Although infertility by itself may not threaten physical health, it does have a serious impact on the mental and social well being of the affected couples.
Infertility is divided into 2 types. Primarily infertility means there has been no previous pregnancy (40% of infertile couple) and secondary infertility if there was a previous pregnancy whatever the outcome (60% of infertile couples)
Infertility affects million of couples in Nigeria leading to untold misery and frustration.
One in four couples is having difficulty in conceiving, and the number of couples seeking medical help to have family has rising dramatically in recent times.
Infertility has always been with man even, from the biblical time. Couples finding it difficult to conceive were far and in between in those days.
The incidence has suddenly been on the increase for various reasons ranging from urbanisation pollutions, stress, chemical exposures, career orientation and late settlement in life. I will discuss a few of these factors.
There are now many observational studies that have shown that the average sperm counts of Nigerians in the urban centres are gradually falling. Many of the causes of the falling sperm count can be traced to environmental pollutions and exposure to certain pesticides, metals and solvents in many industries and especially in the plastic and printing industries. There is also suspicion that many of these pollutants with oestrogenic contents from the industrial wastes may have contaminated the public water systems including the indiscriminate borehole water supplies.
Not only are the average sperm counts falling, men are also producing large numbers of abnormal sperms due to the environmental pollutions. Smokes either from cigarettes or environmental smoke from industries and generators affect fertility by reducing the functions of eggs and sperms.
It is not rocket science to know that the stress level of Nigerians have increased many folds since the early eighties when the economy suffered major turbulence from which we are yet to recover from the structural adjustment programme (SAP) of the government of that time.
Stress affects relationship. Stress is a major cause of Libido (sexual desire) among couples, thus reducing the frequency of sexual intercourse. To get pregnant fast, couple must have sex at least three times a week. Having sex regularly is the best way to get pregnant quickly. Many couples leave trying for pregnancy to only their fertile or ovulation period because of their day to day stressful lives.
Severe stress can also affect female ovulation and can limit sperm production.
Unlike the obvious sexually transmitted diseases of times past such as gonorrhoea which are now easily treated with increasing sophistications in Antibiotics. There is an increasing incidence of CHLAMYDIA infection which has no symptoms and causes damages and not detected until too late.
Because it has little or no symptoms, it has become one of the commonest infections causing infertility.
It damages the fallopian tubes in women and causes swelling and tenderness in the scrotum of men.
Being over weight reduces male and female fertility. In women, being over weight and severely under weight may impaire the production of mature eggs. Obesity predisposes to polycystic ovarian syndrome which in turn affects ovulation.
Age and Late Marriage
Men can maintain fertility to ripe old age. The same cannot be said in women.
Women’s fertility starts decreasing from age 30 and at a faster rate from 35 years onward. The older a woman gets, the older her eggs get also. The quality and the quantity of egg decrease with age.
Age is one of the fixed factors in life. A woman can be forty but feel or claim to be 30 years old, but unfortunately her eggs would remain forty and behave like a forty years old egg.
More women work than ever before and many are increasingly becoming the bread winners due to the socioeconomic problems, unleashed on Nigerian from the early eights till date.
Many women and men are involuntarily delaying marriage and child bearing till very late resulting in increased incidences of infertility.
The peak of a woman’s fertility is between age 20 and 30 years. Unfortunately, many are getting married in their thirties and forties.
Cost of Advanced Fertility Treatment
Advanced fertility treatment such as Invitro fertilisation (IVF) helps more patients to alleviate infertility problem. Problems of No sperm count and total tubal blockage which would have warranted counselling about adoption are now easily treated with Invitro fertilisation. It is however unfortunate that only a few patients can asses Invitro fertilisation because of the cost of this procedures.
Until our governments see infertility as a social problem and subsidize its cost many otherwise treatable infertility problems would remain with us, hence contributing to the rise of infertility and its attendant social problems.
Religious dogmatism affects many couples approach to infertility. There has been an increase in different religious fundamentalism with their plethora of dogma and doctrines since the early eighties coinciding with the economic downturn in Nigeria.
Many couples find comfort in religion and spirituality when it comes to coping with the pain of infertility. But there is a difference between finding comfort and taking direction on which treatment to alleviate infertility.
To many couples, seeking medical help early for their infertility problems, negate their religious belief and faith system.
Seeking medical help and prayers should not be mutually exclusive. Prayers and seeking medical help should work side by side. In any case it is only a foolish and inexperienced doctor that would take any glory for helping couples to achieve pregnancy. Religious Dogmatism limits the hand of God to act only in a certain way.
Many of the couples in these groups finally present themselves for medical intervention in their forties when is more difficult to treat what could have been a simple problem in their late twenties or early thirties.
In conclusion, there is a real danger that infertility could become an epidemic problem in our society due to a combination of many socio economic, environmental and life style issues afflicting our societies from the early eighties.