Infertility in Nigeria is a significant public health issue, affecting many couples across the country.
It is estimated that around 1 in 4 couples experience infertility, with factors like delayed marriage, lifestyle changes, and medical conditions contributing to this rise.
The lack of comprehensive data makes it difficult to pinpoint exact numbers, but infertility is commonly attributed to both male and female factors.
Women face challenges like tubal blockages, hormonal imbalances, and endometriosis, while male infertility is often linked to low sperm count and poor sperm quality. Cultural stigma and lack of awareness further complicate the situation, preventing many couples from seeking treatment early.
Dr. Abayomi Ajayi is the CEO of Nordica Fertility Centre, a leading fertility clinic in Nigeria. With extensive experience in obstetrics and gynecology, he specializes in assisted reproductive technologies (ART) like In vitro fertilization (IVF). Dr. Ajayi is recognized for his contributions to fertility treatment and his efforts in raising awareness about infertility issues in Nigeria and across Africa.
In this exclusive interview with Nairametrics, he sheds light on the rising infertility issues in Nigeria and offers insights into solutions for individuals, healthcare systems, and governments to address this growing concern.
Nairametrics: Dr. Ajayi, you’ve been in this space for years, helping people fulfill their dreams of parenting. Let’s start by situating this conversation within Nigeria’s current fertility challenges. Reports indicate that about one in three Nigerians face infertility issues. How does this align with your observations and data?
Dr. Ajayi: Thank you for the question. You’re right—infertility is quite common here, but preventable factors are ignored. However, we must acknowledge the challenge of gathering accurate data in Nigeria. Historically, we’ve said one in four Nigerians experience infertility, but more recent findings suggest it’s worse. A master’s student once reviewed Federal Ministry of Health data and found it could be as high as one in three.
Most of the available statistics are speculative or based on hospital-based data, which don’t fully represent the population.
For example, a study we conducted at Nordica over a 10-year period showed a 30% decline in sperm quality among men visiting our clinic. Alarmingly, about 12% of men seeking treatment had no sperm at all. These are alarming trends.
Infertility in Nigeria is multifactorial. Lifestyle changes, like increased drug use, smoking, obesity, and other social habits, have significantly worsened the situation. Unfortunately, even when couples come for treatment, many are unwilling to modify these habits.
Nairametrics: You mentioned lifestyle factors. Are these the most modifiable causes of infertility in Nigeria?
Dr. Ajayi: Absolutely. Lifestyle factors are among the few modifiable contributors to infertility. Smoking, drug use, obesity, and poor diet all impact fertility significantly. Many couples don’t realize how these factors directly impact their fertility. Even when they come for treatment, some struggle to adjust their lifestyle because they believe technology will solve everything.
However, no matter how advanced our tools are, we still work with the raw materials eggs and sperm for assisted reproductive technologies like IVF. If the sperm quality is affected by drug use, for example, the embryo we create may not develop well.
The bigger concern is that many couples have unrealistic expectations of technology. They believe science can fix everything, but they forget their role in the process. Infertility treatment is a partnership, and success depends on both the medical team and the couple working together.
Nairametrics: Beyond lifestyle, what other gaps do you see in Nigeria’s healthcare system when it comes to addressing infertility?
Dr. Ajayi: Awareness and financial support are the two major gaps. The financial burden is one of the biggest challenges in Nigeria, which makes it unaffordable for many. Infertility treatment, especially IVF, is expensive, and it’s paid out-of-pocket here in millions, unlike in some countries where the government subsidizes or covers part of the cost.
Many Nigerians don’t fully understand how infertility treatments like IVF work. For example, some believe that undergoing one IVF cycle guarantees a baby, but that’s not the reality. It’s understood that most patients may need 2–3 cycles to significantly increase their chances of success.
Globally, IVF success rates are cumulative. Even in the best-case scenarios for younger, healthy patients, the success rate for one cycle is around 40–50%. For older patients, it’s even lower. After three cycles, the chance rises to about 70%.
Second, awareness campaigns are critical. People need to understand the factors affecting fertility, the importance of preconception care, and how lifestyle changes can improve outcomes.
In some countries, preconception care is mandatory before IVF treatments, especially when the government sponsors the procedure. Patients must demonstrate they’re prepared for the journey. In Nigeria, it’s often a case of, “I have the money, so let’s do this.” There’s no structured preparation. We also need to normalize conversations about infertility and reduce the stigma. When treatments fail, there’s often a blame game—patients may blame their partner or the doctor. Educating families about the complexities of infertility can help manage expectations and reduce unnecessary tensions.
Nairametrics: Can lifestyle changes make a difference in reversing infertility?
Dr. Ajayi: Absolutely. Lifestyle factors are the most modifiable risk factors. Couples need to realize that achieving fertility requires a partnership between them and their doctors. Preconception care—ensuring the body is prepared for treatment—is crucial. Unfortunately, here, it’s a different story. People walk into clinics and expect miracles because they can afford the treatment.
We need to emphasize that fertility treatment isn’t a guaranteed “buy-a-baby” scenario. It requires time, patience, and effort.
Nairametrics: What role do you think the government and private sector can play in making infertility treatments more accessible?
Dr. Ajayi: Health insurance could make a big difference, even if insurance doesn’t cover the entire procedure, it could subsidize medications or other aspects of the treatment. This would make IVF and other fertility treatments more accessible to middle- and low-income families. In countries where the government subsidizes IVF, there are also requirements for preconception care to ensure patients are ready for treatment.
Private sector involvement is also crucial. Partnerships between clinics, pharmaceutical companies, and NGOs can help reduce costs and expand access to care.
In Nigeria, addressing infertility needs a multi-faceted approach involving education, funding, and improved healthcare policies.
Nairametrics: Are there issues regarding infertility that you think are underreported in Nigeria or globally?
Dr. Ajayi: I think we still need more focus on male infertility. We’re not talking enough about male infertility. It’s still seen as a woman’s issue in many parts of Nigeria, but men account for a significant proportion of infertility cases. Raising awareness about this can encourage more men to seek help and avoid preventable lifestyle factors.
The societal stigma around infertility needs more attention. Couples, especially women, face immense pressure, and this psychological stress can further impact fertility.
Additionally, we need more comprehensive data. Without accurate records, we can’t develop effective policies or track progress.
Also, we need to report the successes and possibilities that come with advancements in fertility treatments. There’s hope, and we need to let people know that.
We need to talk more about preconception care. In some countries, patients undergo preconception evaluations and make necessary lifestyle changes before starting IVF. This step increases the chances of success.
In Nigeria, many couples skip this phase, often because they are unaware of its importance or because there are no systems in place to enforce it. The government and healthcare providers must work together to integrate preconception care into infertility management.
Lastly, the economic burden of infertility is rarely discussed. Affordable treatment options and insurance coverage could make a world of difference. With these steps, we can help more families achieve their dreams of parenthood.
