In the days of our fore fathers, all the problems of infertility or what is known as childlessness were put on the doorstep of women. A woman without a child would be called many names like Ogbanje, witches and harlot. In these modern days, the question often asked is how many abortions has she had? It is unfortunate that nobody talks about the husbands. No wonder the saying that “men cannot be barren”.
My experience in the laboratory where an average of 30% of the young men examined last year had infertility problem prompted me to launch this campaign that men have a role to play to solve these problems. It takes both the man and woman to have a child. In as much as I believe that the problems of infertility can be traced to the women but men should not be left out.
Many homes are broken today because of the indifferent attitudes of the husbands to the issue of infertility. In addition, many men are fathers to bastards because they left their “unproductive” wives and were desperately looking for solutions from their girl friends that in-turns rope them in with these bastards.
There are different schools of thought that explain these behaviours of men. Firstly, African men believe that since they are the supreme heads of the house that has the right to query their authorities. Secondly, men believe they are healthy if their organs stand erect in the morning or before the “action”, the sperm is viscous enough to them, they can go for many rounds of sexual escapade and the organs are free from discharge or rashes.
They forget that being infertile has nothing to do with sexual prowess (virility), but rather with absence of healthy sperm in the semen that are capable of traveling to meet the ovum. Thirdly, men with one or two children are difficult to subject to sperm analysis because they fail to understand that anything could happen to sperm at anytime that can trigger secondary infertility.
There is a story of a young lady who visited our Centre for scan. After the scan she pleaded that we should alter her result so that she can use it to protect her three years marriage from breakage. She narrated the trouble she has passed through because of her inability to have a child in the hands of the husband and his relatives. Instead, we counseled her and advised her to bring her to bring her husband for discussions. At the end of the story we realized that the psychological torture this woman was undergoing was as a result of her husband insensitivity because his sperm count was drastically low. He took the result to the hospital and was treated. Thank God that few months after their prayer were heard and he admitted that if he had listened to advice long ago the success would have been earlier.
Infertility is a disease or condition of the reproductive system resulting in the
inability to conceive after one year of unprotected well-timed intercourse.
Conception is a complicated process that depends upon many factors such as the production of healthy sperm by the man and healthy eggs by the woman, unblocked fallopian tubes that allow the sperm to reach the egg, the sperm’s ability to fertilize egg when they meet, the ability of the fertilized egg or embryo to become implanted in the woman’s uterus and sufficient embryo quality. In rough terms, about 33% of infertility cases can be attributed to male factors and about 33% to factors that affect women. For the remaining 34% of infertile couples, infertility is caused by a combination of problems in both partners.
The most common male infertility factors include azoospermia where no sperm cells are produced and oligospermia where few sperm cells are produced. Sometimes, sperm cells are malformed or they die before they reach the egg. In rare cases, a genetic disease such as cystic fibrosis or a chromosomal abnormality causes infertility in men. A man will be considered at risk of being infertile if his sperm count is less than 20million/ml of semen. The World Health Organization (W.H.O) defines this level but it is important to realize that some men with low sperm counts will still prove fertile while others with higher counts prove infertile. The possible causes of a low sperm count are summarily discussed below.
Infected semen occasionally caused by veneral diseases such as gonorrhea and chlamydia. The social behaviors of the young men of today contribute greatly to this infection. Men usually believe the best way to enhance their sexual performance is by drinking concoctions (e.g. paraga). Some of these concoctions contain bacteria or other chemicals that affect the sperm.
Heat can also reduce sperm production. Men whose jobs involve long hours of sitting may also have a reduce sperm count because of overheated testicles.
Frequent intercourse can lead to a dramatic reduction in sperm count and cause the man to be effectively infertile. If you ejaculate as much as 2-3times a day you are likely to have a problem.
Smoking over 20 cigarettes a day has been shown to reduce both the sperm count and the sperm motility. So stop smoking or reduce it to minimal levels.
Excessive alcohol intake can lead to low sperm count for a variety of reasons.
The workaholic man can find that fatigue can have similar effect on his interest in intercourse as well as stimulate a desire for excessive alcohol intake.
Other factors which may contribute to reduce fertility and which can be identified on examination include varicocele which is a term used to describe a condition where there are varicose vein around the testicle and vas deferens. The presence of fluid around the testicle is known as a hydrocele. There can occasionally be anatomical defects in the development of the penis. Consequently, during intercourse and ejaculation the sperm cannot be deposited within the vagina very easily.
Don’t let it worry you too much if there is not as much sperm as you thought there should be. There are methods of improving sperm count. Besides, as long as the motility (movement) is good, it only takes one, technically, to work. If there is a low sperm count, try to eliminate tight jeans, tight underwear. Add vitamin C to your diet to aid the production of sperm-protecting semen. Stop smoking (if you do), eliminate drug use (pot smoking), and limit sexual encounters to times of peak fertile periods. Beware of solvents and chemicals that decrease sperm counts or cause sperm deformation.
Your Doctors can explain to you some techniques as in-vitro fertilization and direct sperm injection that may be useful.
The position best is that of man – on –top with the woman’s hip on a pillow. After ejaculation, she should remain in this position for one hour after the sperm become fluid. Fluidity occurs about 20mins after ejaculation.
Conclusively, men should know that there might be more to their childlessness than witches, ogbanje and previous abortion. The best solution is the understanding between the couples. The Doctor close to your house can help you out. Men should learn to bury their ego in cases like this. Those who consider themselves fit should not forget to undergo occasional sperm analysis to detect early if there is problem.
ABIMBOLA ADEKOYA
Medical Scientist
BIMADE DIAGNOSTIC SERVICES
BETTER LIFE MARKET IJORA LAGOS
