• How technology is revolutionising human reproduction
With the advancement in assisted reproduction techniques, whereby intending mothers outsource pregnancies with donated eggs and sperm to surrogates, a child can now have up to five parents: three mothers and two fathers. Also, a woman can become pregnant twice at a time and bear a set of twins having different fathers. HENRY UMAHI writes.
Little Miss Light, the daughter of popular Nollywood actress, Ini Edo, was lavishly celebrated by her mother when she clocked two years recently. Ini Edo wrote: “On the 15th of March 2021, God blessed me with the greatest gift and my biggest heart desire.
“A shining Light and the most precious, adorable little girl. I never knew how much my life would change and how much comfort and joy a human could bring.
“My smart and loving princess, I love you more than life itself.
“You are a Light to us and to your generation. As you turn two, I rededicate you to the God that gave you to me.
“The One who never sleeps nor slumber. He is doing an excellent job at taking care of us.
“Grow in wisdom and abundance of grace my little angel. Mummy loves you too much.”
Ini Edo did not carry any pregnancy and she did not adopt a child. Yet, the baby is hers.
The question that naturally flows forth from many lips would be, so, how did she do it?
She chose the option of surrogacy. She explained: “The eggs are mine, so genetically, she is my blood. I chose this path to fulfill my dream of becoming a mother. I still have a good number of eggs frozen in case I decide to do surrogacy again or carry my baby myself.”
Ini Edo is not alone. In 2013, ex-beauty queen, Nike Osinowo, admitted openly to welcoming a set of twins via surrogacy.
Indeed, surrogacy is becoming more common or acceptable. Individuals and couples are choosing methods suitable to them to have children or assist others to become parents even from a distance.
Outsourcing pregnancy
What happened was that Ini Edo and Nike outsourced their pregnancies. Known as gestational surrogacy, “it is an arrangement in which one or more persons, typically a married infertile couple (the intended rearing parents), contract a woman to gestate a child for them and then to relinquish the child to them after birth. Gestational surrogacy is also sometimes referred to as ‘contract pregnancy’. It simply means that this mode of parenting allows a couple to have a child by involving a third party in their relationship who serves as birth mother or surrogate mother.
A medical report explained: “Gestational surrogacy is a process where one person, who did not provide the egg used in conception, carries a fetus through pregnancy and gives birth to a baby for another person or couple. The person who carries the fetus is called a ‘surrogate’ or ‘gestational carrier.’ The persons or couple seeking to parent the baby or babies are called the ‘intended parent(s).’
“Many people choose surrogacy as a way to start or add to their family. Most commonly, intended parents are: not able to have children because of infertility; not able to safely give birth to a child because of health conditions; same-sex male couples; transgender individuals or couples; or prospective single males.
“Surrogates should have had healthy pregnancies in the past and a desire to help intended parents who are unable to have children. A surrogate may carry a foetus for someone they don’t know, or for a friend or relative.
“Surrogates must be screened to make sure they are healthy enough to have a baby. Medical guidelines, including Department of Health surrogacy screening guidelines, recommend that surrogates be between 21 and 45 years of age, have had at least one healthy pregnancy and a full-term delivery without complications. Medical screening includes blood tests and other lab work; a physical exam; a psychosocial exam; and consultation with the health care provider.
“Other screenings may be ordered by health care providers who are experts in surrogacy and reproductive health. These screenings help to make sure that the surrogate is medically appropriate to serve as a surrogate and fully understands any potential risks.
“Intended parents are screened to make sure they are ready to begin the surrogacy process. This includes being physically, mentally and legally capable of parenting and can afford potential costs associated with the surrogacy process.
“If an intended parent is providing the egg or sperm, they may be screened for various health issues, as well as genetic conditions. Genetic screening is not done to reveal physical characteristics not harmful to a baby, like hair colour, eye colour or sex.”
Superfetation
Biological miracle sometimes happen in the course of surrogacy. Take this: A single male embryo was planted into a woman’s body and everything was going as well as could be hoped for, until around six or seven weeks into the pregnancy when the doctors discovered something that shocked them beyond words. The surrogate was actually carrying two babies, not just the single one – and the doctors believed that they would be born as identical twins.
Doctors told her about the possibility that the embryo could split in two, despite the incredibly unlikely nature of this rare event. She was pretty stunned, considering the parents only wanted one child at first.
A report said: “In a biological miracle, she became pregnant twice: once with the implanted baby and again with her own. This is known as superfetation and is an incredibly rare medical phenomenon – so rare that the doctors didn’t even anticipate it despite all of their years of knowledge and expertise.”
