http://punchng.com/ovum-trading-inside-nigerias-multi-million-naira-human-egg-business/
*MOTUNRAYO JOEL, who posed as a young lady willing to sell her eggs for money, visited three fertility clinics in Lagos and writes about the multi-million naira human egg trade in Nigeria.*
My two months exploration of Nigeria’s little known multimillion naira trade in human eggs started with a very personal question thrown at me by a complete stranger.
“Are you menstruating?” a nurse inquired brusquely shortly after I had walked into the bungalow at the back of a clinic in Lagos.
I answered in the negative.
Then with the practised ease of someone who had addressed many willing ovum sellers before, she said, “Then come here when you start menstruating, we can only harvest your eggs during your period. Also do a genotype test at any good laboratory and bring it along with you when you are on your period. And don’t come in through the reception next time, just come straight to the back.”
Intrigued, I asked her why I couldn’t come in through the reception. She said, “We don’t want you to run into people you may know. Also, we don’t want the recipients to know the ladies that are selling the eggs that will be used for their In Vitro Fertilisation.”
To this nurse, I was just like any of the small group of women waiting in the reception area of the hospital, (age range: 19-25). It was obvious we were all there to do just one thing: sell our eggs for cash.
One of us was a woman in the corner of the room, holding on to her stomach and writhing in pains. She could barely sit down.
“This procedure is painful, really painful, but it is something one can endure,” she said in a frail voice, gritting her teeth.
On hearing that, half of the faces in the room changed. Fear. Seeing that we were petrified, she quickly assured us saying, “There is nothing to be scared of. I’m just feeling some pains, I will be alright.” But it wasobvious no one believed her. She was still holding on to her tummy.
I moved to an empty space beside her and told her that I was desperately in need of money, hence my decision to sell my eggs. Iadded that I was afraid of the procedure seeing the pain she was in. She told me it was her second time of donating her eggs at the fertility clinic located in Ikeja GRA and I had nothing to fear.
“The last time I did it, I was allowed to sleep for about two hours. After a few hours, you will feel better. But I think they have morewomen booked for the procedure today, so they asked me to vacate the bed,” she said.
I asked her if she was married. She replied, “Yes, I have two children. My husband is aware of my decision. I’m doing this to support him topay the children’s school fees and rent. I’m paid N120,000 each time they harvest my eggs.”
I was surprised at her openness and willingness to converse. I also noticed the other women were chatting.
Fertility medicine is a recent but rapidly growing sub-sector of the healthcare system in Nigeria. Across the country, there is always hugepressure on couples to have children after marriage. Such pressure mostly comes from family and friends.
This pressure, and the re-emergence of a high-spending middle class in recent years, is believed to be responsible for the rapid growthof fertility clinics.
According to experts, 60 per cent of gynaecologic consultations in Nigeria are infertility-related while 25 per cent of Nigerian couplessuffer infertility.
In most fertility clinics, the average cost of In Vitro Fertilisation is N1, 500,000. However, this amount is no big deal to Nigeria’s super rich,who occupy the demand end of this thriving trade. Daily, hundreds of Nigeria’s elite who would like to have their own children, throng fertility clinics for IVF treatment.
But in the hospital that evening, those who use the harvested eggswere not in sight. This group was solely made up of sellers. At a point, ayoung woman walked in.
Dressed in a black-fitting gown with grey slippers, she didn’t look older than 20.
Resting her back behind the wall and admiring her grey-painted false nails, she listened for a while and then joined our conversation: “I have come to pick up my cheque. There is no big deal in the wholeprocess, I’ve done it twice and I will do it all over again. I was paid N120,000 each time I sold my eggs. I decided to do something that would fetch me money. The process is not painful. The only time you feel little discomfort is after your eggs are removed.
“Also, whenever I bring a lady that successfully donates her eggs, I get N20, 000. This is a lot of money. Imagine making N20, 000 at once. I don’t see anything wrong with it.”
The scan room
As I moved round fertility clinics in Lagos, I discovered a small subset of women sellers whom I would call ‘pros’. They are the oneswho have harvested and sold their eggs a few times and who have also built a business around sourcing other willing egg sellers for hospitals.
