Odimegwu Onwumere

Mrs. Olivia Owhonda, a resident of Port Harcourt, the capital of Rivers State, has been having series of miscarriages over a period of six years she got married. The miscarriage comes within the first three months of her pregnancy. She has gone to virtually everywhere, looking for solutions, but her chances of finding one are slim. Her marriage is threatened as her husband is deciding for another wife. She needs help, but hasn’t gotten it from the hospitals and traditional places she had visited. One day, a patient she disclosed her predicament to, at one of the hospitals she often visits, directed her to Nordica Fertility Centre, Lagos, where Obstetrician/Gynecologist Abayomi Ajayi is the Managing Director.

Mrs. Owhonda and her husband visited the Centre and were attended to. The causative factor of the miscarriages, otherwise known in the medical term as abortion, was traced to the husband early this year. The hospital tells the couple that the husband’s sperm is substandard and needs medical attention for corrective measures. The couple looked at each other in utter amazement. The hospital also told the couple to be grateful that they found out this on time unlike many women out there that have been miscarrying over decades and thinking they are menstruating.

Ajayi says that a number of women during their first 12 weeks of pregnancy, spot, bleed or suffer cramps, which is in the ration of 20 or 30 per cent of pregnant women, while 10 per cent miscarry. The doctor does not hinge the finding only on defective sperm, he also says that genetic defect in the embryo is the commonest reason for a first-trimester miscarriage.

Causes of miscarriage
Mrs. Ohwonda and her husband have been travelling to Lagos from Port Harcourt for first hand examination at Nordica Fertility Centre. Dr. Ajayi advises that lifestyle factors in the area of dietary habits can cause havoc to the sperm, while defining male infertility as one or more oddity in a semen scrutiny, with 35 per cent of causes of infertility being from the male factor.

“We don’t know why, but that is what we have seen. We have substantiated that in Nordica, by comparing the sperm of people who presented 10 years ago to the sperm count of people who are presenting now.

“It is obvious to us that there had been about 30 per cent decline. It is like, every year, there is 30 per cent decline in sperm parameter. There is no doubt that sperm is a big issue all over the world.

“Although, every woman has some chromosomal abnormal eggs and every man produces some chromosomal abnormal sperm, when a man has high volume of abnormal sperm, his wife may continue to experience miscarriages even if she has the best eggs in town,” Ajayi says.

He pities women in the miscarriage oddball in this part of the world, saying that majority of their husbands humiliate them for the miscarriages before they most times find out that the problem is not from their wives, but from them.

Helping couples have children
After some period of placing Mrs. Owhonda and her husband on medical examination with the necessary medications, the woman is pregnant and the time she miscarriages is over. Very soon, the family will hear the cry of their baby.

Mrs. Owhonda hubby’s sperm has been boosted. The woman is saying that she is going to write a book on this and the title would be, “The sperm that saved my marriage.”

Apart from ameliorating the case of the once befuddled couple and boosting men’s sperm that are defective through dietary and Sperm Intracytoplasmic Morphologically-selected Sperm Injection (IMSI), which was first introduced as an IVF technique in 2004, Nordica offers free IVF treatment to Nigerians.

The centre offered exclusive free IVF treatment to Nigerians in 2009, when there were heightened fears on the perceived risks associated with Assisted Reproductive Technique (ART), especially In Vitro Fertilisation (IVF).

Thousands of IVF babies have been born since the first one on 25 July 1978, whose name is Louise Brown, born at Oldham General Hospital, Oldham, by planned Caesarean section delivered by registrar John Webster. Brown weighed five pounds, 12 ounces (2.608 kg) at birth.

Reports say her parents, Lesley and John Brown, had been trying to conceive for nine years. Lesley faced complications of blocked fallopian tubes.

The first IVF baby for Nordica Fertility Centre will turn 12 years by 14th of September this year, and the centre has assisted couples with over 1500 babies in the centre.

Dr. Ajayi says that people have nothing to fear about IVF, because it is a known fact that about 25 or 30 per cent of babies born from assisted conception, especially IVF, will be more than one.

In 2009, the centre charges between N600,000 to N800,000 very maximum N900,000 for IVF, unlike in a country like the United Kingdom, where a cycle costs about $4000, the same period.

Defining intracytoplasmic morphologically-selected sperm injection
Dr. Ajayi says that IMSI is where a single sperm is injected into an egg, the only difference is that the sperm is selected using a very powerful microscope compared to the Intra-cytoplasmic sperm injection (ICSI) microscope.

“The image of the sperm is magnified around 6,000 times during IMSI and this allows the embryologist to analyse it in greater detail and choose the healthiest-looking one for injection,” Ajayi explains.

