In an interview with The News Agency of Nigeria (NAN) in
Awka on Friday, Ugwuanyi gave the assurance that infertility is curable once it
is followed up medically.
He stressed that infertility occurs in a couple if they are
unable to achieve pregnancy after one year of regular and unprotected sexual
exposure at least 3 times a week.
He rolled out some medical terms like Fecundability, the
probability of conception in a month or in a menstrual cycle, which varies
across and within age groups for both women and men.
The monthly probability of conception is at most 0.15–0.25
among newlyweds and this declines with increasing age and duration of marriage.
It is this low because fertilization can occur only for about two days around
the time of ovulation in the middle of the menstrual cycle.
He further said the Pregnancy rate per age is as follows:
Women under 30 years have a 70-75 percent chance, Women 30-35 60 percent while
Women aged 36 years and above have 50 percent chance.
He further said that motivated couples that comply with
therapeutic guidelines can expect a 50 to 60 percent chance of conception.
Ugwuanyi said that infertility can be primary or secondary
and described Primary infertility as a subunit of infertility in which the
woman has never been pregnant while Secondary infertility is a subset in which
the woman has previously been pregnant irrespective of the outcome.
He also said that either of the two subsets can be further
classified as unexplained infertility which describes a situation where the
couple have no discernable cause of infertility after a comprehensive
investigation of tubal assessment, Ovulation assessment, Seminal fluid
analysis, amongst others after two years of regular and unprotected sexual
intercourse.
He said the medical term, Epidemiology, is the prevalence of
infertility and Etiology which cause infertility among couples. This shows that
about 10-20 percent of couples of reproductive age will present with
infertility.
According to him, “In Nigeria, 0.2 percent of every couple
has difficulty with conception. 30-40 per cent due to male factor 30-40 per
cent due to female factor, 10-20 per cent due to both male and female factors
5-10 per cent is unexplained.”
He said that infertility in Nigeria is largely secondary and
mainly due to infections such as Sexually transmitted infections (STIs), Post
about sepsis, and Puerperal sepsis, indicating that Tubal damage accounts for
more than half of all female causes of secondary infertility.
Ugwuanyi said that age is another important etiological
factor of infertility as 10 percent of women under 30 years will present with
infertility, and ditto for 15 percent of women between 30 and 35 years will
present with infertility.
He further stated that 30 percent of women between 35-40
years will present with infertility, 60 percent of women above 40 years will
also present with infertility.
Ugwuanyi said that reduction in age-related fertility is
predominantly the result of the decline in oocyte quality, enhanced follicular
atresia, and an increased rate of chromosomal abnormalities in fertilized
oocytes and resulting embryos.
He explained that socio-economic factors that have been
implicated in the propagation of infertility are poverty, smoking, alcohol
intake, and substance abuse.
He disclosed that female infertility etiology are Tubal
damages which may be due to infections or adhesions, another is Uterine fibroid
(bilateral cornual or cervical); Asherman`s syndrome.
According to him, Ovarian which is problems with ovulation,
Cervical factors, Endometriosis are unexplained issues with females while
causes of male infertility were described as Endocrine which is Thyroid
disorder among others.
He said that Coital disorder erectile dysfunction,
ejaculatory dysfunction, abnormal spermatogenesis, mumps orchitis, genetic,
chemical, radiation, drugs, heat Vascular varicocele, testicular torsion,
immunologic Idiopathic are all male issues.
Ugwuanyi said that there is hope in the management of
infertility through evaluation and diagnosis of infertility in a female by
checks on female menstrual history, gynecological and contraceptive history,
past obstetrics history, and past medical and surgical history.
He also stated that in the male management, their history of
genital tract infection, previous genital tract operation, past or present
medical condition such as Diabetes mellitus or renal disease, drug use,
antihypertensive, immuno suppressive, nitrofurantoin, anabolic steroids,
nicotine, alcohol, must be ascertained.
The medical expert said that behavioral and occupational
hazards such as soldiers on special duties, long-distance drivers, and men who
have multiple sexual partners are all parts of the need to be checked.
He said that there is the need for an initial clinical
assessment which is the history and examination of a couple, the general
examination such as their nutritional status, general well-being, height,
weight, male-type baldness, and finger clubbing.
Ugwuanyi said that Breast checks for abnormal nipple
discharge, Abdominal exam, and Pelvic exam Investigations are geared towards
tubal assessment, ovulation assessment, and male fertility status by seminal
fluid analysis.
He said that after all the basics are done, there is hope
for treatment though that is dependent on the causes detected which can be
medical or surgical.
However, he said the hoped of the presence of quality
medical techniques would bridge the infertility challenges.
He said that cases that are not amenable to medical or
surgical treatment options would have assisted conception technique which
includes intrauterine insemination and surrogacy.
He said also that the choice of adoption and acceptance of
childlessness are also hope available to such couples instead of living in
pain.
Ugwuanyi said that quality Counselling and psychological
support play vital roles in the management of infertile couples.
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