What you can do to have your own child — Fertility expert

Infertility is the inability of a couple to achieve conception after 12 months of regular unprotected intercourse. In this part of the world, it quite commonly affects up to one in five couples. As with most other issues in developing countries, there are many misconceptions associated with infertility especially with its causes and treatment options.

In the last edition, I introduced Mr and Mrs O.E, a couple from the south western part of Nigeria that I had the pleasure of attending to a few years ago. Mr and Mrs O.E had been married for about 3 years when I met them. Mr O.E was a well to do building contractor who had an eight-year-old son from a previous relationship before getting married to a 33-year-old fashion designer. They had a glamorous talk of the town wedding on Valentine’s Day of that year. However, three Valentine celebrations, many quarrels, several doctors and tests later, Mrs O.E was still unable to conceive. Her husband had a confirmation of his “fertility” after all, he had fathered a son before. He was convinced that his wife was unable to conceive because she had terminated an unwanted pregnancy while she was an undergraduate. So, he kept on harping on that mistake to the gentle woman’s dismay.  The first day I met them, Mr O. E asked me this: “How do you know if a woman has had an abortion before?” and his wife simply burst into tears. I had to carefully explain that infertility is not a wife or a husband issue; it is a couple’s challenge. In some situations, nothing may be wrong with either of them but there may be a challenge with conception.

I requested for baseline fertility test for the couple and it turned out that Mr E.O had very low sperm counts. With tears in his eyes, he asked me “does that mean the previous child is not mine?” My response was aimed at reassuring him. So I said, “it doesn’t mean that at all. It may be that when you had him 8 years ago, your sperm cells were fine but now that is not the case”.

On second thoughts, I probed him further about the age of the woman with whom he had the son. “How old was your son’s mother when she got pregnant?” His response was “she was barely 22 years old.”

At that age, a woman is most fertile and even with low sperm counts, there still may be pregnancy because at that age, a woman’s egg quality is at its peak. I advised him on the need to have in-vitro fertilisation to achieve conception in his marriage. As you read this, infertility is a thing of the past in that family. Mr and Mrs O.E are proud parents today.

Based on my interaction with them, I realised that so many people have little or no real information about infertility and have swallowed hook, line, sinker, misconceptions from a misguided society. Consequently, I have chosen to write about infertility, what is true and what is only a figment of the imagination. In the first edition, I successfully gave insights on 10 infertility myths; today I would be debunking more myths about infertility.

Myth 1: Infertility won’t happen to me

Fact: This is wishful thinking. The sad fact is that infertility is a common problem affecting about 20-25 per cent of couples in developing countries. Your chances of being infertile are about 20-25 per cent! I am sure everyone reading this knows at least a couple, if not more, suffering from this challenge. Unfortunately, there is no reliable way of being able to ascertain your fertility other than actually getting pregnant.

Myth 2:  I can’t be infertile, I already have a baby

Fact: If you had a baby in the past it simply means you were fertile then, there is no guarantee that something may not have cropped up between then and now causing you to become infertile. This is what we refer to as secondary infertility.

Myth 3: I am too young to have fertility issues

Fact: Unfortunately, infertility does not respect age. While it is true that older men and women have a much higher chance of being infertile, young people may also have fertility challenges personally or from their partners.

Myth 4: Increase your chances of conception by having sex on the day of ovulation

Fact: This is not necessarily so because we know the woman’s egg will stay in the genital tract for about 24 hours and the sperms can for about 5 days. It is advisable to have more frequent sex around ovulation. The challenge is that sex on ovulation day poses performance anxiety on the men whereby the erection may be impaired because of the anxiety from a demand to “perform”.

Myth 5: Abstinence from sex improves sperm counts

Fact: Abstinence does not improve sperm counts. On the contrary, abstinence causes older sperms to accumulate and the older the sperm, the higher the risk of genetic damage and poor fertilization ability. Regular ejaculation is best to have good quality sperm.

Myth 6: The only treatment for infertility is IVF

Fact: This is not so. The treatment for infertility will depend on the cause of the infertility. While it is true that about 60 percent of couples will require IVF, the rest may not. Approach to treatment will depend on the cause of the delay in conception.

Myth 7: Taking hot baths will affect sperm production

Fact: This is a half truth and like a wise old man said “be careful of half truths cause you may have the wrong end of the half!” If one sits for prolonged time in a tub of hot water while taking a bath, the testis are in the hot water for a prolonged period and sperm production may be affected but if what I do is have a hot shower, sperm production is not affected.

Myth 8: I have had a surgery to correct the low sperm counts; I don’t need any other intervention to have a baby

Fact: The most common surgery performed to improve sperm counts is varicocoelctomy and most surgeons give a six month period to get results. So, they counsel that if your wife is not pregnant six months after the procedure, you should see a fertility specialist. This is because about 25 per cent of men who had the procedure will have improved sperm parameters which usually reduce within 6 or 12 months. Another 25 per cent will actually have worsening sperm parameters while about 50 per cent will have no improvement at all. The aim of having the surgery is not just to improve sperm parameters but to achieve conception and if conception has not happened, please see a fertility specialist.

Myth 9: In vitro fertilization has a low success rate and rarely succeeds

Fact: While there are no guarantees in IVF treatment, your specialist should be able to advise you on what your chances are whether they are good or bad.  If the chances are bad, he probably can advise on steps to improve the chances.  Pregnancy rates averages, about 35 per cent and when compared to the chances of natural conception of 20 per cent (in fertile couples) it still offers a lot of hope.

Myth 10: In vitro fertilization is too expensive for most couples to consider

Fact: In-vitro fertilization is expensive all over the world; this is because the drugs, equipment, training, maintenance and support services are expensive especially in developing countries.  Any couple that can afford a decent second hand car can afford IVF.   It’s all about priorities and planning.

If a couple is fertility challenged, a good point to start from is to know what is true and what is not. Misconceptions can very easily send one on a wild goose chase without any profit after all is done. It is important to talk with your doctor, do your own bit of research and have a clear cut plan for action.

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