The Burden of Infertility; What you need to know

...with a baby or without, you are valuable, you are whole and you matter...

Recent data available shows that nearly 50 million couples worldwide experience infertility and nearly 50 percent of gynecology outpatient consultations in countries all over the world are infertility related.

Many homes continue to experience the agony of childlessness and the accompanying turbulence that comes with infertility in some parts of the world. While some couples enjoy the privilege of becoming parents, the same is not the case for many who continue to hope they will one day experience the joy of parenthood.

Infertility is defined as the inability to achieve a clinical pregnancy despite having frequent, regular (up to 3 to 4 times in a week) unprotected sex for at least a year. The inability to become pregnant or the inability to carry a pregnancy to a live birth is considered, primary infertility. On the other hand, the inability to become pregnant or the inability to carry a pregnancy to a live birth following either a previous pregnancy or a previous ability to carry a pregnancy to a live birth, is classified as secondary infertility. 

Infertility may be due to a single cause in either partner, or a combination of factors that may prevent a pregnancy from occurring or continuing. Fortunately, there are many safe and effective therapies for overcoming infertility. These treatments significantly improve the chances of becoming pregnant.

As the burden continues to stare many couples in the face, seeking early counselling, towards a diagnoses of the problem is very important for couples and treatment is often available.

The methods within infertility treatment have improved immensely over the last 2 decades even though there remains an inequitable degree of access and varying affordability to treatment modalities such as assisted reproductive techniques (in vitro fertilization) in many developing countries. This is a huge reproductive health concern.

Causes of infertility can more or less be divided into 3 equal parts. A female part, a male part and a third unexplained part.

Common causes in men include;

Abnormal Semen due to a medical condition, infection, hormonal imbalance, or ejaculation disorders, medications which can reduce sperm count, Mumps, radiation exposure and even mental stress.

Common causes in women include  ovulation disorders/hormonal imbalance, anatomic problems which affect the uterus or fallopian tubes, other medical conditions and medications. Advancing age, excessive exercise, sexually transmitted infections (STIs),smoking, alcohol consumption and mental stress  are also risk factors in women

The main sign of infertility is the inability of a couple to get pregnant. There may be no other obvious symptoms.

In some cases, an infertile woman may have irregular or absent menstrual periods. An infertile man may have signs of hormonal problems, such as changes in hair growth, sexual function, reduced sexual desire, or problems with ejaculation. He may also have small testicles or a swelling in the scrotum.

When should you consider seeing a doctor

In general, you may consider seeing a doctor about infertility if you and your partner have been trying regularly to conceive for at least one year.




You may consider being seen earlier if you're a woman and:

• You're age 35 to 40 and have been trying to conceive for six months or longer 
• You're over age 40 
• You menstruate irregularly or not at all 
• You have known fertility problems 
• You've been diagnosed with endometriosis or pelvic inflammatory disease 
• You've had more than one miscarriage 
• You've had prior cancer treatment 

If you're a man, you may wish to be evaluated sooner if you have:

• A low sperm count or other problems with sperm 
• Swelling in the scrotum (see 'varicocele' below) 
• You have had a previous vasectomy 
• Undergone prior scrotal or inguinal surgery 
• Small testicles or problems with sexual function or desire 
• Had prior cancer cancer treatment 
• Desire to know your fertility status. 

Medic-ALL 2018

Medical Miracle: First Womb Transplant Baby Born

Medic-ALL (07:10:2014)

The first ever baby to be born via a transplanted womb was delivered in September to a 36 year Swedish woman who was born without a womb and received a womb transplant from a friend in her early-60s. The British Medical Journal "The Lancet" reported that the baby was born prematurely last month weighing 1.8kg (3.9lb).

The woman received her womb from a 61-year-old family friend. As the recipient had intact ovaries, she was able to produce eggs, which were then fertilized using IVF prior to the transplant.

