Adoption, another option that would have been easily considered by couples unable to have children, is a very difficult process in Nigeria. While legally adopting children other than those related to the adopter by consanguinity through extended family relationships is not very popular, those who wish to do so face bureaucratic bottlenecks and have to overcome so many hurdles that many potentially formidable parents give up. As reported by Orhue and Aziken, 15 IVF was the most common choice of ART among participants in the present study. The preference for this technology could be related to awareness and the non-complex nature of this process, which is also widely used in Europe and the United States of America (USA)18. In contrast, gestational surrogacy (GS), a legal arrangement whereby a woman agrees to carry a pregnancy to term for another person who becomes the child`s parent, was the least preferred, as it was widely accepted that a woman who wanted to be a “mother” would have to give birth to her baby naturally.14 Fadare and Adeniyi also reported that “this feeling has led some women not to accept caesarean section because it makes them less than mothers”, which explains the lack of popularity of this method in developing countries such as Nigeria20,14. As affected couples seek treatment options, they face other serious challenges such as limited treatment options and the exorbitant cost of treatment in Nigeria2,5. Many couples are reluctant to choose adoption as a means of resolving infertility due to cultural factors and non-specific provisions for adoption in the Nigerian legal system2. Thus, the determination of infertile couples to find a solution to their gynecological problem has led to the attendance of various treatment centers with different interventions. Assisted reproduction techniques (ART), including IVF by in vitro fertilization with fresh or frozen embryos and intracytoplasmic sperm injection (ICSI), have been increasingly used in Western countries since the late 19709 and solve more than 50% of infertility cases10.
ART refers to all forms of treatment or procedure involving the in vitro manipulation of human ova and sperm or embryos to detect pregnancy.9 Previous studies in Nigeria have focused on the prevalence, awareness, perception and attitudes towards ART2,11, but there are few studies on willingness to use ART. The study, the results of which are reported in this article, was therefore conducted to determine the attitude and willingness of infertile people to take ART in Ibadan, Oyo State, Nigeria. Amarachi Nickabugu, a Nigerian lawyer, said of the lack of enforceable laws: “There is a need for laws to also protect the donor, recipient and caregiver, a law that defines who can be involved in techniques and practice guidelines, as well as sanctions for those who break the rules of practice. Since the odds favor young women`s eggs, most donors are young women, often students, and they do so in a vulnerable, helpless and destitute place. This is financial coercion, and it is important that there be legal protection for them against exploitation. In 2014, the National Health Act was enacted. This is currently the only legal framework for egg donation in Nigeria. Article 53 of the law criminalizes the exchange of human tissue and blood products for money and even provides for a fine and/or imprisonment of up to one year for those convicted. But the people Al Jazeera spoke to for this story didn`t know the law existed and didn`t know how it would apply to egg donation. A consultation with a fertility specialist can cost between 50,000 naira ($121) and 110,000 naira ($268). Intrauterine insemination (IUI) costs about 320,000 naira ($780) and a single-cycle IVF treatment with donor eggs costs 252,000 naira ($614) without medication, legal fees and appointments. It is difficult to know the number of legally adopted children in Nigeria as there is no national central adoption centre.
Government agencies responsible for adoption are not willing to share this information. The difficulty of legal adoption has been postulated as one of the reasons for the emergence of “baby factories,” the local term used to describe traffickers involved in harvesting children – where babies born to single mothers are sold to couples or individuals at birth to the knowledge of mothers, presumably so that buyers can raise them as their own. In the past, couples who could not get pregnant were expected to turn to adoption in order to achieve their parental dreams. Today, there are many assisted reproductive technology (ART) options for infertile couples, as well as singles and homosexuals who want children.