Madam False Nails belongs to this group. Acting as if I was scared ofthe process, I squeezed my face and told her I was afraid.
“There is nothing to be scared of. It’s painful but after some minutes you will feel better later. I am the first child of my parents. Every time Iget the N120, 000 after donating, I use it to take care of my siblings and I. It goes a long way to help my family.”
Her friend, who had kept quiet till then, chipped in, “I am an undergraduate from a poor home too. Selling my eggs is not a crime and I do it anytime I need money. This is my fourth time. When I collect theN120,000, it goes a long way in taking care of my needs. Is it not better than prostitution or stealing?”
While it is true that the National Health Act (2014) does notcriminalise the eggdonation, it is silent onthe trade.
Section 51 of the Act states that removal of tissues from living persons must be done in only, “A hospital authorised for that purpose and on the written authority of the medical practitioner in charge of clinical services in that hospital or any other medical practitioner authorized by him or her.”
In Canada, New Zealand and France, there is a ban on monetary compensation for egg donation. The United Kingdom prohibits payment for donors but they may receive a fixed amount of money to cover any financial loss they may incur in connection with the donation. In the United States, the sale of human eggs is not an offence. Prices for harvested human eggs vary, but they range from $3,500 to $5,000.
When the nurse returned, she was surprised to see me hanging around after had I been asked to come back during my menstruation. I stood up and left. But as I walked out, I heard her asking five of the women to follow her into the inner recesses of the hospital.
Crucial tests
The next time I visited the hospital, the nurse was friendlier. She met me with a barrage of questions. “Ha, you are back, do you have your genotype test result? Are you now on your period?” she asked with a huge smile on her face. I nodded my head, smiled back and gave her the result of a medical test carried out at a laboratory in Fagba, Lagos.
“The test result shows that your genotype is AA. The first step is for us to take your blood sample to confirm that the result is genuine.” She directed me to the clinic’s laboratory where I met two nurses. One of the nurses in the lab took my blood sample without saying a word to me.
An obstetrician/gynaecologist at the Kwara State Specialist Hospital, Ilorin, Dr. ShukrahOkesina, explained why fertility clinics conduct blood test.
“Hormones that are secreted in the blood will usually indicate if a woman is ovulating properly and if her eggs are in good shape,” she said.
My next port of call was a popular fertility clinic in Ikoyi. There, a young receptionist threw the ‘menstruation question’ at me again and directed me to the back of the hospital.
After about 30 minutes, a young slim, fair-complexioned lady in a pair of jeans walked in. I smiled at her and asked if she also wanted to sell her eggs.
“I’m really scared, I heard that the retrieval is really painful,” I said to her.
She answered, “No, it is not painful. I have done it seven times. Ensure that you don’t eat heavy food after the procedure. Just drink water and eat light food. I remember the first time I did it, I had a heavy meal and my stomach was very swollen. I could barely walk. I thought I was going to die. I was scared and had to come back to the hospital. I was treated but I had to pay for the treatment, even though I had just sold my eggs to them. I learnt after that.”
“Seven times? Is that not dangerous? Why are you here for theeighth time?” I reeled out my questions with concern etched on my face.
Our correspondent about to do a blood test at the Ikeja clinic
“I need the money. My mum stays with me and I am the bread winner. The first time I was paid N100, 000. I also got the same amount the second time. But by the third time, the clinic paid me more than N100, 000,” she answered.
Medical experts, however, say excessive egg donors stand a risk of ovarian failure. A consultant/obstetrician, Dr. Aloysius Inofomoh, said it is not advisable for a woman to harvest her eggs more than once.
He said, “A lady can donate (her eggs) twice and stop. The more she donates her eggs, the more she has a higher risk of developing cancer because she keeps injecting the fertility drugs into her body. These drugs are not to be used all the time.
“Moreover, a lady has a genetic clock that determines when her eggs would be exhausted. A woman, who frequently donates her eggs, risks ovarian failure and she never knows when her eggs will be exhausted.
