|Dr. Orebamjo Taiwo|
Infertility as a word is the inability for a couple to get pregnant, but, we do not label a couple infertile, until they have tried for pregnancy for at least one year and by trying, they must have intercourse for at least twice a week for a period of one year, before we can ascertain that such a couple has infertility problem. Most fertility centres do not consider a couple infertile until it is two years.
For instance, if you take a 100 couple who have no problem at all and give them a trial to get pregnant within one year, you will find out that 80 per cent of them would have gotten pregnant. By the time the same 100 couple tries for two years, an additional 10 per cent will get pregnant. Afterwards, only the remaining 10 per cent that could not get pregnant needs help.
What are the treatment options for infertility?
The treatment options are dependent on the cause. After one year trial, we start investigations on the couple. Usually, we advocate that a man should be investigated first, but it does not happen that way because of our environment. Usually, the man always feels there is nothing wrong with him.
Sometimes after test is carried out, it turns out that the man is the problem and reasons why they have not been able to bear children. At times, it is the sperm count of the man that is the issue. The woman is always willing to test if there are fibroid. In addition, we also check for hormone profile and if the tubes are in good shape. We also check if the woman is ovulating properly, then whether the couples are having regular sexual intercourse, because in some marriages, the man is hardly around, he comes to see his wife once a month, maybe due to the nature of his job.
For such couple, you may find out that they do not have any problem, but, rather separation. In such cases, we counsel them, but after trying all methods and it still did not work, we recommend In Vitro Fertilization (IVF). IVF is another form of treatment we give to those who have tried to conceive and are not achieving success.
Which infertility treatment options are available in the country?
Apart from the fertility counseling and basic treatment, sometimes after counseling, we find out that there is hormonal imbalance, high prolactin level in the couple and after every treatment administered, pregnancy comes up. For instance, if a sperm test is carried out and it shows low sperm count or no sperm count, then other options like donor sperm is explored. If it is correctible, an urologist is contacted to check if something can be done on the testis to improve quality of sperm. If it is the tube that is blocked, then, In Vitro Fertilization (IVF) which is a process of fertilization that happens outside the woman’s body is done.
Under this method, a woman’s egg is surgically removed and fertilized in a laboratory using sperm that has been given as a sperm sample. Sometimes, when the sperm count of the man is very low and not useful for IVF, we consider Intracytoplasmic Sperm Injection (ICSI), it is a specialized form of IVF that is used for the treatment of severe cases of male-factor infertility. We also have the traditional insemination called IUI which stands for Intrauterine insemination.
It is a fertility treatment that involves placing sperm inside a woman’s uterus to facilitate fertilization, the goal of IUI is to increase the number of sperm that reach the fallopian tubes, and subsequently increase the chance of fertilization, and then surrogacy which an individual is contacted to carry the baby for the couple. These are under legal guidance and consent given by either party. Also, we have the egg sharing or egg donor programme in which we get a younger woman to provide eggs for an older woman whom is easier to fertilize and increase the success rate.
Why did you choose to venture into infertility management?
The reason is because I found out that one out of three (33 per cent) couples have fertility problems. Over the years, I found out that these percentages are very high. A typical African man in our environment knows the importance of having children. It can be a very painful thing for a couple not to have a child. They would go to any length to achieve conception and sometimes they run to people who will do more harm than good to them. As a result of that, I decided to look for other means aside the regular gyneacology practices to be able to assist these couples and we have been doing that.
How old is the centre?
The centre was opened on December 26, 2014, but operation started January 11, 2015.
What missing link is the centre going to offer to the teeming couples with infertility issues?
In regular gynecology treatment for fertility which I have been offering for 14 years before starting Lifeshore Fertility centre, I found out in the past few years that it gets to a point when I cannot help the troubled couples anymore. So, I referred those who require IVF to IVF centres, where facilities are available for their treatment. Then, I asked myself; ‘Why I am referring my patients elsewhere when I can do all that? I gathered all resources together and replace the missing link and that is what we have today as the centre.
Can you share your success story, though the centre is barely a year?
We have had few success stories. Some of them are currently undergoing antenatal at the moment and have not delivered yet. By God’s grace, they will deliver their babies safely here.
What are your goals in terms of infertility treatment?
My goal is to be able to put smiles on the faces of couples who are looking for children. I am an African man and I understand the importance and value of children to couples. Children complete the family. I may have gone to the Western world to study, but I know couples here need to have children. Ultimately, it is God that makes it possible and not the hospital, but with his will, success is ours.
You mentioned earlier a situation where couples who stay apart find it difficult to bring forth offspring, what about a situation where at first meeting the woman gets pregnant, how can you describe that?
I will say it is an excellent situation. Putting everything in perspective, what we should realize is that in a month, every couple trying for a baby has a 30 per cent chance of getting pregnancy, which is the way God made it. God made it in such a way that the fertility among human beings – their reproductive system is not as efficient as lower animals.
This is because human beings have ability to reproduce all year round but, lower animals have what is called mating season. During those mating seasons, their chances of pregnancy is at the highest level, because it is only that time that pregnancy can be achieved. One thing we also need to understand is that the fertility of a woman reduces as her age advances.
A woman has the ability easily at the age of 20 to 25, will not have that ability to get pregnant at the age of 35. It does not mean she cannot get pregnant, but she may require some help before that can happen. All women are born with their eggs right at birth and if she is born with 2000 eggs, as her age increases, so is how old her eggs will be. If she is 30 years of age, her egg will be the same age and that is how it goes. A 30-year-old egg is easier to fertilize than a 40-year-old egg. That still does not mean that a woman at 50 cannot give birth.
In all the fertility options, which is the latest globally?
The latest is the Intracytoplasmic Sperm Injection (ICSI) but, there are now variations of ICSI. The ICSI process is taking one sperm and injecting it directly to an egg to achieve fertilization. In IVF, what you do is to isolate the egg and put it in the pathogens and surround it by sperm. Eventually, when the sperm penetrate the egg, it fertilizes it. In IVF, large quantity of sperm is required, while in ICSI, a small quantity of sperm can give rise to pregnancy.
There are other things that could happen, instead of waiting two or three days to transfer the sperm to the egg, you can wait longer to see the sperms that will not survive, and such sperm cannot be transferred. The ones that have waited until five or six days outside have a higher chance of continue survival inside. There is also sex selection; in the United Kingdom, it is not allowed to be carried out because it is believed to upset the balance of nature. There are other places offering such services like Switzerland and Czech Republic.
What do they mean by it ‘upsets the balance of nature’?
What it means is that, all living things that are put on earth, if you say they are from God or nature provides them, where you have a certain number of women, there will be a certain number of men for those women all over the world. Nature will always try and balance out. It is only human beings that always upset that balance.
After the Second World War, the ratio of women to men in United Kingdom was three to one, in Europe as a whole was five to one and that is because most of the men were killed in the war. 50 years on, it has balanced itself and without any genetic engineering. Where there are five men in a household, there are also five women in another household. A lot should be done to change the mindset of people in terms of the sex of their child. All children are gift from God, whether male or female.
This story was published in Newswatch Times on January 21, 2016.