Keeping infertility at bay

Dr ALFRED MURAGE, discusses the frustrations many couples are facing after postponing child bearing to pursue their careers

About one in every six Kenyan couples, experience conception problems.

The frequency increases with age, with women being the hardest hit after they clock 35 years.

More couples are increasingly post-poning childbearing to pursue their careers, only to be frustrated when they want to have a baby.

The causes of infertility are multiple and sometimes complex. Some of the common causes identified in the country include blocked tubes (mainly due to previous STIs), problems with sperm production and transport and infrequent or failure to ovulate. At times doctors do not find any cause.

Woman factor: She must have normal functioning reproductive organs, experience regular menstrual cycles and ovulation.

The fallopian tubes need to be normal in order to transport the released egg towards the inner portion where fertilisation occurs.

Man factor: He must produce normal sperms. Regular sexual intercourse — about two or three times a week, gives a good chance of about 25 per cent conception in each menstrual cycle.

How do you protect yourself from becoming infertile?

Couples wishing to conceive should lead a healthy lifestyle — avoid smoking, reduce alcohol intake and maintain a right weight. This increases their chances of conception.

Although some causes of infertility are not preventable, there are several things you can do to maintain a good fertility potential:

• Avoid sexually transmitted infections by not having multiple partners, use condoms, get screened and treated promptly if you contract an infection.

• Maintain a healthy weight through regular exercise and a good diet

• Stop smoking and use of recreational drugs

• Beware of rapid decline in fertility after the age of 35

How long should I wait before seeking help, if I’m not getting pregnant?

A healthy young couple should try for a pregnancy for at least a year, before seeking medical help. This is because the chance of pregnancy is a cumulative event and by the end of one year, 85 per cent of couples will have achieved a spontaneous pregnancy.

Earlier intervention may be unnecessary, costly and sometimes may do more harm than good.

Situations that warrant earlier medical assessment:

• Women with irregular menstrual cycles may not be ovulating regularly.

• Previous sexual infections may have damaged fallopian tubes or sperm transport in men

• Women older than 35 have rapidly declining fertility and should be assessed earlier.

• Problems with sexual inter course.

• Chronic medical diseases like thyroid disease.

Note: Avoid taking over-the-counter drugs to boost fertility without gynaecological evaluation, as they may pose some risks.

For instance, prolonged use of the commonly prescribed clomid tablet may cause serious risks such as ovarian cancer.

What tests should be done if I’m having a problem conceiving?

A medical evaluation will give guidance on which tests are necessary. Some tests are costly and should not be done as routine.

Initial simple tests include assessment of sperms and confirmation of ovulation. In some cases an evaluation of the reproductive hormone profile is recommended.

Further testing may involve an imaging examination to assess the fallopian tubes, uterus, ovaries and testes.

Some women will also require assessment of their reproductive organs though keyhole surgery to further evaluate the pelvis, fallopian tubes and the uterus.