Doris Obinna
There are pertinent questions that agitate the minds of women about fertility: The fertility rate, ability to have babies within a certain time and need or otherwise of medication, among others.
These questions are understandable. Much has been said about women’s fertility, especially in relation to age, to worry those who are married. As a woman ages, her eggs age also, diminishing in quantity and quality.
However, science has proved that age is not much of a barrier in reproduction. Age could reduce the chances of a woman getting pregnant and having a healthy baby, but it is now possible to reverse the natural effects of aging on fertility, as there are certain factors that impact fertility potential that could be controlled.
A reproductive endocrinologist and fertility/In Vitro Fertilisation (IVF) specialist and Medical Director /Chief Executive Officer, Lifelink Fertility Clinics, Dr. Kemi Ailoje, said older women could actually have babies through assisted reproduction as well as following certain procedures.
On how to go about this, Ailoje said: “You can check your anti-mullerian hormone (AMH), a substance produced by granulosa cells in ovarian follicles. Then you do a follicle track for them. The AMH is something you can check at any time of the day to tell you your fertility rate; it is not about being young; some people are over 40 and can still naturally get pregnant much more than people who are less than that age; so, there are other factors.”
The specialist, who is founder, Foundation for Women and Children’s Health Education, Empowerment and Rights (KOFOWCHER Initiative), an organisation dedicated to advocacy, education and empowerment of women, youths and children, especially the less privileged, said family history of infertility is one major factor to be considered.
According to her, if the “tube is block, before you go into IVF, as the last resort, you should have done assisted conception, such as timed intercourse, natural mating, know your ovulation.
“Sometimes all these requires simple techniques to help you get pregnant, and of course, we know that there is male infertility.”
Causes of infertility
According to World Health Organisation (WHO), infertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.
Ailoje said: “Both male and female suffer infertility. For the men, it is low sperm or low sperm count and that can be tied back to genetic factors, lifestyle modification, heavy smoking, alcohol, age, and occupation. If someone is a long distance driver, for example, it could be a problem. In the male, these factors constitute about 40 per cent. In the female it is also 40 per cent. The unexplained factor is 10 per cent.”
She said in females, “it has always been advanced maternal age, i.e. age-related factors. You can’t just marry at 21-year-old if your parents are not supporting you. So, by the time the female child is getting married at 36, then she starts giving it a try for two to three years. By the time they try for one year at 37, there is a decline in fertility, natural decline.”
Harmful habits that damage fertility
Dr. Ailoje noted that women are the cause of infertility problem. She condemns wrong use of drugs in treating discharges and others, declaring: “You have diarrhea you use Flagyl; you have a discharge, you use this and that, all of it actually changes the flora for a woman. But unfortunately, most young women do not know that the natural way to keep the flora of female organ is best with water. Most of them are losing their vaginal pH – potential of hydrogen and acidity that fight diseases – by washing their vaginal with soap and water. They douche at times with lime and chemicals to keep fresh. All these practices, in the long run, affect the fertility in the future.”
She admonished women to take the right medicine for the right thing. “If a person has pain in the head, it is a different thing from pain in the stomach; you take the right medication and be sure of the specific receptors that would grasp those pain in the body.
“In other word, young women should take care of their adolescent productive health. Have knowledge of sexuality education. Know what you should do at a certain stage.”
Speaking about age and fertility, Ailoje said at advanced maternal age, when a woman who is over 40 they start releasing so many eggs. “That is the reason you see twins common in older women. The body is trying to shut down; the ovaries have had these eggs since you were born and wants to discharge them.
“As a woman is growing, she is losing all those good quality eggs. By the time she is approaching 40, the body is saying we have done enough in the last years, it is time to shut down; they start releasing quite a number of eggs; so you see twins, triplets. Even when you do assisted conception for women that are older, most likely they will take in with twins because the body is just about to shut down.”
The IVF option
In Vitro Fertilisation (IVF), is an assisted reproduction procedure, whereby the eggs are fertilised and then implanted in the womb.
Ailoje said there isn’t 100 per cent guarantee for pregnancy success in one IVF cycle. According to her, if a person has subfertility, which means their hormones are just not enough, “we would need to top up that hormone to the optimum fertility stage and when one is at that stage, the chances of getting pregnant is a lot better than when in their suboptimal stage.”
The cost of IVF in Nigeria is the first headache of childless couples, who want to try the option. Ailoje said: “It is not a cheap deal. It is not for everyone and the truth is the fertility of every woman is naturally 25 per cent and as IVF is a form of assisted reproductive technology (ART), your success rate might be zero to 100.
“It is either a woman is pregnant or she is not pregnant, but the chances is one in every four.”
She, however, said Lifelink Fertility Clinics, through the Foundation, is making IVF available to those who cannot afford it.