Infertility: A Shared Responsibility

Male Sperm

Majority of people are of the opinion that when the issue of infertility sets in between a husband and wife, the woman is to be blamed for failing to conceive. An expert recently explained that both the man and the woman have equal share of the problem, Steve Dada writes


Nowadays, cases of infertility are very rampant and no one seems to know why it is so but when a couple experiences delay in achieving pregnancy, men usually lay the blame at the door step of the women, in an assumption that women are in all cases at fault for their inability to achieve conception. But experts have said that issue of infertility is not one in which women should be apportioned an exclusive blame.

 

In a recent interview with THISDAY, a Gynaecologist and Medical Director of St Ives Hospital, Dr. Tunde Okewale, explained that women’s inability to conceive is not their exclusive fault but a fault between the man and the woman. He also bared his mind on what he considers as the reasons for the upsurge in cases of infertility.

 

Infertility, according to him, is defined medically as difficulty of achieving pregnancy after two years of having regular intercourse between a man and a woman which can either be primary or secondary.

Primary infertility, according to him, means that a woman at a point had conceived but the pregnancy was terminated or was medically certified to have missed her period due to conception or had a baby before. However, if it is not on record that a woman had ever conceived at all, this he noted is referred to as secondary infertility.

Okewale said infertility is not always woman’s fault, stressing tha

t most times it could be woman’s fault but added that about 40 per cent of cases could be due to the man. ‘’But in actual practice, when you are working with couples, it is very rare for you to trace infertility to only the woman or man. In most cases, you find that both of them have a little bit of problem here and there.

 

“In fact, we define fertility as the sum, which is the addition of the fertility of the man plus the fertility of the woman. That means if you have a very fertile woman, she can compensate for the man who is not very fertile and vice-versa. In actual fact, that’s how it works out in nature.’’

Okewale further said that infertility in a man means that “such a man is not capable of impregnating a woman of normal fertility apart from the psychosexual subject like impotence. Usually, what one finds in real life is that there is problem with the seminal fluid with the spermatozoa or sperm of the man.”

According to him, the sperm count may be too low or the movement of the sperm may be abnormal or the shape of the sperm may be abnormal or there may be some abnormalities with the actual fluid itself usually caused by some sort of infections.

 

He noted that there is what is known as Azoospermia, which means there is no sperm at all, but added that the problem is not as bad as it sounds noting that many a times this may be due to a blockage of the tube which can be corrected by an operation which he said is always worth trying to find out the cause of the problem.

 

He also mentioned oligosspermia, in which case the sperm count is less than 20 mill per ML, which means that the sperm is not capable of fertilising an egg. He also talked about other abnormalities that could prevent normal fertilisation to take place. For example, he noted that certain percentage (about 60 per cent) of the sperm has to move forward quite vigorously but said in some conditions one finds out that just about 10 or 20 or even five per cent of the sperm move at all.

According to him, there is also abnormality in the shape of the sperm noting that some sperm may have two heads, some two tails and some may have the head joined to the tail. In his view, those ones are not capable of fertilising the egg. He stressed that one needs at least 50 per cent normal shape of the sperm to be able to fertilise the egg.

 

On the part of the woman, Okewale said late marriage can be responsible for the high rate of infertility as against the case of women marrying as early as 15/16 years. “Nowadays, women will marry as late as 30 given the fact that an average lady today will want to go to school and acquire enough education and by the time she is completing her education she is already attaining the age of 30 years which is already late.”

 

Late marriage, according to him, is not good because fertility declines as a woman advances in age noting that the woman’s fertility continues to decrease until the age of 50, which is referred to as menopause. “So getting married late means that fertility at age of 30/35 cannot be the same as at 15 years.”

Another reason is what he described as sexual revolution which started in the sixties when there were lots of contraception and free sex. Okewale said most infertility could be due to infections from having multiple sex partners.

 

He lamented that some of the sexually transmitted diseases, which were believed to have become things of the past are still very much around and are back with vengeance citing the example of syphilis and gonorrhoea as some of such diseases that women and men are still being infected with and now HIV/AIDS. These diseases he said are contributing to high incidence of infertility.

 

Stress, according to him, is one of the greatest causes of infertility. According to him, “a woman who is active/chatting now you can see immediately the moment any form of stress is applied her ovulation is switched off. The stress could be as a result of examination, accident, preparation to get married or having to locate to a new area. According to him, “some women in such situation may think they are pregnant because they missed their period and they may rush to the hospital anxious to know whether or not they are pregnant but when a test is conducted the result will be negative showing that they are not pregnant.”

 

For men, he said quite a number of them who have come to the hospital with very poor sperm count could not find any other reason other than stress, “and once you asked them to change their lifestyle with no drug treatment you find out that the sperm count improves just by removing stress from their lives.’’

 

The fertility expert, who just opened a new ultra-modern facility in Victoria Island, Lagos, said for 15 years the management of the hospital has been serving the residents of the state providing first class medical services at an affordable cost, noting that presently the hospital runs two facilities on the Mainland.

 

He said all facilities of the hospital are managed by a group of consultants in gynaecology, paediatrics, medicine and surgery, who he said are all abreast of modern trends and developments in various specialties supported by highly experienced family practice doctors, nurses, midwives, laboratory scientists and a customer focused administration support team.