The medical doctor adds that Nigerians have to be sensitised about IMSI, with investigations revealing that IMSI has increased pregnancy rates in people with previous failures in ICSI. This has also seen to less abortion rates over five years in the country.

He says that IMSI is only indicated when there is less than two million sperm count and motility less than five per cent. First, sperm count is low, and then there is higher incidence of genetically deformed sperms. Much of the problems with bad sperm are genetics, and they can burn out.

“Selecting the best sperm for ICSI is not a big deal if most of the sperm are normal. Where it becomes trickier is when you are hard pressed to find a normal appearing sperm in the sample.

“Some defects like sperm with two heads, huge heads, two tails, and kinked tails are easy to detect and avoid with standard magnification.

“Other defects, like vacuoles in the sperm head are not always glaringly obvious at the lower magnification (300x) used for selecting sperm for ICSI,” he says.

Nigerian men accessing treatment
The doctor adds that the impressive results that are spread either by words of mouth, media or other ways are the reasons Nigerian men are now accessing treatment.

“The macho thing is disappearing. There is no shame in it. The sperm parameters are becoming worse, and therefore it is necessary to bring it to the front burner and we cannot talk about it without talking about technology that offers hope, because we know there is no drug right now that solves the problem of deranged sperm count or bad sperm parameters. Intra-cytoplasmic Morphologically-selected Sperm (IMSI) is helpful,” Ajayi says.

Sabotage in semen’s level
Months before the findings and the subsequent counselling of Mrs. Owhonda and her husband, another leading voice in medicine, Dr. Sunny Abarikwu of the Department of Chemical Sciences, Redeemer’s University, Ogun State, told Nigerians in a public presentation that there’s tremendous sabotage in the level of semen expected of young men of child bearing age, not only in Nigeria, but all over the world.

“Although little is known about what is responsible for the decline in male sperm count worldwide, significant associations have been reported between impaired semen quality, including sperm count, motility as well as morphology and exposures to heavy metals such as cadmium and lead, mycotoxins such as aflatoxins, pesticides, industrial chemicals and endocrine factors,” he said.

Science says that standard sperm count is deemed to be between 40 million and 300 million per millilitre. In August 2016, Mail Online reviewed American Journal of Epidemiology, and warns that men who watch TV for more than five hours have average sperm count of 37 million per millilitre of fluid, while those who hardly watch TV have 52 million per millilitre of fluid.

“Decreases in testosterone were detected in men watching many hours of television, the researchers added. The hormone testosterone plays a key role in the development of male reproductive tissues such as the testis and prostate, as well as promoting secondary sexual characteristics such as increased muscle and bone mass, and the growth of body hair,” says the report.

Dr. Abarikwu exposed the deterioration in semen quality of young healthy men worldwide, adding, “In Nigeria, the problem is further compounded by a variety of factors such as sexually transmitted infections, genito-urinary tract infections/inflammations and deficiencies of dietary antioxidant nutrients, thereby increasing male-factor contribution to infertility in the population.”

Dr. Ajayi affirms, “Heat is a factor in male infertility. The enzymes required for the production of sperm are very sensitive to heat. Men, who frequent saunas or hot tubs, wear tight pants, sit at a desk all day, or stand in front of a hot stove may be inadvertently heating their testicles to such a degree that they can’t make sperm and get their partners pregnant. The reason that the testicles hang out and away from the body is that it’s about four degrees cooler than the normal body temperature. That cooler temperature is required for sperm to thrive.”

How to boost sperm
Dr. Abayomi Ajayi advises men to eat diets high in antioxidants in order to have quality sperm. He adds that such foods are amongst beans, apples, lettuce, carrots, and walnuts. He says that these are the highest in plant omega-3s.

There are also recommendations of dark green vegetables, which is said to be rich in vitamins C, E, and A, calcium; magnesium and potassium. Spinach, pulses, potatoes, oranges, bananas, pawpaw, beans, avocado, okro, avocado, corn, carrots, inter alia are also recommended for B vitamin.

“Alcohol affects the way the liver functions and it ultimately disturbs hormonal levels by affecting the way your body produces sperm, because alcohol is toxic to the testes and it can harm sperm when they are produced and prevent them from developing properly or stop them altogether from reaching the egg,” experts add.

At Panoramic Hall of the Civic Centre, Victoria Island in Lagos recently, while sensitising the public on fertility, the Nordica Clinic Manager, Mrs. Tola Ajayi counsels, “A couple should undertake professional counseling before embarking upon investigations and treatment. This can open up channels of communication and keep a couple in contact with each other as they undergo what can turn out to be a challenging course of action.”

Onwumere is a Poet, Writer and Consultant based in Rivers State. Email: odimegwu@journalist.com