However, the boys were born with different skin colours. In fact, they looked nothing alike, and it was hard to even believe that they were brothers from the very beginning.
Multiple parenthood
In the case of Nike and Ini Edo, it could be said that their children have two mothers. But intending (rearing) parents can supply a surrogate with donated sperm and egg. That is to say, the egg and sperm they brought to be used by the surrogate to conceive came from other sources because of severe sperm disorder or lack of sperm, infertility or any other reason. If that be the case, the child so conceived will have three mothers and two fathers. The mothers are the woman who donated her egg to an intending (rearing) mother, the intending mother who gives the egg to the surrogate, and lastly, the surrogate. The fathers are the man who donated sperm to the intending father as well as the intending father.
Different folks, different tales
One of the popular assisted conception techniques is In-vitro Fertilization (IVF). It “is the joining of a woman’s egg and a man’s sperm in a laboratory dish. In vitro means outside the body. Fertilization means the sperm has attached to and entered the egg.”
However, controversies have trailed the procedure. While some say it challenges nature, others argue that it complements nature.
For renowned fertility doctor and founder of Omni Medical Clinic, Professor Osato Giwa-Osagie, it gives a sense of fulfilment, putting smiles on faces of couples who could not achieve pregnancy naturally. He said: “It is always a very good feeling when you assist couples to get what they desperately want. People who don’t have children are very desperate; they are prepared to do almost anything. But when you are prepared to use your skill to assist them to have babies, it gives you a good feeling.”
Rev. Fr. Peter Paleve, the Head Coordinator, Catholic Dioceses of Makurdi, Benue State, said: “IVF is an artificial way of insemination. In In-vitro fertilization, you have to get some sperms from the male person and take it to the lab and then try to manufacture, underline the word manufacture, a baby from the lab. This process interrupts the natural process from birth to death. By interruption, it tampers with the human dignity and integrity of the human person.
“In the Bible, we say man was made. He was not manufactured, he became man incarnate; he was made man. So, any process that interferes with the natural course of giving birth, no matter how lofty it may sound, it is not acceptable by the church because the human integrity is lost, the human person is lost in the manufacturing of the human person which is out of God’s creation plan.
“Looking at it, someone may say this thing has helped a lot of marriages from breaking and has brought a lot of families from crisis. But in the Bible, we are told that it is not a must that everybody must give birth. Some are made eunuchs from birth, some are made eunuchs because they want to serve God and some made by human beings. So, that you are barren is not a curse. We should learn to accept it.”
Paleve, who is heading High Level Deanary and the Parish Priest of St Ann’s Mission, Iordye, added: “Children are taken as gifts and a gift could be given and could not be given but when you insist that it is a must and then you go against the natural law of nature by artificially inseminating, there is an implication here too.
We are not against science. God is the one that gave human being the ideology, the knowledge and He gave man the injunction: go, develop, subdue and conquer the world. But then go according to nature. When we refuse to go by the nature and use our intelligence negatively, it becomes a problem.
“So, the church talks about the respect and the natural order, respect for human order and respect for the human person. Somebody is created in the image and likeness of God and not manufactured. Where the natural cause of intercourse is eliminated, there is an aberration. So, where you don’t have the cause of natural intercourse and where you fundamentally destroyed the ideology from which human person is made, the family is completely removed out of this. And where you say the intercourse is not needed then intercourse becomes a thing of fun, not a thing of procreation.
“So, the church, being the custodians of morals and knowledge, seeks to correct this. The human fundamental basis of creation which is the family and togetherliness is disrupted.
“The Bible says the people perish because of lack of knowledge. Where our systems and culture have so stereotypically conditioned us that this is it, I think it is high time we began to erode these unnecessary false stereotypes that now subdue us to some anomalies.”
Asked what the church would do with children born out of this process, he said: “Like the case of homosexuals, the church does not accept homosexualism in any way but then you can’t throw away the bathing water and the child. The church does not send away people. When a child is given birth to, you have come into the world and we accept you but then we are saying, fundamentally, the basis for this is wrong.”
Rev Fr Theophilus Hwande, the priest in-charge of St. Anthony Quazi parish, Agwakume, George Akume way, Makurdi, Benue State said: “The Catholic Church’s position on in-vitro fertilization (IVF) is rooted in its understanding of human life, procreation, and the dignity of the human person. The church teaches that human life is sacred from the moment of conception, and that procreation should occur within the context of the marital union between a man and a woman.
“The Catholic Church opposes certain aspects of IVF because it involves the separation of the procreative and unitive aspects of the marital act. In IVF, the process of fertilization takes place outside the marital act, typically in a laboratory. This separation is seen as contrary to the natural order of procreation, as it bypasses the conjugal act that is meant to be the expression of the marital love between a husband and wife.
