Tracking progress in infertility treatment

Prof Dapo Ashiru

In recent years several fertility experts and other stakeholders have focused intensely on the issue of infertility. Infertility is more critical because of the United Nation’s declaration that everyone has the right to have a baby. In other words, having a baby should be by choice. Hence everything must be done to get everyone access to fertility care.

Infertility is the inability to get pregnant after a year of unprotected intercourse. About 10 per cent of couples in the United States are affected by it. Both men and women can be infertile. According to the Centers for Disease Control,  a third of the time the diagnosis is due to female infertility, a third of the time it is linked to male infertility, and the remaining cases of infertility are due to a combination of factors from both partners. The cause is unknown for approximately 20 per cent of couples. The reason is not determined (unexplained infertility). Consequently, the WHO meeting has now made clear definitions for male infertility and female infertility distinct from each other.

An NGO, the Merck Foundation, under the leadership of its Director, Rasha Kelej, collaborating with the African Fertility Society, has enabled us to unravel through the various campaigns in Africa some of the consequences of infertility on the continent. In Nairobi, a lady called Jaque got her two hands amputated by her husband because she did not have a baby! She became famous worldwide as one of the stigmas that come with infertility even when it is the man’s fault in 50 per cent of the cases. It is why we need continuous education on this subject that affect many homes and marriages.

There is a worldwide emotional epidemic of infertility. As of today, 25 per cent of couples are infertile. Even in India which has severe overpopulation, the most common reason for a visit to the doctor is infertility.

In Nigeria, infertility which used to be a small area of gynecology practice, has now become a vast discipline with several doctors devoting their clinics solely to it.

During the recent conference of the African Fertility Society and the International Federation of Fertility Societies in Kampala Uganda, held on March 1, 2018, the number of IVF clinics in Nigeria was revealed to be close to 70. The number of IVF clinics in Africa is near 160, and in comparison today the number of clinics in Chicago city alone is over 80! It is clear that Nigeria is now recognised worldwide as a part of ART (Assisted Reproductive Technology) providers. We can confidently say today that virtually 95 per cent of IVF cases are treated in Nigeria by Nigerians.

Thirty years ago, more than 80 per cent  of complicated cases of IVF in Nigeria had treatment abroad. These practitioners, under the monitoring guidelines by the Association of Fertility and Reproductive Health in Nigeria  and The African Fertility Society, have saved the country and Africa several resources in foreign exchange being spent previously on overseas medical treatment for infertility.  It is noteworthy that many of the African countries still cannot provide ART services, however.

It is now well known that human ability to get pregnant decreases with age, which explains why only one per cent of teenagers are infertile while a vast majority of infertile couples are in their 30s. It is well documented that from our teen years when the last thing we want is a child, to our mid-thirties when we are finally secure enough to start our family, our ability to conceive decreases almost by 25 per cent.

Research shows that in the past 30 years, infertility has increased and those over the age of 30 have the most problems.

If you are in your 30s and have been working to establish yourself in your profession, please take note.  In planning to start a family in a few years, you should realise that there is a 25 per cent chance you will not be able to do so without medical intervention. It is for this reason that the definition of infertility is made to include a person of age 35 years who has not been able to achieve pregnancy within six months of attempt at conception.

Other factors that may make it difficult for you to get pregnant include abnormal organs, immunological factors and another malfunctioning of the body system. The dramatic increases in infertility over the last 30 years are due to various factors. They include increases in sexually transmitted diseases, environmental toxins in our food – such as heavy metals in fish, environmental pollution particularly in the oil-producing geographical zones, declining sperm counts from absorption of toxic substances and even the increased tension and anxiety of the modern life.

In all other animals except humans, the desire to have sexual intercourse is timed to correspond precisely to that moment when the female is ovulating or producing eggs for fertilisation. Take for instance a dog or a rabbit. Once the woman is ovulating, she seeks out the male, and, after intercourse, the female is usually pregnant with multiple pregnancies. Humans, however, desire to have sex at any time regardless of whether there is an egg that can be fertilised in the woman and it makes us reproductively more inefficient than other animals.

We know that in all species, there is a very short window; in fact, a matter of days during each month that the female is fertile and can get pregnant with intercourse. The timing of sex is therefore crucial if a species is to have an efficient and high fertility rate.

source: the punchonline