Dr. Abayomi Ajayi, founder, Nordica Fertility Centre has raised the alarm about growing infertility cases among men in Nigeria. In this interview with Saturday Sun, he explained some lifestyle principles that need to be changed to save more men from infertility. He also spoke about his own lifestyle and lots more.
All over the world, infertility is usually linked to women, why did you say that male infertility is on the increase?
I think it’s probably cultural, probably from the point of view that a woman would get pregnant. That’s why when pregnancy is not coming, the first person to ask is the person who is supposed to be pregnant. But we know now that someone is supposed to get that person pregnant also. We can see that all over the world, sperm count is decreasing and Nigeria is not an exception. We can see a sharp decline in sperm count in Nigeria. What we are saying actually is that it’s becoming so alarming that for everyone out of two samples that we receive in our laboratories, one is not good and that’s about 50 percent. When we receive about 900 sperm samples we see about 50 percent that is not good, 12 percent has no sperm at all and 38 percent has a lot of sperm . All over the world people are looking at what is the cause of this? There are some countries now as much as about 40 percent of their men have low sperm count. So, it’s a worldwide event and of course in a place like Nigeria where data is not available you can rotate snippets like we are doing. It would have been lovely to do a community survey to look at what the situation is. But what we can just do is with the ones that come to clinic. But one of the things we know that causes this or that causes sperm count to be low, especially the ones that is controllable to us is lifestyle. We need to be talking about lifestyle changes for our young men so that we can prevent to some extent male factor infertility. The other things are not really in our control. For example, if you inherited low sperm count, there is nothing anybody can do; it is not the same if it is because of whatever you are doing either knowingly or unknowingly. Someone just left my office now and said someone has a high cholesterol. I said it’s what you put in. You need to modify some of these things in order for you to get good results. Apart from raising awareness, we also need to table the solution. Probably the solution might be to prevent rather than to treat. That’s why the lifestyle factors are very important to young men.
Taking of lifestyle, what are these things that men should do or not do?
We saw in a study that when you are obese, you are likely to be two and half times predisposed to not having sperm count to when you have ideal body weight. Obesity is one of the things we need to curb in young men. Of course, there are some habits too to curb. For example, cigarette smoking and hard drugs, they also affect sperm count. We see now that our young people indulge in those things, it’s likely to have effects in their fertility overtime. Sometimes your vocation can be part of it. Like some industries , paint industries, petrochemicals. We also did a study and the sperm count in the oil producing areas is worst than the other parts. These are some of the things we also need to talk about for men to understand some of these things. We talked about over exposure to pesticides, over exposure to insecticides, the kind of exercises you do also is a factor. Cycling over a long period of time, anything that increases the temperature of the scrotum is not good, including your underwear. We recommend cotton underwear instead of nylon. Then drugs. Even some prescription drugs can have effects on fertility talk less of those who take drugs without being prescribed for them. The story is told of somebody, he said his sperm count was low, he has a friend whose sperm count was low and he asked his friend what he used. He told him what the doctor told him to use but he forgot to tell him he was supposed to take it only one month. This guy bought the medicine and was using it like forever, like about nine months. The drug is supposed to boost and then come down. This guy has been doing a wrong thing for a long time and this can expose him to some cancers. We need to go away from not going to the doctor, and just using drugs not prescribed.
You mentioned inherited low sperm, how does that occur?
One of the things we forget to state is that diseases can be inherited. There are some causes of low sperm count that you can inherit. That is one of the problems when ICSI (Intra cytoplasmic sperm injection) was invented–– are we sure we are not passing on low sperm count to the offspring? Some causes of male factor infertility are carried in the genes and that can pass on to the offspring. It’s like a looming epidemic; it’s on the horizon, we are not even talking about it. So, it is important that we bring it to the forefront for the young men who are planning to raise family so that they can as early as possible preserve their fertility before they lose it.
As a fertility doctor, are there cases you deem as bad case that you couldn’t handle?
