BY EVELYN OKONMA

WHEN guests are invited for a wedding ceremony, they not only keep the date of event in mind for attendance, they also begin to calculate when the intending couple should welcome their first child. And so at the reception, it has become com­mon and rather nauseating for couples to be reminded over and over again that in nine months, they are expecting to hear that a baby has arrived. Some comperes would even voice that they are trying to hurry the day’s event so the newly married can go home and commence the business of baby mak­ing. And so the tension to have babies begins right on the dance floor.

If after one year, a child has not been produced, it is a big problem. And in recent years, issues bordering on infertility have been on the rise. Ac­cording to a popular English Proverb, ‘Necessity is the mother of Invention’. This means that when something becomes very important or essential, we are forced to find ways of getting or achieving it.

Scientists have thrived on this, look­ing for ways to help couples who can­not conceive naturally to have babies through other processes. The first ma­jor breakthrough was the invention of the in vitro fertilization (IVF) in 1978.

On July 25, 1978, Louise Joy Brown, the world’s first baby to be conceived via in vitro fertil­ization (IVF) was born at Oldham and District General Hospital in Manchester, England, to parents Lesley and Peter Brown. The healthy baby was delivered shortly before midnight by caesarean section.

Before giving birth to Louise, Lesley Brown had suf­fered years of infertility due to blocked fallopian tubes. In November 1977, she underwent the then-experi­mental IVF procedure. A mature egg was removed from one of her ovaries and combined in a laboratory dish with her husband’s sperm to form an embryo.

The embryo then was implanted into her uterus a few days later. Her IVF doctors, British gynecologist Pat­rick Steptoe and scientist Robert Edwards, had begun their pioneering collaboration a decade earlier. Once the media learned of the pregnancy, the Browns faced intense public scrutiny. Louise’s birth made headlines around the world and raised various legal and ethical questions.

The Browns had a second daughter, Natalie, several years later, also through IVF. In May 1999, Natalie be­came the first IVF baby to give birth to a child of her own. The child’s conception was natural, easing some concerns that female IVF babies would be unable to get pregnant naturally. In December 2006, Louise Brown, the original “test tube baby,” gave birth to a boy, Cam­eron John Mullinder, who also was conceived naturally.

Today, IVF is considered a mainstream medical treat­ment for infertility. Hundreds of thousands of children around the world have been conceived through the procedure, in some cases with donor eggs and sperm.

The scientific innovation has however moved from the widely known IVF to what is now called Assisted Reproductive Technology (ART) , which covers a lot of other areas apart from IVF including surrogacy. Since the birth of the first test tube baby 33 years ago, so many persons including Nigeria s have benefitted from this technology.

It has become very com­mon in recent times for couples to have multiple babies through this process. Medical and legal experts have however stressed the need for a national legal framework to regulate the activities of stakeholders in Assisted Reproductive Technology (ART) practice in Nigeria.

The experts say it is worrisome that 33 years after the first test-tube baby was delivered, there was still no leg­islation in place in Nigeria to guide against negligence, abuse, exploitation, baby trafficking and other anomalies in the system.

They spoke in Asaba, Delta State, as panellists during the 2022 Nigeria Bar Association (NBA) annual conference with the theme: Legal Practice in Nigeria – Our Reality.

The panel session, chaired by Justice Flora Azinge of Delta State High Court spoke on the sub-topic: Assisted Reproduction and the Law.

Members of the panel included the Medical Director of Nordical Fertility Centre, Dr. Abayomi Ajayi; Medicolegal Consultant, Laolu Osanyin; Acting Chief of Cross River State Customary Court of Appeal, Nkechi Usani; and Head of Legal Department of Alex Ekwueme Federal University Teaching Hospital, Joyce Esene.

The chairman of the panel, Justice Azinge, said ART has provided the needed succour for many couples who could not bear children naturally. Azinge, however, said there were issues associated with the practice which must be addressed by all-embracing national legislation.

In his contributions, Dr. Abayomi said there was the need to address the issues of cost of procuring ART; age limit of patients who want ART; the number of embryos to be transferred to a surrogate; marital status; donor garment; religion; and others.

He emphasized that the issue of ethics when it concerns health delivery has to do with differentiating between what you have the right to do and what is the right thing to do.

He gave instances of elderly men in their late 70’s coming to request that they should be assisted to father chil­dren. This according to him, they often declined, explaining that if a child is born to such people at such advanced age, the parent would be incapable of raising him or her due to age.

In his words, “Human reproduction had generated more emotion than any other part of medicine and we need to careful as so many issues are coming up, including who owns the child’s DNA.

“These are some of the things that are coming up. The doctor also needs to be protected by laws. The fertility preserva­tion that the doctor also gives informed consent.

“Things are happening. Just like in ev­ery profession, there are cowboys, even in medicine, there are cowboys. How can we protect people from these cowboys?

“I will conclude by saying that it is high time we had a culturally sensitive national regulation to guide practice in this vital area of medicine.

“We should resist copy and paste. I belong to a group of fertility doctors who are doing something and we are asking that the NBA join us in doing it so that Nigeria and Nigerians will be safer,” he said.

On her part, Esene towed the line of Ajayi and bemoaned that the National Health Act which came into existence 25 years after the first test-tube baby was delivered, was not encompassing as far as ART practice was concerned.

According to her, “In the entire National Health Act, the word ‘gamete’ was only mentioned once, revealing a large vacuum that needs to be filled”.

Esene said Lagos is the only state that has developed guidelines for ART practice but that it is not applicable outside the state because of jurisdiction.

“In Lagos state for instance, transfer of more than three embryos leads to the closure of the clinic. And it has been emphasized that patients have the right to decline treatment at any point during the process

“Other than Lagos State, other facilities operating ART could be compromised because they would want to protect the glory of the facility and the name. It takes only a medical doctor or healthcare provider who is upright to protect the ethics of the profession.

“There needs to be a distinct legal regime for ART. Lawmakers, NBA, and stakeholders should come together to create a good regime that would cover everything that needs to be covered – the ethical part, legal part and so on.

“ART has come to stay, it is now a reality which should be considered as our future,” Esene submitted.

In her contributions, Usani put is this way, “It is a crying shame that up till now, 33 years after the first test-tube baby, we have no legislation.

“The best we have are the guidelines issued by Lagos State. Even if it sanctions medical personnel, it has no power or effect over the non-medical players in the ART industry who can indeed make things to be exploitative.

“I hope that at what will come would be a specific legislation, home­made and tailor-made for our own ART industry.”

The concern of the medi­cal and legal experts both­ers on the fact that lack of proper legislation can make room for exploitation and even human trafficking where young women are held hostage in ‘baby facto­ries’ and made to give birth to babies that are eventually sold.

With a proper legal frame­work however, ART and the attendant activities that come with it can achieveit’s full potential.

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