You have finally agreed with the man in your life that you are ready to have children. You discard the contraceptive you’ve been using and closely monitor your ovulation every month but a year down the line, you are yet to conceive. You visit your gynaecologist who confirms that there’s nothing wrong with you. You then continue trying unsuccessfully for another year before you begin to worry.
A visit to the doctor by both of you and several tests later, you receive the news that it’s your man who is infertile. The pain in his face is heartbreaking. After all, traditional belief is that it’s only a woman who can be infertile.
Today, however, doctors are seeing more and more cases where men are completely infertile or they lose their fertility for a number of reasons. Doctors say cases of infertility (or sub-fertility) are on the increase among urban couples, and men are more affected than women.
Statistics by the University of Nairobi’s Department of Obstetrics and Gynaecology show that men constitute 52 per cent of infertility cases among couples.
Prof Koigi Kamau, the chairman of the Fertility Enhancement Centre at the Nairobi Hospital says most infertility cases among men are caused by an earlier infection of mumps or infections that block tubes such as vas deferens. Some chronic illnesses such as tuberculosis (TB) also play a big role in male infertility.
For women, Prof Kamau further explains, blockage of the fallopian tubes is a major culprit as well as fibroids and chronic diseases such as TB.
It is only after spending a day at the University’s Infertility Laboratory that it becomes clear just how prevalent the problem is among young married couples today.
When we visited the laboratory last week, it was hard to get information about the operations that go on there, perhaps because of the confidential nature of the records. We, however learnt that a comprehensive research is underway to reveal “all about male infertility in the country.”
From provisional findings, more than 60 men present themselves for fertility tests at the laboratory every month, with each day recording at least three cases, according to George Munyao, a technologist on male infertility. Of these, 80 per cent are aged between 27 and 35.
“This is the active marriage age when couples want to have children. We have found many of them are experiencing sub-fertility,” explains Munyao.
The laboratory handles all semen analysis cases referred by doctors at Kenyatta National Hospital and from other public and private hospitals.
“It is the largest research centre for leading gynaecologists in town,” says Munyao. “Semen analysis takes less than two hours,” he adds.
Here, we are keen to find out just what a man who suspects he is infertile needs to do.
“It is not normally a come in-come out affair,” explains Waweru Njoroge, the chief technologist at the department.
“We ask for a sample of the semen which must not be more than an hour after it has left the body system,” he explains.
In fact, men are encouraged to come and remove the sample at the laboratory.
According to Munyao, for a fertility test to be done, sex is not supposed to happen at least for three to seven days prior to semen “extraction” as the quality of the spermatozoa is affected.
So what does this analysis investigate?
“We want to find out how active the spermatozoa is the count (it should be more than 20 million spermatozoa per mili-litre) and the physical characteristics” says Njoroge.
At this point, the researcher attempts to demystify a commonly held myth.
“The volume of semen does not mean there are many spermatozoa. One can have a lot of semen but little spermatozoa,” he says and adds “And having many spermatozoa does not mean they are all healthy enough to fertilize an egg.”
“You find that many have died off, are weak or just inactive,” chips in Munyao.
Once deductions are made, the patient is referred to a doctor for specialised treatment.
Then there is the matter of sperm donation.
“The people who come for semen analysis are not the ones who necessarily supply sperm banks at various fertility centres,” Prof Kamau explains.
“Here at the Fertility Enhancement Centre, we source for quality sperms ourselves. There are a lot of characteristics that we look for,” he says.
“We actually concentrate in colleges and universities. One of the reasons is that many people desire to sire children who are most likely to be intelligent,” he says.
Rigorous screening is done on illnesses such as Hepatitis B, chronic diseases, hereditary conditions and HIV AIDs among other health problems.
Once all standards have been reached, the sperm is kept at a temperature of about –196 degrees centigrade.
Operational for the last four years, the centre has seen an increase in the number of couples seeking to be assisted to conceive.
“Today, couples are more empowered and you find that both parties want to participate in the fertility testing, as opposed to before where only the woman was tested,” says Prof Kamau.
According to official statistics, between 10 and 20 per cent of those who do the tests actually need to be medically assisted to achieve conception.
“Another 10 per cent are unable to achieve conception at all,” he adds.
The procedure comes at a cost, however. Although sperms are not sold and donors are not paid, it costs, on average, about Sh30,000 for a process called Intra Uterine Insemination (IUI) and about Sh300,000 for another process called In Vitro Fertilisation (IVF).
Other health facilities that have specialised in infertility issues are Dr Solomon Wasike’s Afya Royal Clinics and In Vitro Fertilisation (IVC) Centre started by Dr Joshua Noreh.
Source: Daily Nation
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