Helen Tesfay (not her real name), who is in her mid-forties, has been married for almost two years. But she and her husband have been trying to have a child but have been unsuccessful.
“When we go with the family, ‘Why don’t you give birth?’ They say. This is also worrying. I don’t have a child, so I feel really bad right now. All my sisters have given birth. I feel very bad because I don’t have children,” says the resident of Mekelawa, about the impact of not having children after getting married.
“A child is a very important thing. If I make a house, what if I am alone?” she asks.
Helen told the BBC that despite having stopped menstruating, she visited various medical professionals to try to conceive. Even though she took the medicine prescribed for this, it did not make a difference.
But now she says she’s found a promising solution.
Helen Even if you stop menstruating; She was told she could get pregnant if she could find an egg donor.
This type of treatment is provided by Ado Maternal and Child and Infertility Treatment Center in Mekele, Tigray.
Helen, who heard from the center’s medical staff about the new baby’s incubation method; She explains that she has been asking close women she knows to give her eggs for the past few weeks.
Although she did not get a happy response from most of the people she posed the question to; She told the BBC that her brother’s wife had expressed her willingness to give her eggs.
An icon that provides this type of infertility treatment; The permission to collect sperm and female eggs from donors was obtained from the Food, Drug and Health Control Authority of Tigray region about three months ago on December 24, 2016. is it.
The center Ado’s owner, Dr. Samson Mulugeta, told the BBC that after obtaining this permission, he successfully created the first embryo by connecting a donated sperm and his wife’s egg.
Yusuf Ibrahim, Deputy Director of the Regional Food, Drug and Health Control Authority, confirmed to the BBC that the pregnant wife and her husband are awaiting the birth of the child.
Other patients at the center are also waiting to have a baby from a donated sperm or egg, says Ado’s owner, Dr. Samson. For this reason, the center is calling for willing people to donate sperm and eggs.
The treatment of a child with donated eggs and sperm
According to Dr. Samson, the specialist of uterus and fetus; The women who are being given birth with donated eggs “have a womb that can carry an embryo; They say they are eggless. They explained that women who are in this situation will be fertilized by combining their donated egg and their husband’s sperm.
And those who give birth with sperm donation; The specialist who say that if the husband has “semen but no sperm cells”; He explained that the fertilized sperm and the wife’s egg will meet and create a fetus.
In vitro fertilization (IVF) is the process of creating a fetus by connecting a woman’s egg and sperm in a technologically assisted way. When this artificial fertility treatment is performed, the egg and sperm are brought together outside the uterus in a laboratory.
The embryo created in the laboratory is placed back into the uterus and the normal natural process of pregnancy and childbirth continues.
In this treatment, a donor egg or sperm is used if the husband or wife is having fertility problems. For the first time, a child was born with this medical method in 1978 in Europe, and since the last three decades, the medical method has developed in different ways and has become widely used.
According to data from the World Health Organization, more than five million babies have been born since the beginning of technology-assisted abortion until last year.
Dr. Samson, Gynecologist and Fetal Specialist; Ethiopians who have difficulty having children say they often travel to India to get this treatment. Indian medicine that requires 15 to 20 thousand dollars; They add that he has “a lot of fatigue.”
According to Dr. Samson, apart from the high cost, Ethiopians who come to India with eggs or sperm donated by someone else face another problem.
The Ethiopians said, “When they go abroad, the pregnancy they bring with them is from India.” [የህጻናቱ] Hair is changed, their appearance will change. There will be less pressure from society. Although they are happy to give birth, the semen and eggs they will be given will be from India, so it will have its own pressure,” he explains the problem they have noticed.
Dr. Samson says, “It is the problem of the society that pushed us to enter this work.” “The person who understands the problems of these people is a childless person,” they said. For another,[መደበኛውን ህክምና] When we work, when we tell them ‘we didn’t get sperm from your fruit’, it’s because they see the situation of going straight to divorce, their ten-year love falling apart at once.
