‘Infertility is common among men and women’

Dr Adewole: It is when a couple (man and woman) are together and having regular sexual intercourse and cannot achieve pregnancy after one year. I say this because I have met couples that don’t have sex regularly and still complain that they can’t conceive. As a matter of fact the couples don’t live in the same place. The husband works in one state and the wife another. And they only meet once in three months, so such a couple cannot achieve conception because when they have sex may be when the woman is not ovulating, there is no conception.  After one month of sexual intercourse, it is assumed that an average 25 percent of the couples should have conceived and after six months, usually 60 percent of couples should have achieved pregnancy. And after one year, about 85 percent should have achieved conception. But this is not always the case, hence we have infertility problems. And study has shown that infertility is almost as common among men and women. The prevalence in men and women is 50/50. So when you are talking of infertility, it is unethical to deal with only one partner. The couples are meant to see their doctor together and then investigate together. The problems could be with a woman’s ovary, uterus or the genital tracts. The first problem usually in the genital tracts is the tubal factor. Remember that for the sperm to get to where the ovary is, and then to the uterus, you need a connection, so the tube connects the two. And if there is a problem with the tube, we call it the tubal factor of infertility. This is more common among Africans because of the risk in pelvic inflammatory disease. This is because most times, they are poorly treated or not treated at all. That is one of the reasons African have high rate of infertility.

The other factor that could cause infertility is when there is ovarian problem. If there is no egg, what will the sperm fertilise? When the ovary has a problem and cannot produce eggs (i.e. when the woman does not ovulate) or cannot produce quality egg, then that is a problem.

WT: When is the woman most fertile?

Dr Adewole :It is during the ovulation period. It is usually 14 days to the next menses of the woman.

WT: How common is infertility?

Dr Adewole : In Nigeria, it is between 15 and 20 per cent.

WT: What is the cause of infertility in men?

Dr Adewole : The most common causes of male infertility include abnormal sperm production or function, impaired delivery of sperm, general health and lifestyle issues, and overexposure to certain environmental elements.

Most cases of male infertility are due to problems with the sperm, such as impaired shape and movement of sperm. Sperm must be properly shaped and able to move rapidly and accurately toward the egg for fertilization to occur. If the shape and structure (morphology) of the sperm are abnormal or the movement (motility) is impaired, sperm may not be able to reach or penetrate the egg.

Low sperm concentration. A normal sperm concentration is greater than or equal to 20 million sperm per milliliter of semen. A count of 10 million or fewer sperm per milliliter of semen indicates low sperm concentration (subfertility). A count of 40 million sperm or higher per milliliter of semen indicates increased fertility. Complete failure of the testicles to produce sperm is rare.

Impaired delivery of sperm. Problems with the delivery of sperm from the penis into the vagina can result in infertility.

WT: Is it possible for someone to detect that he/she is infertile before he begins to meet his/her partner?

Dr Adewole: It is possible, but it is unnecessary. For a woman that does not have  problem with her menses, and has not had any infection because she takes care of herself properly, or has not been having any inflammatory disease, or has not undergone any termination of pregnancy by quacks for those women, there may not develop infertility problems. But for women that have problem with their menses or has not been seeing her menses at all, or a woman that has had many inflammatory disease, there is need   to see the doctor.

WT: What is the way out for such women?

Dr Adewole : These days it is practically impossible to say a woman is infertile because the society has advanced to the level that there is always a way out. So the best thing is for the woman to see her gynaecologist to enable them investigate and know which method is appropriate to take the woman through. Some of them are advanced technologies while by mere counseling some can achieve conception. And for some taking fertility drugs but again, people just take fertility drugs without prescription but my advice is that they should always take fertility drugs with the prescription of a gynaecologist because they also have their own side effect. If they take it too much they could develop what is called Ovarian Apastulation Syndrome. A condition where there is excessive production of eggs leading to abdominal pain.