Fertility experts are of the opinion that the high prevalence of infertility can be tackled if young Nigerians are presented with information needed for its prevention in the future and attaining general reproductive healthy lifestyles. Charles Ajunwa and Martins Ifijeh write
Indications from a 2010 study on infertility by the World Health Organisation (WHO) suggest that at least 50 million couples across the globe are experiencing one form of infertility or the other, with majority of cases arising from developing or underdeveloped countries.
The estimate shows that while 12.5 per cent of women around the world are experiencing one form of infertility or the other (2.5 per cent of primary infertility and 10 per cent of secondary infertility), the percentage for men is generally unknown even though it may be as high as that of women.
The study also showed that infertility is a major health concern that should lead to several innovative approaches to tackling it.
Fortunately, countries like the United States, Germany and the United Kingdom have taken the lead in addressing the growing number of infertility in their various countries through awareness on general reproductive healthy lifestyle and the forms of assisted conception approaches available.
But for developing countries like Nigeria, the prevalence has continued to rise. Already one in four couples, (that is 25 per cent of Nigerian couples) are suffering from one form of infertility or the other, leading to unhappy marriages and inability to complete homes.
It is in tackling this growing public health issue in Nigeria that the Chief Medical Director, Lifelink Fertility Clinic, Lagos, Dr. Kemi Ailoje, is advocating for preventive approaches, such that all the causes of infertility would have been eliminated even before reproductive life starts.
She believed when young Nigerians have access to vital information regarding their fertility status, issues of poorly done abortion processes, pelvic inflammatory infections, damages due to intake of concoctions and indiscriminate use of antibiotics, would have been dealt with even before reproductive life starts.
“If in Nigeria, young girls especially, are encouraged to seek information on ways to prevent infertility, we won’t be having the high prevalence we are presently noticing in the country. Simple things our young girls and boys do can matter in their reproductive life later in life.
“For instance, many girls wash their vaginal area with soap. They douche, believing that’s the way to keep their vagina clean and fresh. But, what they are actually doing is aiding infection because as they wash, they are losing their vaginal PH and acidity. It is the acid content around the vaginal surface that fights diseases. Such women need to know the natural way to keep the flora of the female organ. As little as this information, it can prevent infertility in the future.”
Ailoje, who is a Reproductive Endocrinologist, Fertility and Invitro Fertilisation Specialist said another reason why fertility education is key for youths, especially girls, is that most young girls take all types of concoctions or antibiotics in the treatment of infection and vaginal odour, adding that self medication and certain substances have been proven to affect the reproductive life of a woman.
“Such women should be told what type of drugs they must take for infection, fibroids, and other types of health issues. Self medication is never advisable. Also, the fact that a friend took certain substance for infection or discharge and it ‘worked’ doesn’t mean you should take the same thing. Infections could be uniquely different for different people. Abuse of treatment may lead to infertility later in future.
“Another thing is that some young girls go to quacks for abortion. They take all kinds of herbal concoctions to eliminate pregnancies. At the long run, by the time they are ready to start having babies, they may end up not able to conceive because of the manner in which the abortions they did years ago were done,” she added.
She said there are also cases in which some girls have unprotected sex for years without signs of pregnancy, adding that such persons should be able to walk into a fertility clinic to find out if something is wrong with their reproductive organs.
“It is because of issues like this that we established the Fertilink Profile, as part of efforts to bridge that gap between young boys or girls and the society. These categories of people are ignorant of a lot of things when it comes to reproductive life, and that ignorance on the long run contributes to the high infertility rate we are experiencing.
“We are bridging the gap between parents and their children. Parents just want their kids to be doctors, lawyers, but they are not thinking about their reproductive life. If this gap is there, the girls might end up doing abortions for their boyfriends in places that may be the cause of their infertility.”
She said when most girls finish their university on or before 21, what happens between their next seven years could be vital to whether or not they can be fertile or not. Between 21 and 28 years is when many pursue their career.
“By 28 or so, they now tend to be ready to start having babies. Maybe at this point, they will complain of irregular periods or other issues that have happened to them over the course of these years. If someone does not have regular periods, how then can the girl know her ovulation time, or when to have timed intercourse? So fertility education is very important,” she explained.
While noting that Lifelink Fertility clinic is open to such counseling for girls and boys between ages 18 and 25, she advised couples to also take advantage of the fact that there were now fertility experts in the country who can provide them with up to date information on how to tackle their infertility.
“As part of our own little way, we have made sure we equip our centre with up to date technology so that couples with fertility issues can walk up to us and have their issues sorted out either through counselling or through treatment.
Enlightening couples, Ailoje said in Nigeria, women contribute 40 per cent of infertility burden, men contribute 40 per cent, while unexplained factors contribute 20 per cent. “Example is, there are situations when a male with 100 million sperms meets a female with 15 follicles yet no pregnancy, that is an unexplained infertility, and it is 20 per cent common.
“For the men, their infertility could be exospermia or oligospermia, which means no sperm or low sperm, and that can be tied to genetic factors, lifestyle modification, heavy smoking, alcohol, age, occupation (a long distant driver sits on his testis and if that persists for years could lead to low or no sperm count.) For the female, pelvic inflammatory disease, advancement in age can be a factor and many other factors can be the cause.
On whether IVF is affordable at Lifelink Fertility Centre, Kemi said even though the facilities needed for the treatment are expensive, the procedure is affordable. “We have all our state-of-the-art machines and facilities. That is because we want to be able to provide quality care for Nigerian couples.
“So, for those who truly are unable to afford it, we have also set up a foundation to vet them and select those that should be assisted. We have done IVF for a vulcanizer who is married to a tailor. Even if the vulcanizer repairs 180m tires, he may not be able to raise the money, so that is the reality on ground. Our foundation vets those who want free IVF and give it to those who are more likely not to be able to afford it themselves.”
She also cautioned Nigerians not to patronise quacks in the industry, adding that poor regulation has caused many organisations to claim they are fertility centres.
“When you go for treatment, make sure you see the equipments. Make sure you find out about the centres before committing to them,” she added.