“Ovarian failure is when the ovary is resistant to effect of hormones that make it release eggs, because the eggs have been exhausted. A woman is supposed to release a number of eggs in her life time.
“Unfortunately, some women’s risk of degeneration (eggsexhaustion) is higher than others because they have a lower amount of eggs to release in their life time.”
Another obstetrician/gynaecologist, Dr. ChiomaOnyekwere, acknowledged that a woman who trades her eggs multiple times risks ovarian failure.
She said, “The issue is that every woman has a specified number of eggs. Once a woman exhausts her eggs, she is done. The more she frequently donates her eggs, the more she has the tendency of reaching a time of burnout earlier than it should have been. Naturally, egg is released just once a month, but in the process of egg donation, there is what we call super ovulation, the drugs cause more than one egg to mature.
“A woman has a specific number of eggs and frequent donation could lead to depletion. For commercial basis, it is advisable a woman donates her eggs once or twice. These ladies should also bear in mind that they need to raise their families.”
In Nigeria, the minimum wage is N18, 000 and about 112 million out of its 160m population are living in poverty. Thus, many young women find the offer of fertility clinics irresistible.
“The money is very tempting, it takes care of bills. It is so hard to say no. In fact, the hospital calls me voluntarily. I think it’s because my eggs give good results during the IVF for the recipients,” the young seller at the Ikoyi fertility clinic said.
As we carried on, a nurse walked in and separated the lady who wasabout trading her eggs for the eighth time and I.
It was time yet for another blood test.
We went into her office, she took my blood sample and gave me yet another form to sign.
I took the form and tried to read the tiny prints before signing. That action upset the nurse and quickly she grabbed the form, and pointed her hand to where I was meant to sign. I insisted on reading the form.
“You can go now, we will call you later,” she said.
She never did.
At another fertility clinic located in Onikan, I told the female receptionist that I wanted to donate my eggs, she told me to go upstairs.
I met a nurse who asked me for my personal data.
Then she said, “Have you given birth?”
I answered in the affirmative.
She replied, “Oh sorry, we don’t accept ladies who have given birth.” As I walked out of the hospital, I asked the security guard if ladies sell their eggs frequently at the hospital.
He stated, “You need to come here on Tuesdays and Wednesdays. It is always full with young girls that are trading their eggs.”
After three days, the hospital in Ikeja called again. “You need to come in for another test,” the nurse on the phone said. Before I could ask what this new test was about, she dropped the call.
I went a day after her call and met her at the back room again. She gave me an infection screening form and asked me to go to the laboratory. On my way, I popped into a toilet, just by the laboratory, and took a picture of the screening form.
On getting to the lab, a nurse that I was meeting for the first time took my blood sample again.
I decided to strike a conversation with her after giving her the infection screening form. She explained that apart from confirming my genotype, the hospital also wanted to be sure that I had no infection.
She said, “We just want to make sure you don’t have any infection and we also need to check your hormones.”
I went back to the first nurse and she asked me to go home that they would call me later. As I was about leaving, she gave me the sumof N1, 000.
“It’s for your transportation,” she said.
‘You have good ovaries’
After about two weeks, I got another call from the Ikeja fertility clinic asking me to come for a scan.
On the day of the scan, I met a mother and her daughter in the waiting room.
I went close to the mother and said to her, “Is the scan painful? I am really worried.”
She replied, “There is nothing painful about it, they will just put an instrument in your private part to check your ovaries. Within a few minutes, it will be over.”
Her daughter who looked like a 19-year-old, chipped in, “Mummy, I am scared. I hope it won’t pain me.”
“I’ve told you many times that it is not painful,” her mother retorted.
The nurse in the room also gave words of encouragement and said to me with a smile, “I don’t know why you are scared. I have been telling you that no pain is involved. Let me take you to a doctor for consultation.”
She took me the doctor’s office and turned back.
The heavily built and dark-skinned doctor started the conversation by asking me questions about myself, my parents, my occupation and knowledge about egg donation.
“Are you sure you are ready for this, why do you want to sell you eggs,” he asked further.
“I just want to help women that can’t bear children,” I answered.
“That’s very good,” he said.
