Job Osazuwa
It is the expectations of most couples to, as soon as possible, welcome babies into their homes after tying the nuptial knot. Often times, they would set a timeframe for themselves for conception as well as the arrival of the baby.
In many cases, such expectations are overstretched as a result of delays in conceiving by the woman, which could span across many years or even decades. The waiting gradually snowballs to anxiety, disappointment and gloom. And in the end, it could be dashed.
Understandably, giving birth to babies is seemingly the major reason that brings young men and women together to become husbands and wives. In this part of the world, unions are often termed worthwhile when their homes are blessed with children.
Some desperate wives or husbands have fallen into the hands of fake spiritual warlords who claim to possess the power they need to have their own babies. But the couples end up being enmeshed in more woes. In the process, the charlatans fleece their victims of millions of naira and valuable property. Rather than ameliorating the couples’ problem, they compound it.
Gynaecologists have raised the alarm over the increasing rate of infertility among men and women in Nigeria. They have identified different factors that could be responsible for the unhealthy trend.
The World Health Organisation (WHO) defines infertility as when a couple is unable to get pregnant after having unprotected, regular sex for about one year, when the woman is less than 35 years.
Specialists have explained that for a pregnancy to take place, a woman must produce and release a healthy egg from one of her ovaries and a man must produce viable sperm, which can successfully fertilize the woman’s egg. Also, the egg must travel through a fallopian tube toward the uterus) and the fertilized egg must attach to the inside of the uterus.
A consultant gynaecologist and obstetrician, Abayomi Ajayi told Daily Sun that it could be difficult to tell whether infertility was on the rise in Nigeria or not due to lack of reliable data. However, he said there might be increase judging with the increasing number of patients that are now visiting clinics for a solution. He said one out of four couples experiences infertility.
“In places where records are well-kept, it might be true that infertility is increasing, especially with men. The female could be responsible or two of them combined. In some cases, you could do your basic tests but can’t find any reason why the couple should not have a baby, which we call unexplained.
“One of the major causes of infertility is unhealthy lifestyle. People smoke heavily; gulp all manner of soft and energy drinks. Our lifestyle consists of the choices that we make which can greatly influence our fertility and general wellbeing. People are not conscious of what they eat,” he said.
He blamed those who have been swindled by false prophets and quacks for refusing to access the right information on infertility. He said infertility was not in any way controlled by any spiritual power but simply biological. He stressed that accurate knowledge is the most powerful tool needed by the public in tackling infertility.
Speaking on in vitro fertilisation, which is easily called IVF, as one of the means of bearing children, Ajayi said that a lot has been achieved in using such a medical innovation to treat infertility in couples. He said that assisted reproduction has come to stay and it is putting smile on the faces of couples who cannot have babies on their own.
Speaking from his over 35 years of experience in human reproduction, he noted that the acceptance of medically-assisted means of getting women pregnant has increased over the years. He said that he was pleased with the level of awareness in Nigeria.
He said: “All the same, we still have our challenges which are the cost of doing IVF and shallow knowledge. Many people still have superficial knowledge about how science works in this direction. People need to have deeper knowledge on this subject. I usually tell people that it is a branch of medicine that if you want to be part of it then you have to know much about it in order for you to get the best result. Patients have ill-informed expectations when it comes to IVF.”
Throwing more light on how IVF works, Ajayi who is the medical director of Nordica Fertility Centre said that it is a process whereby fertilisation takes place outside the womb with the aid of technology and expertise.
Said he: “God is supreme because He uses one egg and sperm to achieve fertilisation, why many eggs and some sperm are needed in assisted reproductive system. The more eggs we get, the better the chances of achieving pregnancy.
“Success rate is dependent on the age of the woman, principally. It can also be determined by the quality of egg of the woman and the sperm of the man. The second thing is the uterus. Once fertilisation has been achieved outside the body, we need implantation. For implantation to occur, we need the embryo to be viable, meaning it must be receptive to the uterus. If all these factors are not in place, there might be failures. The best age to carry out IVF is bellow age 35, where there is 40 to 50 per cent success rate. Some people have done three circles and succeeded in all while some others have done same circles and failed in all.
“Mind you, also, the hormone that produces the semen in men decreases with age. It is natural that the parameter in the semen to decline from about age 35. There is erectile dysfunction in men who are overweight.
“Infertility can be treated with drugs, surgery and assisted conception. As at 2016, there is no drug for sperm booster for men. But there are drugs to boost female ovulation. In all, most of the patients benefit more from assisted conception. We use drugs to increase production; sperm preparation and fusion of both egg and sperm.”
A gynaecologist, who is based in Lagos, Kennedy Immaculate, said infertility might be caused by many other reasons, such as genetic factors, age, or too much exposure to certain chemicals and toxins.
He said that it was unfortunate that many men suffering from low sperm count or abnormal sperm function blame their wives for their inability to bear children. He advised couples to always ensure that they run a comprehensive diagnosis when faced with infertility challenge.
He explained that low sperm count or abnormal sperm function could be caused by undescended testicles, genetic defects/deoxyribonucleic acid (DNA) damage, diabetes, prior bacterial or viral infections such as mumps or adenovirus and trauma or prior surgeries on the testicles or inguinal region. He said that it could also be caused by enlarged veins (varicoceles) in the testes that can increase blood flow and heat, both of which affect the number and shape of the sperm.
He added: “Others factors are exposure to chemicals like pesticides, radiation, chemotherapy; excessive intake of alcohol; stress; tobacco smoke; steroid use; overexposure to heat and surgical removal of one of the testicles due to cancer. Semen entering the bladder instead of emerging through the penis during orgasm (retrograde ejaculation) and certain genetic diseases (such as cystic fibrosis) are possible reasons too.”
“Infertility in women is largely as a result of hormonal issues. This is when hormone disorders are present, which usually lead to problems with ovulation. These can be due to the lack of the necessary synchronized hormonal changes leading to the release of an egg from the ovary. Women can as well experience disorders of the thyroid gland. That is either too much thyroid hormone or too little thyroid hormone can interfere with the menstrual cycle or cause infertility.
“There are also gland disorders; structural issues; fallopian tube damage or blockage; diminished ovarian reserve, premature menopause or cessation of ovulation (primary ovarian insufficiency); changes in egg quality or quantity that can affect fertility.
On the right diagnosis to be done, he said: “Blood, urine and imaging tests can be done. A sperm analysis can be done to check a man’s sperm count and the overall health of the sperm.”