“Additionally, IVF often involves the creation and subsequent destruction of embryos. The church teaches that each human embryo is a unique and irreplaceable individual, deserving of respect and protection. The intentional destruction or disposal of embryos is considered morally wrong because it treats human life as a mere commodity and violates the inherent dignity of the human person.
“From a biblical perspective, there is no explicit mention of IVF in the Bible since it is a modern medical technology that did not exist during biblical times. However, the Catholic Church draws upon biblical principles and moral teachings to inform its position on IVF.
“One relevant biblical principle is the understanding of marriage and procreation as a sacred union between a man and a woman. In Genesis 1:28, God commands Adam and Eve to ‘be fruitful and multiply.’ This indicates that procreation is intended to occur within the context of marriage.
“Furthermore, the Bible consistently affirms the value and sanctity of human life. Psalm 139:13-14 states, ‘For you formed my inward parts; you knitted me together in my mother’s womb. I praise you, for I am fearfully and wonderfully made.’ This passage highlights the belief that human life begins at conception and is to be respected and protected.
“In summary, the Catholic Church opposes certain aspects of IVF due to its understanding of the sacredness of human life, the importance of the marital union and the inherent dignity of the human person. While there is no direct biblical reference to IVF, the church’s position is guided by biblical principles concerning marriage, procreation, and the sanctity of human life.”
Archbishop Alli John Alli, who is an Executive member of the Clerics Congress of Nigeria (CCN), said: “Number one, the church is scientifically very ignorant. We do not know how to originate or relate science which is human nature to spiritual matters.
“Can you imagine if there were sperm banks in the days when the two sons of Judah were killed. Remember, the Bible said they went into her but because they didn’t want to preserve child of hers, they splattered their sperms on the ground and God killed them. But did the children have children of their own? The Bible didn’t mention it but they were killed. The opportunity they would have had to bear children was denied them.
“So, what science is trying to do is to preserve something for us that are not against the principles of God. If only you can comprehend what science has done and can do and related it with the some scriptural facts, we won’t have a problem.
“So, the church should not kick against artificial insemination. If the church does kick against IVF, what is their basis and on what grounds? But the basic fact is that the church is scientifically ignorant.
“They are anointed but do not have knowledge. If they know what it entails for the mystery of science to be able to incubate and have that same reproductive promise continue. If the pastor in question was to struggle with child bearing and science came along the way to help him, will he reject it? Would you say no to it?
“There is no specific reference in the Bible as regards this subject but this is how we can go to second law of interpretation. If God has said go into the world and reproduce, reproduction should not only be by impregnating a woman through sexual intercourse. Whatever aid, help or assistance that can be required or acquired to help those families carry out this inordinate promise, it is welcomed, its acceptable. It is a promise of God that we should multiply.
“If I have a battle with infertility because of certain things in my dysfunctional organs in my body and science comes along to help me get an erection, get a penetration, bring out sperms equivalent to producing the child in my wife, what is wrong there?
“But ignorantly, the church will resist it because they don’t know that it is a pre-ordinate promise of God to go out and multiply. So, whichever way you can multiply, we can choose to say I need children but I don’t want to carry it. So, what is the moral ground for refusing to do that?
“Satan has no hands in it. This is pure science and people should be allowed to take the options available to them.”
Imam Haruna Rasheed, Assistant Secretary General, Council of Islamic Scholars, Benue State Central Mosque, Makurdi, said: “It’s approved and allowed if it fulfilled the following conditions: First, that the need for that should arise from the couple (not for business or fashion). Secondly, it should be done by a professional doctor who specialises in that field and third, the sperm to be used should be from the couple and be released through the ways approved by the Islamic injunction. “Sometimes, some people masturbate or use certain objects to satisfy themselves sexually. The process of getting the sperm to be used has to follow the normal procedure, it has to be when the man and his wife come together in an intercourse. Any other means is not Islamic.”
Hamza Musa Imam, who is in-charge of the North Bank Mosque, Makurdi, Benue State, said: “If it is the husband’s sperm that is being used, there is no problem. When you are using another man’s sperm to fertilizer another man’s wife, Islam is not in support of it.”
Anthony Umunna, a young Catholic Priest of St. Peter Claver, Ajao Estate, Lagos, shared his thoughts on IVF and Biblical principles. He said: “My own position is that, in principle, the teachings of scripture present no moral objection to a married couple using IVF (as long as no human embryos are destroyed in the process), because it is simply enabling an infertile husband and wife to overcome their infertility and thereby experience the blessing of having children.
