Infertility: 12 Major Questions Answered by Dr. Agboola Feranmi

Infertility, according to the World Health Organization (WHO), affects about 48 million couples and 146 million individuals globally. Individuals hoping to have children in future usually share certain concerns about the possible causes of infertility and how to prevent them. Also, couples or individuals battling infertility most times have several unanswered questions about childbearing options, the costs and available sites for assisted reproduction. That is why today’s interview with Dr. Agboola Feranmi is set to address many of the common questions surrounding infertility. Stay with us as we dive into these questions below.

Healthfacts: What is Infertility?

Dr Feranmi Agboola: Infertility is the inability to achieve conception after 12 months of unprotected sexual intercourse.

Is infertility gender specific?

No. This is because there are different factors that contribute to infertility. There’s a male factor and there’s also a female factor so it could be any gender that’s contributing to the infertility.

Can a person be infertile even after having a child?

Yes. This is because there is something called primary infertility and there’s also secondary infertility. Primary infertility is when that person has never been able to get pregnant before while Secondary infertility is when the person has gotten pregnant before but presently develops an inability to get pregnant.

Is infertility age related?

Yes, that is true. This is because with increasing age for females, the fertility rate reduces so the chances of a woman getting pregnant reduces as she grows older.

Is infertility weight related?

For the female reproductive system to function effectively, there’s a required weight, it’s not a fixed weight but a range, so when the woman is below that weight which we call underweight or far above the weight which we call overweight/obesity, it might predispose. You can’t really say it’s a major causative factor just that it might predispose, because she can start having irregular menstrual cycles if she’s overweight or obese. With excessive reduction of weight too as found in some models or athletes, some of them tend to have irregular menstrual cycles due to that, so there’s a way weight plays a role in fertility. But it’s not really a clear factor, you can’t say the reason a person is infertile is because they’re underweight or overweight only that it can play a part.

Is infertility stress related?

The way we react to stress differs, for some people, yes, stress affects their reproductive system; the way their hormones are regulated works in a way such that it now has a back play on fertility.

It takes how many years of trying to know if a couple is infertile?

In my definition earlier, I already mentioned that, if you can establish that a couple have been having unprotected, regular, penetrative, ejaculatory sexual intercourse for a year (12 months) and after that, conception was not achieved, you can establish infertility.

Can excessive use of contraceptives cause infertility?

Of all the contraceptive methods available which include the barrier method, condom, hormonal methods (oral contraceptive pills, implants, intrauterine contraceptive devices) and the surgical method, the surgical method (removal of the womb, tying of the fallopian tubes or vasectomy) is the only permanent one, that is, it is the only method that can result in a permanent inability to have a child. This is because the other methods are reversible, they are temporary and reversible. The only thing with them is that they all have different durations of reversibility. For the injectables, immediately after the last shot wears off, she can get pregnant. The implant and oral contraceptives might take a while but except for surgical contraception, these other methods cannot cause a permanent inability to conceive.

Are there childbearing options for infertile couples? What are they?

Yes. Whatsoever is causing the infertility can be treated, it could be a hormonal imbalance for all you care, and that can be treated, if she has PCOS or she’s not ovulating well, she can have an ovulation inducing drug used. For some women, just reducing their weight can help them achieve conception. Some have fibroids and just undergoing a surgery that removes the fibroid nodules can help them achieve conception.

For the male factors, the man has to do a seminal fluid analysis just to be sure he’s ejaculating the right quantities or volume of sperms and that the sperm can move and are healthy. When it’s now established that a man and woman cannot conceive through sexual intercourse, there are other childbearing options which we called assisted conception, that’s where the in vitro fertilization (IVF) comes in and the ovum donation. If a woman can produce healthy eggs and the man too has healthy sperms but they are not mobile enough or he’s not producing enough volume; to ensure conception takes place, they can use a method of artificial insemination. For ovum donation, if the woman cannot produce eggs again, she can have eggs donated to her by someone else.

What is the estimate of the cost of some of the childbearing options in Nigeria?

For assisted contraception, it’s very expensive, I must say the truth. I know a person should have at least 1.5 million naira when considering IVF and the center where you want to do it matters too because the cost differs from center to center.

Can you give a few examples of hospitals where these options are available?

IVF is available in the University College Hospital (UCH), UCH even has a center specially designed for it. Vine Branch, Ibadan also does it. Those are the few ones I’m sure about for people in Ibadan.

Lagos and Abuja also have a lot of centers, but they might be more expensive

What advice do you have for couples currently trying to have a child?

The first thing I would like to say to them is that they shouldn’t panic especially the women. Come to the hospital rather than panic or settle for very ridiculous options. Most advisably, you should try to present in a secondary or tertiary hospital, that is, state or teaching hospitals. Make your complaint where you can have a proper examination done and you can have a care that is tailored to your needs. What is most important is, don’t panic! Funny enough, some cases of infertility are due to not doing the right things, like some couples who are not staying together, they only see each other maybe once in a month and that’s when they get to have sex. So, the best thing is just present in a hospital, complain and let them examine you.

Thank you very much for such a wonderful interview! We’re sure our readers have learnt a lot.

NB: You can drop your questions or concerns about infertility that have not been addressed in the comments section or use the “let’s chat” feature that appears on the website. We will surely get back to you with a response.