a 100mm visual analog scale (VAS). Clients' pain experience and correlates were evaluated using Pearson's correlation and the student's t-test. The mean pain score was low and the duration of the procedure did not significantly affect the severity of pain felt by the client. Most (69.0) clients would prefer the same sedation and analgesia for any subsequent procedure. Conscious sedation and analgesia are one of several methods used to relieve pain during oocyte retrieval in IVF procedures. The information in this study is of value when considering the management of pain in patients undergoing oocyte retrieval procedures. (Afr Reprod Health 2008; 12[1]:30-34)

Fecondation in vitro en Afrique

L'importance sans cesse croissante de la consultation de sterilite a incite les autorites du Cabinet de Gynecologie-Obstetrique de Dakar de creer au sein de leurs activites une unite de Procreation Medicalement Assistee (PMA) integree au lieu d'exercice. Ainsi; une etude a ete consacree a la fecondation in vitro (FIV) essentiellement; pendant trois annees. Apres ces trois annees d'experience (1989-1992); et malgre les conditions de travail tres difficiles; on peut dire que ce cabinet a reussi 26 pour cent de taux de fecondation; 14;7 pour cent de taux de grossesse par cycle complet et 23;6 pour cent par transfert d'embryons