•40% men suffer low sperm count
•Late marriage in women big factor
•Couples now queue at orphanages to adopt babies
•15 fertility clinics to the rescue
•IVF costs N1.2m
By PATRICK ASONYE & AGAPTUS ANAELE
Sunday, May 25, 2008
By the accounts of Nigerian medics, there is an upsurge in the number of couples seeking fruits of the womb in the country, a trend experts attribute to a number of reasons ranging from late marriages, environmental factors and decline in the quality of sperm.
Indeed the situation has given rise, in some instances, to the dislocation of some otherwise ideal families founded originally on love.
Worse still, evil merchants, taking advantage of the situation, have set up shops and are surreptitiously trading in babies of indigent mothers like stocks on the floor of the Stock Exchange. Quite a few have been nabbed in the process.
Those that bother to do the right thing run accredited orphanages, now with unprecedented patronage.
At the spiritual level, some self-professed miracle workers have been at their very best, all in an attempt to convince baby seekers to look into their places of religious worship, and be glad that they did.
Yet, the problem remains that Nigerian men are by the day losing their virility to empirical reasons.
On that score, medical personnel are of the opinion that stress alters the reproductive system by impairing hypothalamic function responsible for reproduction in both sexes, fertility declines with age.
They also fingered environmental pollution, substance abuse, obesity in women, and multiple sexual partners that lead to sexually transmitted infections, resulting in tube blockage, as key factors fuelling infertility.
Hear Professor Oladapo Ashiru, Medical Director of Medical Art Centre in Lagos: “The number of infertile couples is on the increase and more worrisome is that the number of men presenting with low sperm count is on the increase.”
Sunday Sun gathered that the statistics has shot up from 15 per cent in men to 40 per cent.
The development has led to the proliferation of fertility centres, churches with bogus claims of miracles and spiritual homes, making couples desperate and even gullible in the hands of opportunists.
Over 15 fertility centres have sprang up in four cities - Lagos, Port Harcourt, Benin City and Abuja.
More worrisome is the fact that it has, in some instance, led to the breakage of many homes. Sperm donation and surrogate motherhood, hitherto perceived as abomination, have become rampant in the country.
However, few genuine Assisted Reproduction and Fertility Centres offer solution to infertile couples, but at exorbitant prices.
On the average, it costs Six hundred and fifty thousand Naira (N650, 000) for a procedure of Assisted Reproduction.
Sunday Sun gathered from orphanages in Lagos that the demand for adoption far outstrips supply, so couples now queue for months on waiting list, further affirming that all is not well with procreation process.
Prof Ashiru speaks:
Yes, infertility is on the increase in Nigeria. The population that is involved with regard to infertility is as high as 20-25 per cent of married couples. One in five couples have fertility problem and the trend is on the increase for two reasons.
One, there is increased awareness about the problem. Secondly, there are more problems that are occurring within the system, that are technological-related that are creating fertility problems.
For both men and women, the first are emotional stress. Our society is a highly stressed society. From home to work, and the kind of things that goes on, are all stress-related. There is stress in getting on the traffic on the road; there is stress in achieving what you want to do. Even, when you go to the store to buy something, there is stress. There is fear from armed robbery. Economic, financial stress is there, because we live in a society that places a lot of emphasis on money as opposed to value of professionalism. The level of stress that goes into marriage planning and the money spent by the couple is high stress-related. All these have far reaching consequences on a centre in the brain called the Hypothalamus, the centre that controls some of the reproductive functions.
Stress is a condition that triggers the adrenal gland. This is known as the stress gland. When there is too much pressure on the adrenal gland, it will control the ovary and the sperm cell, and the brain. Under normal circumstances, when it is stable, it balances these two hormones, the brain and the hypothalamus and the ovary, so they circulate like an orchestra in symphony, to bring out this tune and at the end of each month, it will clock at 28 days to produce an egg. Stress, either from the environment or your thought, goes straight to the adrenal gland.
If you can’t handle it, it releases some hormones, and could lead to high blood pressure. If you can’t handle it, it releases some hormones that create problems for the ovary and metabolic process, so the person may start to eat too much. It may release something that affects mood, leading sometimes to depression. When that occurs, it may affect the ovaries and the woman may no longer ovulate every 28 days. Sometimes it may be 19 days or it could be delayed. Sometimes, it could lead to early miscarriages.
Effect on men:
In men, stress is known to reduce sperm production by 15 per cent. It destroys the spermatozoa.
Many people now marry at late. Twenty years ago, people married at the age of 25 or even earlier. Today, people are getting married at the age of 32 or older. I am referring to the women or ladies. And for the men, it is even slightly higher. At this age, reproductive function is already declining. From basic raw statistics, for somebody that is between 16 and 21, fertility is almost 75 per cent. By the time you get to age 40, it has declined to eight per cent.
Environmental hazards: generators and all:
There are too many things in our environment leading to infertility. There is no electricity. Excessive use of alternative energy leads to the release of hydrocarbons and they are definitely having far reaching consequences on the sperm production process in men and the ovulation process in women. Smoke release is also a major factor. If you look at our society, the level of pollution that we are witnessing now cannot be compared to what we saw in the 70s and 60s. Almost every other house has a generating plant and when there is no light (public power supply), they all release fumes and pollute the air.
Poor water source:
We don’t have enough regulation to control our water system and there are a lot of poisons being released into the water system. In some cases, petrol stations are sited near the river. We site soap and dry cleaning industries in the various places. These have serious consequences on fertility.