Absolute uterine factor infertility is considered the only form of female infertility which remains untreatable. This condition is often consequence of "Rokitansky syndrome" a condition in which a female is born without a uterus (womb). Cancer treatment is another scenario in which a woman can be left without a functioning womb. Adoption and surrogacy have proved the best options for such women in the past to have children. However, this news of a woman with Rokitansky syndrome giving birth to a baby following a womb transplant brings hope to women with absolute uterine factor infertility.

The researchers from the University of Gothenburg in Sweden who performed the transplant have been investigating the viability of womb transplantation for over ten years, conducting trials on rodents and non-human primates before attempting the procedure in humans.

The Swedish couplent through sessions of in-vitro fertilization (IVF) to produce 11 embryos which were frozen. Doctors at the University of Gothenburg them performed the transplant. The donor was a 61 year old family friend who had gone through menopause seven years earlier. One year following the transplant, one of the embryos was transferred into the transplanted womb and pregnancy ensued.

The baby was born prematurely after 32 weeks via caesarean section after the mother developed preeclampsia (a condition associated with raised blood pressure in pregancy) and the baby's heart rate was discovered to be abnormal. The neonate was discharged from the neonatal unit 10 days after birth and reports reveal that both the baby and mother are doing well.

The transplant team was led by Prof. Mats Brannstrom who described the birth in Sweden as "joyous". While he continues to work with other couples with similar needs, the happy Swedish couple still celebrating the birth of their "miracle baby boy" will soon have to decide if they want a second.

Medic-ALL.Inc 2014

Ref: Medical News Today
      : BBC
     

Infertility: A Scourge in our Face

Nearly 50% of gynaecologic outpatient consultations in the country today are infertility related. Many homes continue to experience the agony of childlessness and the accompanying turbulence in some cases in a country where infertility is fast becoming a plague. While some couples enjoy the privilege of becoming parents within a year or two of getting married, the same is not the case for many who continue to hope they will one day experience the joy of parenthood.


Infertility is defined as not being able to get pregnant despite having frequent, regular (up to 3 times in a week) unprotected sex for at least a year. The prevalence of infertility in Nigeria is put at between 20 and 25 percent among married couples according to latest qualified estimates.


Infertility may be due to a single cause in either you or your partner, or a combination of factors that may prevent a pregnancy from occurring or continuing. Fortunately, there are many safe and effective therapies for overcoming infertility. These treatments significantly improve the chances of becoming pregnant.

As the plague continues to stare many couples in the face, we doctors believe it is very important to seek early counselling and possible intervention to help tackle the problem.

The frequency of infertility depends on the age of the woman and the couple’s general health and life style.

The methods within infertility treatment have improved immensely throughout the latest 20 years. Today, we therefore have a great knowledge of the causes of infertility and the possibilities of treatment.

As, earlier noted, the causes of infertility can more or less be divided into 3 equal parts. A female part, a male part and a third unexplained part.

The main sign of infertility is the inability for a couple to get pregnant. There may be no other obvious symptoms.

In some cases, an infertile woman may have irregular or absent menstrual periods. An infertile man may have signs of hormonal problems, such as changes in hair growth, sexual function, reduced sexual desire, or problems with ejaculation. He may also have small testicles or a swelling in the scrotum.

When to see a doctor




In general, you may consider seeing a doctor about infertility if you and your partner have been trying regularly to conceive for at least one year. You may consider being seen earlier if you're a woman and:

• You're age 35 to 40 and have been trying to conceive for six months or longer 
• You're over age 40 
• You menstruate irregularly or not at all 
• You have known fertility problems 
• You've been diagnosed with endometriosis or pelvic inflammatory disease 
• You've had more than one miscarriage 
• You've had prior cancer treatmen 

If you're a man, you may wish to be evaluated sooner if you have:

• A low sperm count or other problems with sperm 
• Swelling in the scrotum (see 'varicocele' below) 
• You have had a previous vasectomy 
• Undergone prior scrotal or inguinal surgery 
• Small testicles or problems with sexual function or desire 
• Had prior cancer cancer treatment 
• Desire to know your fertility status. 

To be Continued......

Medic-ALL

Refs: Mayo Clinic (U.S), Nordica Fertility Centre (Lagos,Nigeria)