Call for sperm and egg donation
Ado Maternal and Child and Infertility Treatment Center; Dr. Samson says that the preparation to give this treatment started before the war in Northern Ethiopia started. Because of the war, efforts to start treatment were halted, and after the war, the process resumed.
The center is currently looking for people willing to donate sperm and eggs.
According to Dr. Samson; Not everyone can donate sperm or eggs. Donors of both sexes have criteria that qualify them beyond voluntariness.
Male sperm donors must donate more than 1.5 ml of semen. There should be more than 15 million sperm cells in one milliliter of semen. In addition, the donors must be screened to ensure they are free of HIV, hepatitis virus and other infectious diseases.
Dr. Samson explains that there is also an age limit for women who donate eggs. Women who are eligible for egg donation are between the ages of 20 and 30. Furthermore, female donors must have previously given birth.
Dr. Samson explains the reason for this requirement; “[የወለዱ ሴቶች] Their eggs are tested. Because they gave birth. There is confirmation that their eggs are normal. The younger the egg, the better the quality. If it is a quality egg, the chances of conception are high. It goes to 80, 85 percent. This is the experience of working in the world.
The owner of the center stated that donors who meet these requirements will enter into an agreement with the institution. As the uterus and embryo specialist explains; One of the issues in the agreement is that it is not specified to whom the donated sperm or egg will be given.
“When donating blood, it is not known to whom it is given. It is meant to save human life. “Here, helping people is thought of,” he said, pointing out that his approach follows the same principles as donating blood.
However, there are cases where it is possible to know to whom the donated sperm was donated. One of these is when recipients bring their own donors.
Dr. Samson mentioned that the agreement to be signed during the donation is a solution for this. The gynecological and fetal specialist explains that they cannot raise a question of paternity on the child born after the embryo is created with the eggs or sperm provided by the donors.
“The sign on the contract is ‘I am donating voluntarily.’ It is said that the fetus that is created, the child belongs to those who receive it. Therefore, it is not something that will bring much controversy,” he said, raising one of the main issues of the agreement.
Male and female donors who agree to this contract go through different procedures. Dr. Samson says that male donors should abstain from any form of sexual intercourse until the day of sperm donation after they have been tested free.
They explain the process by saying, “They give semen through masturbation” on the day the sperm is taken. Men who donate seeds will be given ten thousand birr “incentive money”, they said.
The process for female egg donors takes longer than that for male donors. Before donating, women who go through the process receive an “injection to stimulate the egg,” explains Dr. Samson.
“[ለጋሽ ሴቶች] They will take injections for about 10 days. When we think that the egg has grown [እንቁላል] We collect through the ultrasound that penetrates the uterus,” he explained the process.
Female donors receive more “incentive money” than male donors because the process of donating eggs is not as “easy” as that of men and they have to travel to the center for days. Dr. Samson stated that the amount given by the center to donor women is 30 thousand.
So far, the owner of the center said that he has not been able to find volunteers to donate eggs or sperm. Referring to the lack of awareness for this, “…we are trying to explain that it works in another world, it is to help a person in need.” I think it will take some time,” he said.
The process of creating an embryo with donated sperm and eggs
According to Dr. Samson, patients must be sure that they are unable to have a child with any other option before entering into a treatment that allows them to have a child with donated eggs and sperm. Once this confirmation is obtained, the matter will be brought to the center’s board and the process will be reviewed.
The obstetrician-gynecologist; “[የቦርዱ አባላት] You see the process. What are the patients diagnosed with? What options do they have? [የሚለውን መርምረው] They confirm with their signature that ‘the only option is to donate’,” he said, explaining that patients are told to prepare after this.
Dr. Samson explains that women who donate eggs take medication for 10 days to prepare the uterine wall. They also mentioned that the sperm used for these women comes from their husbands.