What we need to get right is, people need to make right decisions. There is always a husband for everybody and there’s a wife for everybody. There’s also a solution for every problem; the thing is, is that what do you want? Sometimes, people come to the fertility clinic they think they know what they want or they don’t even know what they want, they just want a baby. So, there are different categories. Some people just want a baby and they don’t mind how they get the baby even through other means that is not IVF. Some want a baby and they are asking the doctor to do what is not possible, like raise a man that is dead. Examples abound. Like you are over 50, you come to fertility clinic and say I want to use my egg. You are asking the doctor to raise the dead because you have run out of eggs and you are asking the doctor to raise your eggs. It’s something that is impossible and you could say it’s a difficult case but it does not mean there’s no solution for that problem. We do respect people’s opinion. The best we can do is to counsel the person on the options. The moment you said this is what you want and you understand the implications of what you want, we will respect that. But when the result now comes, we still talk to you again about the possible options that would help. To answer your question directly, there’s almost no case that has no solution but whether the solutions are acceptable to the couple is a different thing. Even to a woman that is sick and her health does not support pregnancy, there’s surrogacy. There’s always solution to almost everything. If the couple says they don’t want your solution there’s nothing you can do about it.
Being a fertility doctor for years, how has the journey been so far?
No regrets. I think the most important thing to me is the result. You can see all the babies’ pictures around. When I work sometimes and I remember to look at those pictures, some of them have stories that I remember. I just smile. I think we have been able to add to many families to help them complete their family. And that for me is not something that you can quantify in anyway. We have been able to do some new things too. One of the things that we are also planning to do is, there’s a new way of removing fibroid. We are having a conference this February . We are bringing this thing that you don’t need to do surgery to treat your fibroid. We are also starting new things in the country that we think would benefit the populace.
How do you relax when you are not thinking of Nordica?
The funny thing is that I thought overtime that Nordica will get less and less of my time. I don’t think so because I’m even getting more absorbed into it.
Maybe the only time I probably don’t think about Nordica is when I go for Christmas break. Sometimes, it’s difficult. It’s like you are married to your work. Probably Nordica is my first wife, now my wife is the second wife. It’s interesting when you make people smile carrying their babies. It just consumes you without you knowing it. Why do you want to struggle? My wife prefers me being unfaithful to her with my work (laughs). I know how to shut down everything. I used to enjoy going to parties––I no longer enjoy going to parties. Parties don’t trip me anymore. I used to enjoy dancing but now I no longer dance. I think it’s a phase. I need to rediscover my interest again in something else. I still love music but now I don’t dance.
What music do you dance to?
‘Gbe body eeh.’ I still do ‘Gbe body eeh’ once in a while but that has changed.
Why did you ask your wife to join you at Nordica?
We have been working together for almost 13 years now. I think first of all, my weakness is her strength and her weakness is my own strength and I’m very impatient. She’s very patient. When I realized that, I thought that she should come over to Nordica. In the past years, I was very impatient. People don’t just understand me. Some people take it for being wicked, all kinds of interpretations. If you know me very well, that is not true. I needed someone who can interpret to them who I’m really. She’s more approachable. Once I have something in my head until it’s done, don’t stand in my way. She was like my interpreter. That was how we first started and she was able to do that properly. After a while, we got used to working with each other. When I want things done and she’s the one standing on my way ‘wahala dey’. Now, one is getting more matured.
You are really fashionable, what would you say to that?
People say that. I don’t drink, I don’t smoke, I don’t womanize. I must do something now. ‘Man no die man no rotten’ (laughs) I think fashion is just a second nature for me since when I can remember myself. I have an eye for things. Fashion just occurs naturally to me.
You usually celebrate endometriosis in March every year, any new thing in the pipeline?
Yes. We are trying to bring together other African countries. We want to launch Africa Endometriosis Support. We are going to hold a meeting to launch it in Nigeria. The president of the European Endometriosis has agreed to join us. That programme is going to bring Africa and Europe together in endometriosis. We would have our walk, and other programmes in March. But this other programme will be launched in May. March is endometriosis month all over the world, I didn’t fix it. It just coincides with my birthday.