Infertility

Let’s talk about Infertility again. We will be looking at the definition, classification, causes, and management of infertility.

INFERTILITY

Definition: It is the inability to conceive after having regular unprotected sex by couples for up to one year. Know the key points: inability to conceive, unprotected sex, up to one year. So, every couple living together for up to 1 year without achieving pregnancy can be said to be having an infertility problem.

Classification:

(A) It can be classified as:

1. Male infertility
2. Female infertility

(B) It can also be classified as:

1. Primary: When the person has never become pregnant in her life before.
2. Secondary: When the person has been pregnant before but is finding it difficult now.

Today, we will be discussing male infertility in detail. Female infertility will be a topic for another day. Note that most Nigerians see infertility as a woman’s problem. This is totally wrong; in fact, about 50% of infertility currently is from men.

Male infertility occurs when a man does not produce any sperm cell at all (azoospermia) or does not produce enough (low sperm count or oligospermia). It can also be caused by the inability to have an erection needed for sex. Conditions that can lead to this in a man include:

1. Hernia or groin surgeries
2. Varicocele (looks like a bag of worms inside a man’s scrotum)
3. Exposure to radiation like the one from mobile phones, cancer treatment, etc.
4. Smoking (especially Indian hemp)
5. Alcoholism (beers, gin, etc.)
6. Working or constantly staying in a hot environment (furnace, bakery oven, etc.)
7. Too much hot bath
8. Exposure to toxins and dangerous chemicals
9. Overweight
10. Genital infection like chlamydia, gonorrhea, etc.

There is a rise in cases of male infertility in recent times, especially since the era of mobile phones. In fact, the normal sperm count has been reduced by WHO from at least 20 million per milliliter to at least 15 million per milliliter.

Other causes of male infertility include:

1. Erectile dysfunction (the man cannot achieve an erection enough for sex)
2. Congenital abnormality like non-descent of the testis, Klinefelter’s syndrome, etc.
3. Hormonal imbalance in men
4. Retrograde ejaculation (when sperm released by the man enters the bladder instead of coming out of the penis)
5. Health conditions like diabetes, stroke
6. Undescended testis

Tests to know if a man is not fertile:

1. Semen Analysis – most important.
2. Scrotal Scan.
3. Genetic studies like karyotyping.
4. Screening for other health-related conditions, e.g., if diabetes is suspected, check blood sugar, etc.
5. Hormone analysis.

Note: ALL THESE TESTS ARE AVAILABLE AT SUNCEL DIAGNOSTIC AND LABORATORY.

Know that male infertility is diagnosed when a man has a low sperm count (less than 15 million cells per milliliter) or if the man has zero sperm count.

Effect of infertility in men:

1. Inability to impregnate a woman.
2. Psychological trauma (this is why our men will do anything possible to avoid semen analysis or following their wives to the hospital).
3. Aversion (dislike) for sex.
4. Relationship failure as no woman will continue to stay with an infertile man.
5. Suicide tendencies.
6. Anxiety which may lead to psychiatric disturbances, etc.

The mood of an infertile man during hospital visits.

Management:

Detailed management protocols are available on this platform and at our facility, SUNCEL DIAGNOSTIC AND LABORATORY. For those outside Imo State, our management protocols can be made available to you at your doorstep—just private chat admin for more information.