28th September, 2011
Dr. Bimpe Oladudoye, a medical officer works with Crystal Specialist hospital, Akowonjo
Infertility has been a serious issue for decades in our society. What is infertility?
Infertility is the inability to concieve or get pregnant despite regular unprotected sexual intercourse within a year or six months of trying.
The thing is that a woman must release an egg from one of her ovaries, this egg must go through a fallopian tube toward the uterus (womb). This is to say a man’s sperm must join with (fertilize) the egg. Along the way, this fertilized egg must attach to the inside of the uterus .
Is infertility real? I mean does it exist?
Yes, infertility is a common problem in our society; about 10 per cent women, about 6.1 million women in the world aged from 15-44 years have difficulty in getting pregnant or staying pregnant.
People think that infertility is a woman’s problem only, how true is this ?
Infertility has been grouped into two, that is the primary and the secondary group, secondary infertility refers to couples who have been pregnant at least once, but never again, while the primary group are coupless who have never been pregnant after at least one year of unprotected sex.
To say that a woman is the cause of infertility is not 100 per cent correct but to the ignorant. That is why some people can still say that, medically it has been discovered that 60 per cent of men are the cause of infertility. These days, we have discovered that infertility is not only a woman’s problem. Both the man and woman can have problems that leads to infertility.
Let’s put it this way. About one-third of infertility cases are caused by the woman’s problem, another one problem is from the man while other cases are caused by a mixture of male and female problems or sometimes an unknown cause; but one would have to know the cause of infertility to know how to go about treating it.
What are the causes of infertility?
Infertility could be as a result of infection that was not treated properly or an undetected infection.
Let’s start with the male cause of infertility- there is this problem called varicocele (VAIR-IH-KOH-SEEL). This happens when the vein in a man’s testicle are too large, it heats the testicle.
Also, a wide range of physical and emotional factors can cause infertility. Infertility maybe due to problems in the woman, man or both. Infertility testing invoves a complete medical history and physical examination of both partners. Sometimes injuries or other damages to the reproductive system block the sperm, at times a man can be born with this problem.
At other times, the problem starts later in life due to illness or injuries e.g cystic fibrosis often causes infertility in men. Other things that could cause increase in risk of infertility in man is inadequate treatment of sexually transmitted diseases.
Should a woman be more bothered than a man due to inability to get pregnant?
No, infertility is not always a woman’s problem, both genders can have problems that cause infertility.
What kind of infections lead to infertility?
Endometriosis is the growth of cells similar to those that form the inside of the uterus, but in a location outside of the uterus. Endometriosis implants are most commonly found on the ovaries, fallopian tubes, outer surface of the uterus or intestine and on the surface lining of the pavity cavity, which can also be found in the vagina, cervix and bladder. Treatment for this can be through medication or surgery.
Others are Chylamdia in women, which is spread through sexual contact. Low testosterone can affect both man and woman.
Causes in male are undescended testicle and injury to the scrotum, while in females it includes ovary condition. Treatment includes in male testosterone replacement therapy.
How can infertility be treated?
What works for infertility can be when pregnancy rates may increase with the use of gonadotrophin for male infertility, pregnancy rate may increase with the use of gondotrophins for male infertility. Male infertility contributes to 50 per cent of infertility in couples. Around 39 per cent of infertile men have what we call idiopthics infertility (male with an unknown cause or origin).
Treatment with gonadotrophins (types of hormones) have been used for the idopathics male infertility.Analysis did not find enough studies to draw conclusions about the use of gonadotrophins for the treatment of idiopathic male infertility.
However, analysis shows that the four included studies showed a significant increase in pregnancy rate, during and within three months after gonnadotrophin treatment of men with idopathics subfertility.
Is it possible for family planning to cause infertility?
It very possble for family planning to cause infertility in a woman. That is why we don’t encourage women that don’t have children yet to have it done. My advice to my patients is that barrier method is the best (usage of condoms). Rather that the injectable and the pills method, in some women there is what we call hormone imbalance that occur as a result of change in the woman’s body. At times, it could be irreversible, leading to infertility in the woman. Also, fibroid could also be a major hindrance to conceiving. That is why infertility should be managed.
How then should infertility be managed?
The male and female should do the necessary check up. As for the female, let her go for regular transplant scan, ovalarie test for infection, seek for medical assistant concerning your uterus, DUB distinction uterus bleeding, PID pelvic inflammatory disease, tubal blockage.
In infertility there is primary factors, which affect both the male and female. This trace of factor on male could be from the urinary, medical causes are diabetes and hypertension. Most men wih diabetes don’t have the urge to have sex with a woman. Female factors, which are with the uterus disfunctional ovilataries. Late marriage can also be the cause of infertility; tubal blockage is another factor.
Secondary infertility can be through termination of pregnancy (TOP), meeting can also cause infertility when husband does not meet with their wives at least three times a week and meeting at the right time.
Another factor is biasal body temperature, hormonal test or assa should be looked on.
Can you please tell us a little about sexual and urologic problems of diabetes?
Having diabetes can mean early onset and increase severity of bladder symtoms (urinary incontinence and urinary tract infections) and changes in sexual function. Men may have erectile dysfunction and women may have problem with sexual reponse and vaginal lubrication. Keep your diabetes under control and you can lower your risk of sexual and urologic problems.