Couples venturing into the realm of In Vitro Fertilisation (IVF) are urged to embrace proactive awareness, according to Dr. Abayomi Ajayi, a renowned expert in the field. Understanding the intricacies of IVF before embarking on the journey is emphasised as crucial, allowing couples to make informed decisions, manage expectations, and navigate potential challenges. Dr. Ajayi stresses the value of preemptive knowledge, even when the immediate need for IVF might not be apparent. This proactive approach ensures preparedness for potential setbacks, discouraging heavy investments in a single IVF cycle without considering the possibility of multiple attempts. Such foresight serves to mitigate the risk of mental health complications, fostering a comprehensive understanding before embarking on the transformative IVF journey.
Dr. Abayomi Ajayi sheds light on essential factors that individuals contemplating In Vitro Fertilisation (IVF) must grasp. He accentuates the immeasurable impact of mood on IVF success, revealing the intricate connection between emotional well-being and outcomes. Dr. Ajayi underscores the imperative of maintaining a positive mindset, as mood intricately influences hormonal balance and implantation rates during IVF. Emphasising the active role of men in the IVF journey, he stresses the significance of their comprehension and engagement in the process. Decision-making, informed by a comprehensive understanding of factors contributing to IVF failure, emerges as a critical aspect. Age is identified as the primary factor influencing IVF outcomes, with a decline in the quality of eggs and sperm after the age of 45. Dr. Ajayi highlights the paramount importance of a good egg, sperm, uterus, and hormonal balance for successful IVF, positioning men’s knowledge and support as pivotal for positive and effective outcomes. “Mood affects whether you get pregnant or you don’t get pregnant. And so, when you are depressed, the chances of pregnancy are less, even when we do IVF. That’s why we will, most of the time, want to keep you in equilibrium; it helps because implantation is still an interplay of hormones, and studies have shown that mood affects the success rate of IVF. So, as much as possible, we implore the patient to be cheerful, do the things that you enjoy, don’t let this make your life come to a pause,” he shared.
On the role of men in the pursuit of successful IVF, the fertility specialist underscored the significance of men being well-informed about the IVF process and actively engaged in the journey. “I tell people that if the clinic is working very well, the success is determined by the man and the woman in front of me because it’s the raw materials that they give us that we can work with. Age; if the woman is 45 years old and she’s asking to use her eggs, we know globally that if you are over 43 and you are using your eggs, the success rate is less than five per cent. So, if you are 45 and you insist on using your eggs, then what you’re asking me to do is to wake the dead. I understand that there are some psychological issues involved and that is why I’m not going to say don’t but I’m going to give you the facts why you should not. I won’t say don’t but if you insist, we will establish it formally because if the process fails I won’t have you accusing me or running to the social media accusing the clinic of stealing your eggs and all sorts of things.
“When I hear such things, I just wonder and laugh, what stealing or selling a 45-year-old egg would achieve, an egg that cannot even be useful to the owner? So, we need people to understand some of these things that they should understand it, not at the point that they need it. So, people need to know that age is the number one reason for failure because we know that the quality of the eggs especially, is worse with age. The man is not spared either, the quality of the sperm starts decreasing from age 45 because of the DNA fragmentation index which increases with age from above 45 dramatically. That does not mean they cannot father a child but the chances are lower than a younger man. So, age is the number one factor, the uterus also but I’d rather want to look at this from the angle of, for IVF to succeed, what are the important things? Okay, so we need a good egg and sperm that have avoided all the issues that can reduce the quality; a good uterus with no issues with improperly done previous surgeries, especially fibroid surgery, all of which can affect the rate of implantation; and good hormones too to boost the chances of implantation,”
Dr. Ajayi also explores the introduction of High-Intensity Focused Ultrasound (HIFU) technology, an innovative, non-invasive method for treating fibroids that extends beyond IVF. He challenges the misconception linking fibroids to infertility, stressing the importance of precise diagnosis and identifying the root causes of fertility issues. Describing HIFU as ultrasounds converted to heat energy, he underscores its efficacy in removing fibroids without surgical intervention, preserving the possibility of vaginal delivery.
“So, what do you need to get pregnant? Ovaries, for you to release you need the eggs and the sperm and the uterus is only needed for implantation. However, the good thing about HIFU is that it does not affect the ovaries at all because it’s ultrasound and not x-ray, so the ovarian function is preserved, fertility is not affected at all. What is important here is to have a uniform endometrium needed for implantation, so, if the fibroid is not up to 5cm, it doesn’t need to be touched because it doesn’t affect fertility. The problem that we have is that people think when you have fibroids then the person is infertile, that is not true. Fibroids do not cause infertility, but it’s associated with infertility.”
Given the intricate nature and emotional responses associated with IVF, Dr. Ajayi emphasised the integration of mental health support into fertility and IVF at his clinic. To address the significant mental health challenges faced by patients and prospective patients dealing with infertility, the clinic now incorporates the expertise of psychotherapists and psychiatrists. Dr. Ajayi acknowledged the existing in-house counseling services but emphasised the necessity to extend the support beyond counseling, recognising the complex emotional aspects intertwined with fertility treatments. He said: “What we’re looking at now is that we might need to take it a notch higher by having psychologists and psychiatrists to work with us, than just counselling because counsellors cannot prescribe drugs. We don’t necessarily have to employ them but work with us, to start with and we’ll see how that goes. If we see the need to have them full time, then we’ll start considering it but we are beginning to see more and more that many people really need to see beyond the counsellor.”
While expressing optimism about the regulation of IVF practices in the country, the fertility expert shared insights into the driving force behind his passion for raising awareness on the matter. He clarified that his concern for general IVF awareness is not centered on personal reputation. He emphasised that reputation is not a factor, highlighting the crucial aspect of creating awareness. The goal is to ensure that individuals understand the potential challenges associated with IVF and the factors contributing to its success or failure. Dr. Ajayi underscored the importance of demystifying IVF, making it clear that it is not shrouded in secrecy. His focus is on providing factual information so that those considering IVF, regardless of the location, are well-informed about what the process entails and what is required for its success. The primary concern is for people to be equipped with the necessary knowledge to make informed decisions, irrespective of the clinic or specialist they choose, emphasising that the awareness campaign aims to benefit those impacted by this knowledge when they decide to undergo IVF.
He duly recognised the imperative of regulating the fertility industry, underscoring the significance of engaging practitioners and experts in formulating these regulations. The discussion delves into the ongoing initiatives by organisations and government bodies to tackle this issue. In conclusion, Dr. Ajayi imparts invaluable knowledge and perspectives on fertility and reproductive health. The overarching lesson emphasises the vital role of awareness, preparation, and informed decision-making in the pursuit of successful IVF and fertility treatments. As societal awareness grows on these subjects, individuals gain the capacity to make more informed choices on their path to parenthood.