“I won’t address the morality of several related issues such as adoption, surrogate motherhood, embryo adoption, and the possibility of human cloning, but I’ve discussed them at length elsewhere. Infertility has been a source of deep sorrow for both men and women, but especially for women, for all of human history, as we see from some of the early chapters of the Bible. In Gen.11: 30, Sarah was unable to bear children to Abraham. Jacob’s wife, Rachel, was unable to bear children for a long time after her marriage to Jacob as was Samson’s mother, the wife of Manoah. Hannah, the mother of Samuel, cried out to the Lord in deep sorrow because of her infertility. In the New Testament, Zechariah and Elizabeth had no child, because Elizabeth was barren, and both were advanced in years. but, again through God’s miraculous intervention, Elizabeth eventually gave birth to John the Baptist.
“These narrative examples portray overcoming infertility as something that pleases God, and it is often a manifestation of his special blessing on a couple. Other passages show God’s great blessing when he gives the barren woman a home, making her the joyous mother of children. And God in his wisdom shows compassion for the deep grief of childlessness in several passages, such as the stories of Rachel and Hannah. The Bible is consistent with the frequent theme in the scriptures that children are a great blessing from God as it revealed that children are a heritage from God, the fruit of the womb is a reward from Him.
“Given the force of these biblical passages, it is right to consider infertility as something that, in general, we should seek to overcome with the confidence that God is pleased with such efforts. Infertility shouldn’t be something about which we’re indifferent, such as the colour of our hair or eyes, but rather something we see as yet another result of the fall, one of the disabilities and diseases that entered the human race after Adam and Eve sinned. Infertility was not part of God’s good creation as he originally made it or intended it to function.
“Modern medicine (and medicine in the ancient world, for that matter) can be used to overcome many diseases and disabilities today. We should view this as a good thing, and as something for which we can thank God. God put resources in the earth for us to discover and develop, including resources useful for medicinal purposes, and he gave us the wisdom and the desire to do this.”
Forty-five year-old Muslim cleric, Adama Ibrahim from Ishaga Mosque, Lagos, noted: “It is human nature to want to have children. The Qur’an says that ‘wealth and progeny are adornments for the life of this world,’ which means that families seek two things: to have a secure financial future and children. Because one of the prayers of believers described in Qur’an is ‘O, Lord, grant us spouses and offspring who will be the comfort of our eyes’, seeking a cure for infertility is, thus, appropriate.
“There are a few case scenarios depicted in the Holy Qur’an which helps us to gain a proper insight into the problem of infertility. The first illustrates the story of Ibrahim (May God give him His blessing) and his wife Sara as revealed in the Qur’an (surah 51: 28–30). And they (Angels) gave him (Ibrahim) glad tidings of a son endowed with knowledge. But his wife came forward clamouring, she smote her forehead and said: ‘A barren old woman! They said: Even so has thy Lord spoken and He is full of wisdom and knowledge.’ The aged Sara had willingly resigned to her destiny of being infertile but yet continued to be firm in her faith and true to her husband. She remained a complete, faithful woman in every other way. And she offered Hajar to Ibrahim in marriage, so as to enable him to have children. She was ultimately blessed with a child, Ishaq.
“As with the example of Ibrahim, Zakaria remained faithful and supportive of his infertile wife. In surah 21: 89–90, Allah says: ‘And (remember) Zakaria, when he cried to his Lord: ‘O my Lord! Leave me not without offspring, though Thou are the best of inheritors.’ So, we listened to him and granted him Yahya (John). We cured his wife (barrenness) for him. They were ever quick in emulation in good works; they used to call on us with love and reverence, and humble themselves before us.’
“Being infertile does not make one any lesser a man or woman. Like Zakaria, one should beseech Allah for the blessings of offspring. The Qur’an also said, ‘Marry the kind and fertile women who will give birth to many children, for I shall take pride in the great numbers of my ummah.’ This clearly means that Islam gives strong and unequivocal emphasis to high fertility.”
An Ifa priest said the Yoruba tradition and culture treat any child produced through the sperm or egg of any person other than those of the parents of the child as a bastard. “IVF is acceptable to the culture and tradition of the Yoruba people provided it is done with the sperm of the husband and not a donor sperm. What Yoruba traditional religion or culture frowns on is to use donor sperm or egg. If it involves donor’s egg or sperm, such a child could be likened to a bastard. This is antithetical to the ideal of the family in Yoruba land,” he said.
Challenges
Fertility doctor, Ayo Olayinka, explained that some of the major challenges to IVF include epileptic power supply and the foreign exchange crises.
