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2 The report aims to answer these questions on the Nigerian Infertility Market • What is the market opportunity and is it expanding? • What is the competitive positioning i.e. who are the major competitors? • What internal and external factors are critical for success? 1 3 Overview: Types of Infertility services offered in Nigeria Initial Evaluation • Consultation : o Includes medical history and physical examination o Some centers include investigation as part of the consultation fees • Labs include and not limited to: o Follicle Stimulating Hormone (FSH) o Luteinizing hormone (LH), o Prolactin, o Testosterone (T), o Estradiol (E2), o Progesterone (P4), 17hydroxyprogesterone (17-OHP), o Thyroxine (T4), o Thyroid stimulating hormone (TSH) o Semen analysis • Imaging will include o Ultrasound o Hysterosalpingogram • In some cases, laparoscopic surgery may be indicated to evaluate for endometriosis or pelvic scarring Source: Interviews, Site brochures Procedures • Ovulation induction and cycle monitoring with provision of Clomid • Controlled ovarian stimulation followed by timed intercourse • Intrauterine insemination (with husband’s sperm) • Donor insemination • In-vitro fertilization (IVF) • Intra-cytosplamic sperm injection • Intra-cytoplasmic morphologically selected sperm injection (IMSI) • Surgical sperm collection • Ovum donation, • Embryo freezing • Semen freezing • IVF surrogacy • Surgical Intervention including myomectomy and laparoscopy • Sex selection • Cyst aspiration • Preimplantation genetic diagnosis • Polymerase chase reaction 2 3 Overview: History and trends (1 of 2) 1986 • First baby to be delivered in Nigeria from gamete intra- fallopian transfer • IVF performed by Profs. Giwa-Osagie and Ashiru of the Lagos University Teaching Hospital 1989 • Three years later ,they successful delivered a baby girl conceived via in-vitro fertilization (IVF) 1998 1999-present • A pioneering breakthrough in IVF was achieved at Nisa Premier Hospital, Abuja (established in 1996 which later achieved Nigeria 1st IVF multiples and delivery from frozen embryos) • Authenticated by the Federal Government in 1998 3 Source: http://www.nigeriavillagesquare.com/forum/archive/index.php/t-31746.html • In the private sector, over the next several years, 10-12 infertility units/clinics were established in urban metropolis such as Lagos, Abuja, Port Harcourt ,Kaduna • Several of these clinics have satellite locations