The nurse interjected our conversation and said it was time for my scan.
The doctor and I walked to the scan room and had to wait for a few minutes before entering because another young lady was still dressing up in the room.
When we entered the room, we met an elderly doctor. The first doctor then said to the elderly one, “Let me do this while you watch.”
I was asked to change into a brown robe in a secluded corner of the room. I turned to the nurse who was waiting outside the changing corner and asked why two doctors wanted to attend to me, when only the elderly doctor attended to the lady before me.
“I won’t do this scan with two doctors in the room,” I told her sternly.
She walked up to the doctors and told them that I said I wanted only the elderly doctor to attend to me. The youngerdoctor walked out of theroom in annoyance.
“Relax, lie down on the bed and spread your legs,” the elderly doctor said.
“I’m scared,” I said to him.
He replied, “Don’t stress yourself. I am a very calm doctor. If you feel any pain, tell me to stop.”
He brought out a cream, long plastic instrument about the size of a ruler and commenced the invasive examination.
On the screen, my reproductive system appeared in black and white.
“Look at your ovaries, you have good ovaries. That’s your bladder there. Everything seems to be fine here. There is no problem.
“You see, it wasn’t painful,” he said to me as he finished.
I went back to the bungalow at the back of the hospital. The nurse gave me the terms and conditions form and asked me to sign it.
One of the terms and conditions in the four-page document given to donors at the clinic read:
“I understand that there is a risk of getting pregnant, so there is need for abstinence from sexual intercourse.”
Other conditions include relinquishing any rights to any child resulting from the eggs of the donor, accepting the administration of hormones/drugs/ anaesthetics, among others.
Luckily, the nurse stepped out of the room and I took a picture of each page of the form before she returned. I signed the form and gave it to her. She gave me another N1, 000 for my transportation and said I should expect a call from her.
Important drugs
On April 4, the nurse at the Ikeja clinic asked me to come for some fertility drugs.
I met two different nurses who gave me a lecture on the importance of the drugs.
One of them said to me, “You will make the hospital be at a loss if you don’t complete your dose or stop half way.
“We will give you two bottles of the drug now, including 23 pieces of syringes, mentholated spirit and cotton wool. When you finish the two bottles of the liquid drug, you will come in for the third bottle. To give yourself the injection daily, you can choose any spot below your navel or your thigh.
“It is important you use either of these two spots because this drug needs fat to transport itself. When you put the syringe into the bottle to suck out the drug, make sure it’s 50ml, which is half. You must not fillthe syringe with the drug. Also, you must not miss any day. Once youstart, you must take it every day within the same hour. If you skip anyday, it will spoil the process.’
She added that if I developed any complications, I should come straight to the clinic.
“What are the likely complications?” I asked.
“You may experience pain in your breast, dryness in your vagina, headaches, nausea, Ovarian Hyper-Stimulation Syndrome. But OHSS is not a serious condition and it doesn’t happen to all the girls that sell their eggs.”
Then she gave me a form that would help me keep track of how I administer the injections daily.
As I was about to leave, she gave me N1, 000 for my transportation. “We will call you after about three weeks when you must have finished the drugs just to check on how you are doing and that everything is fine.”
But a clinical pharmacist at the University of Nigeria Teaching Hospital, Enugu, Mrs. Ogochukwu Onwujekwe, said the side effects of the drug were graver than the nurse mentioned.
She said, “The injection is a gonadotropin releasing hormone agonist that controls the release of eggs from the ovaries by stopping the production of natural hormones.
“It is used to desensitise the pituitary gland to stop the natural production of the follicle stimulating hormone and the lutenising hormone. When this is achieved, synthetic Follicle Stimulating Hormone, Luteinising Hormone and Human Chorionic Gonadotrophinsare then administered in order to artificially stimulate ovulation.
“The possible side effects include Central Nervous System-headache, light-headedness, mood changes and nervousness. This also includes heart-palpitations; skin-pimples; dry skin; itching; allergic reactions; changes in scalp and body hair. Musculoskeletal-tumour flare may manifest an increase in bone pain and spinal cord compression. There is also the worsening of urinary tract symptoms, blood in urine, increase in menstrual bleeding, urinary obstruction, vaginal dryness, hot flushes and loss of libido.”