He said: “A lot of our consumables are sourced outside this country; we don’t get to buy the most sophisticated consumables locally and you can imagine that exposes us to a lot of forex variation. We know that in Nigeria, any business that wants to thrive must solve that power equation that we have thankfully been able to overcome. The other challenge is lack of information. The relative difficulty in getting prospective donors to donate eggs to couples that are incapable of using their own for treatment, so there’s still a lack of education, awareness and general information about the process.”
He also enlightened that IVF was not a process to be ashamed of, rather it helped to end barrenness.
“My message is that the world has evolved and our ideas have to evolve as well. The world no longer sees IVF as anything that should be frowned upon. I’ll tell the couples who are struggling to achieve conception that it is nothing to be ashamed of, this is just like seeking treatment for malaria or typhoid. You come in, the doctor assesses you, determines the best treatment option and then deploys a solution.
“The high rate of infertility among couples in Nigeria has proved that the perception of In Vitro Fertilization (IVF) is not well understood by most couples seeking conception. Infertility remains a huge challenge for most married couples but the solution proffered by science which is the IVF is adversely hindered by the people‘s religious and socio-cultural perception of the phenomenon.
Lagos-based medical doctor, Tunji Olaleye, from the Mother and Child Fertility Clinic, Yaba, opined that for conception to occur, the sperms, eggs and hormones must be in the right condition.
Hear him: “Hormonal causes of female infertility are too voracious to explain all. Polycystic ovary syndrome is one condition that is characterised by infrequent ovulations or complete absence of ovulation, which is known as anovulatory cycles. This is caused by a disorder in the hypothalamus, pituitary (these are organs in the brain) and ovary, from where the egg grows and gets released. PCOS is also linked to obesity, insulin resistance, acne and excess hair growth on the body.
“Another cause of infertility in women is Hypothalamic dysfunction. Two of the four hormones responsible for ovulation each month are follicle stimulating hormone and luteinizing hormone. These hormones, together with the others are released at specifically set times during the menstrual cycle. Conditions that affect the release of these hormones may cause infertility. These conditions include obesity, sudden or substantial weight loss or increase in weight, emotional stress etc. The menstrual period can be so severely affected as to render the woman infertile.
“Gluteal phase deficiency is another actor of infertility. The hormone, progesterone initially produced in the ovaries and carried on by the corpus luteum (the hollow left after an egg has been released from the ovary) may become deficient. Insufficient progesterone will not be able to sustain the pregnancy. Known as luteal phase deficiency, this condition strictly speaking leads to abortion of the pregnancy. The next hindrance to fertility is Hyperprolactinaemia. Prolactin is the hormone secreted when a woman is lactating and breast-feeding. On the other hand, this hormone blocks oestrogen production and release, thereby effectively preventing ovulation. Indeed, breast-feeding is a known contraceptive method used especially by rural women to space their children.
“Tubal infertility. The fallopian tubes can be damaged and blocked. When this happens, sperms can no longer pass through to meet with and fertilise the eggs. In some cases, the blockage may be partial allowing the smaller sperm cells to pass and blocking the fertilized egg from passing. Infections from the vagina and the uterus are major causes of fallopian tube blockage. “These may infect and multiply in a location in the tube where the blockage could occur. Gonorrhoea and Tuberculosis are likely infections that can cause this. A previous surgery in the pelvis or directly involving the fallopian tube after an ectopic pregnancy is another cause of tubal blockage. Cervical stenosis, which is narrowing of the cervix during excessive instrumental abortion can also cause infertility in a woman.”
Ethics brouhaha
A Briton, one Simon Watson, once claimed to be donating sperm once a week. He said: “Usually, one baby a week pops out. I reckon I’ve got about 800 so far, so within four years I’d like to crack 1,000.
“I’ve got kids all the way from Spain to Taiwan, so many countries. I’d like to get the world record ever, make sure no-one’s going to break it, get as many as possible.”
In Nigeria, some men are donating sperm recklessly because of the financial benefits. And unscrupulous practitioners are using such sperm selfishly on their clients/ patients.
Now, there is the danger of incest spreading: What if someone conceived with donated sperm or eggs or both marries another person conceived with the same donated sperm or eggs? Or what if the donor sleeps with one of his sons or daughters?
Meanwhile, stakeholders are calling on the authorities to make a law to comprehensively address critical issues related to illegal human organ trafficking and the unethical use of gametes, human ovarian eggs, sperm and embryos.
*With additional reports by Ngozi Nwoke (Lagos) and Scholastica Onyeka (Makurdi)