If the sperm is taken from another man due to a problem with the husband, then the wife’s eggs will be collected. “The wife keeps producing eggs. [የሚስትን] “The day we collect the egg, it means that the donated sperm will connect with the egg to become a fetus,” he explained the difference.
The obstetrician-gynecologist; They state that in both ways, the egg and sperm are made to meet in a laboratory.
“The egg and the sperm meet and an embryo is formed in the laboratory. The embryo stays in the incubator for three days. We checked the stage of the fetus, its growth and confirmed that it is normal. “We insert the embryo into the uterine wall of the recipient woman,” he explained the process.
According to Dr. Samson, this process may cost 350 to 500 thousand birr. The cost of carrying out the necessary procedure is much lower than that paid in other countries.
What does the law say about artificial reproduction?
Yusuf Ibrahim, deputy director of the Tigray Regional Food, Drug and Health Control Authority, told the BBC that his office gave Ado permission to accept sperm and egg donations following a request from the center.
The official office in November 2016. According to the request, before granting the license, various assessments were carried out to ensure that the center is capable of providing the requested service.
Mr. Yusuf mentioned that the educational preparation and experience of the professionals providing the treatment as well as the technological equipment used were evaluated by the experts and the requirements were met.
“[በተጨማሪም] We will see in our declaration whether it opposes the federal law or not. Because we have nothing to object to according to this decree [ፈቃድ ተሰጥቷል]He explained that the legal issue of the country has also been evaluated.
The Deputy Director; “In Tigray [ውጭ ሀገር በተለገሰ ዘር] There are four, five children born. They look like foreigners. The child to be born will not go with our skin. [በዚህ ምክንያት] In order to reduce the psychological pressure on mothers, we agreed that it would be better to give the treatment here with our semen and eggs,” he said, raising another issue that led to the center getting the license.
In the letter in which the authority stated that the license had been granted to Ado; The war’s impact on the reproductive health of the region’s residents, as well as the economic pressure to seek this treatment abroad, were cited as reasons.
The BBC observed that this letter refers to the “Food, Drug and Health Care Management and Control” regulation approved by the Council of Ministers in 2006. This letter, written by Mr. Ibrahim, mentions that in Article 57 of the regulation, “no prohibition is placed on the donation of male and female sperm”.
The article referred to in the letter is the part of the regulation that deals with “artificial reproduction treatment”. This article stipulates that licensed facilities can provide this treatment.
the rule; “Artificial reproductive treatment can be provided by a health facility and health professional licensed by the appropriate body,” he says. Renting a womb and “creating a person through cloning technology” are forbidden activities in the same article.
However, the artificial reproduction mentioned in the regulation does not include sperm or eggs donated by another person, Ato Kalakchew Tsedal, the executive director of health, health facilities and professional supervision at the Ministry of Health, told the BBC.
In 2006 The regulation’s definition of “artificial reproductive treatment” includes two types of treatment. the first; It is “the transfer of sperm to the internal reproductive organs of the female for the purpose of procreation in a manner different from that known naturally.”
Another definition given to “artificial fertility treatment” is; “The result of the union of the male and female races; Mixing male and female sperm outside the body to transfer it from the woman’s womb.
According to Ato Kalakchew, although there is a standard in Ethiopia for obtaining a license for health institutions that carry out this treatment called “IVF”, the license does not include the creation of embryos from sperm or eggs donated by another person.
“As a country, this can only be done between husband and wife. We cannot recognize any donation other than this,” the minister explained the following procedure.
As a result, Ato Kalakhe said that they “cannot comment” on embryos created by donated seeds. They added that they do not know about the permit issued in Tigray region.
However, he pointed out that the states can choose their own way based on the actual conditions regarding health issues. The Chief Executive; “[የጤናን ጉዳይ በተመለከተ] Regions have something to adjust, improve or customize according to the actual situation of the regions. But you can’t change some things. There are federal and state powers under the Constitution. Therefore, even if there is health in the state and the federal government, the states have the opportunity to adapt to themselves.