For donors who have had the procedure many times, the clinical pharmacist highlighted the price of continuous usage of the drug.
“It could lead to a high order of multiple pregnancies and could give rise to a medical condition called Ovarian Hyper-Stimulation Syndrome. This happens when the ovaries overreact to continuous use of a fertility drug that stimulates egg growth. Most cases are mild but it could lead to serious illness and even death,” she said.
The African Anti-Abortion Coalition , in a September 2012 report, stated that over 10 million poor African women will die each year from the resulting complications of OHSS, or suffer kidney failure, liver failure, cancers, infections and infertility.
Although there have not been official report of deaths from egg donation procedures in Nigeria, some of the women this correspondentspoke with said they experienced some side effects from taking theprescribed drugs. Their experiences included headaches, cramps and nausea.
Last year, a 23-year-old Indian woman, Yurma Sherpa, was said to have died after an egg donation procedure at an IVF clinic. Shereportedly sustained internal bleeding in her pelvic region and her ovaries were “hypertrophied.”
According to a report by the Indian Express, the post-mortem found haematoma or clotting of blood in the peritoneum (stomach cavity), around her uterus and ovaries, indicating internal bleeding.
The Managing Director, Global Profile Alliance, Dr. Philip Njemanze, is totally against the egg trade. According to him, there should be a law against it because of the harm it does to the donors and because some IVF clinics are taking advantage of the procedure.
He said, “In the British embryology law, it is stated that one cannot use an egg from a British, European and American woman. African women are an exception. This is because these countries are now harvesting eggs from Africa. Once the egg is harvested, it is fertilized with sperm and it becomes a whole human being. Some of the eggs these girls sell are sold abroad.
“Nigeria has the largest egg harvesting operation in the world. Today, millions of Nigerians are exported in small test tubes from IVF clinics around Nigeria for money. These biotechnology companies who buy these eggs slaughter them in European and American laboratories for embryonic stem cell research.”
Njemanze further spelt out the risks of the process:
He said, “Retrieval of eggs is a high risk process; the process itself involves an operation. An ultrasound is done to locate the ovary anda long needle is passed through a space. By passing this needle, the doctor is bound to pierce through areas to remove the egg. This process automatically decreases the chance of every donor having children because women are born with a specific number of eggs. Through the operation used to remove eggs, the donor may develop an infection because that area, where the egg is, is a sterile area. As the eggs are drawn out, microorganisms are introduced. Infection is one of the major immediate effects of this process. It is a high probability. If the donor doesn’t develop an infection, the donor is bound to develop infertility to some extent, it is a major risk.
“Secondly, before eggs are extracted, the donor injects herself witha series of injections to make her eggs grow in an unnatural way. The drug she injects herself with makes all her cells grow. If there is a cell turning cancerous, and the body could have suppressed it using the defense mechanism of the body, what happens is that, that cancerous cell begins to grow incontrollable. Most women who donate eggs may develop some kind of cancer — cervical, breast or any type of cancer. Cancer is a major risk. “Her organs — liver, kidney — all have a limitation to the amount of growth a body can stimulate in a natural way. Once such growth is stimulated, the normal function of such organ is compromised; hence she is at a risk of developing liver failure andkidney failure.”
‘We are disappointed in you’
About 28 days after collecting the drug, the nurse called to ask when I was coming in for the retrieval of my eggs. “You should have finished using the injection, when are you coming for the procedure?” she asked.
I told her that I decided to pull out of the process.
She became livid.
She said, “Do you know how much loss you have brought upon the clinic? The lady, who we partnered with you, to collect your egg hasalready paid for your test, and other bills. Is it fair that she now has to pay for another egg donor? Please return our drugs, each of those bottles cost us N8,000, we can’t afford to waste such money.”
The nurse has called back about 15 times since then.
Editor’s note: The names of hospitals and sellers are not used in this story because donation/sale of eggs is voluntary and legal in Nigeria.
No comments:
Post a Comment