Bad urban planning:
Previous governments made use of area planning by strictly reserving some areas as residential and some for commercial purposes. In developed societies, residential areas are strictly residential, maybe with one or two corner shops but here, areas reserved for residential are converted for commercial use. All these emit serious toxins into the air.
Men firing blank
Men are having very low sperm count. The percentage of men with low sperm count is higher than that in the US. From my experience in Chicago in the US, the male problem is about 30-35 per cent, but in our country, the male factor is rising. The uses of hard substance, smoking, alcohol and marijuana have far reaching effects on sperm count and sperm production.
Occupational hazards, like those who work with heavy metals and those who work in hydro and petrochemical industries are at risk. Men working in plastic and paint industries are also at risk, because these are occupations that are known to drastically damage the sperm.
Sperm count hitherto:
From raw information, when you have 10 couples with infertility, ten years ago, the problem was predominantly tube blockage, and those who are unable to ovulate and may be 15-20 per cent with low sperm count. Then, you could help them if you concentrate the sperm and inseminate it into the woman. But today, you are having as high as 35 per cent of men with low sperm, if not 40 per cent and a substantial per cent, say 15-20 per cent of them, you will have to get the sperm and inject it into the wife, through the procedure we call intracytospemic sperm injection (ICSI), because the sperm on their own cannot do anything. A low percentage of them have obstruction to the sperm, which are genetical factors whereby the sperm are blocked on the pathway, so you have to do a special procedure called testicular extraction to extract the sperm from the testis and then use it by ICSI to achieve fertilization and get them pregnant.
Sperm count is the amount of sperm that is produced in semen. When a man ejaculates, he comes up with a fluid, either grey or yellowish in colour. The semen contains very small cells known as spermatozoon for one and spermatozoa for many. Normally, it should be 60 million in one ml and a man should be able to produce about 2-3mls per ejaculate. So you will be expecting about 120-200 million sperms in that ejacula.
You could have oligospermia, in which case the sperm is there, but in small quantity and anything below 40 per cent or 40 million per ml is oligospermia. However, a man that has 10 million sperm cells can get a young lady that is very fertile pregnant. Whereas a man that has 40 million sperm cells and has a woman that is old and not so fertile may find it difficult to impregnate the woman. The next one is Exospermia in which there is no sperm cell at all, or Dispermia, that is abnormal sperm cells or Aspermia, which means there is no sperm produced at all in the ejaculate.
There is also low motility. The sperms are there, but they are not very motile; they can’t move all the way to the tube from the vagina where they are deposited. By the time they get to the uterus, most of them are dead, because they are slow moving.
Artificial sweetners like saccharine can cause low sperm count. Wearing very tight pants can cause testicular overheating. It creates a very high temperature around the scrotum and that burns the sperm cells. Sperms thrive when the temperature is low, slightly below the body temperature.
In the US, 10 per cent of women between the ages of 44 have impaired fertility and about 25 per cent of these women will have infertility problem when they get married. On a general level, we are looking at 37 per cent of infertile women between age 35 and 44 have infertility.
As age progresses, the problem of fertility also progresses. A higher percentage of women are having fertility problem because we are not marrying early. If they marry early, the problem is less. But in our own environment here, some of the causes of infertility in women are attributed to stress.
Obesity is a major factor in our environment. Overweight women have polycystic ovarian syndrome. It is a condition in which the ovary, rather than produce follicles that will make egg, they produce empty follicles known as cyst, and these follicles will line the ovary and they are not be able to ovulate. This is a condition that creates infertility because the excess fat that is there does not allow the ovary to have proper hormone functions, so rather than have those hormones going to the ovaries; they are working on the fat cells. This is an easily treatable condition if early detected. Women who are also underweight and those suffering from nutritional deficiency and low vitamins also have problems with fertility, just like marathon and long distance runners. Caffeine and alcohol can also cause infertility. Perpetual habit in terms of multiple sexual partners. It can lead to infection and sexually transmitted diseases which is the core of blocked tubes.
What couples should do while waiting:
When couples are newly married, they should begin to be aware of the anatomical and physiological processes that control conception. If you are a man, make sure that you preserve your reproductive processes. Stay away from pesticides, smoke inhalation and the same for the woman. If you notice any infection or discharge in the penis, make sure you give it immediate attention. Same for the woman, because these are things that could lead to chronic infection that could block the tube, or blow up the passage of the testis (Urethra).
If the woman notices that her period is irregular or unusually painful, she should seek medical attention. If the flow is excessive or little, she should see the doctor to ensure everything is okay immediately they get pregnant. Before, we used to say that infertility is when the couple is married for one year and they have tried without conception, but because our people are getting married late, they should seek medical consult immediately within three months, not to wait for one year. Those parameters of one year is when they were getting married at 21-24, because you can delay for one year and you still have a lot of time. But now, a lady that gets married at the age of 32, and has ovarian shut down at age 35, the time available for her is not much.
The options are quite many. You could seek medical attention from your doctor. If that doesn’t work, you need to take further investigation.
Fraudulent fertility centers:
I have to warn that there are some people out there that are not really practising advanced technology, but they are telling people that it is what they do. In the last two months, I have seen four women coming to my clinic to complain. One said that she went to a doctor, got pregnant, and she had a surocal suture. We did a scan and there was nothing in the uterine cavity. And we looked at the cervix, there was no suture. Another one had said she was going to have her baby in June and we did a scan and her uterus was empty. People have to be careful.