INFERTITY A RISING SCOURGE

The issue of infertility is gradually becoming an epidermic and its time we brace up to combat the surge and improve treatment options. In the tropics this problem has become a thorn in the flesh as the cost of management is very high. its important we understand what infertility is about and know what the appropriate treatments are. Some people undergo invitro fertilization but they don’t really need it.

what are the steps to take when you are newly diagnosed with infertility.

Infertility is said to occur when a couple married or unmarried have had unprotected sexual intercourse for 2-3 times in a week for over 12 months and are unable to conceive.

                                                       how baby forms
                                                   

               

                                                                               the female reproductive tract

Factors that can affect fertility-

1-      AGE- above 35years the ability of the ovaries to produce good quality eggs drops.This explains why IVF labs advocate the use of donor eggs for the above 40years .Endometrial atrophy is also common in this age group

2-      INFECTIONS-infections can cause adhesions ad this can block the female tubes. This infections are the regular ones we have that have not been treated properly.in the male it can also leads to prostatitis and poor quality sperm.

3-      ENDOMETRIOSIS-this is aberrant endometrial tissue found outside the uterus. It could be in seen in the ovaries, fallopian tubes or pelvic cavity where it leads to scarring overtime and blockage of the tube may result.

4-      AUTOIMMMUME DISORDER-this relatively common factor is not talked about so much due to the minimal diagnostic tools. It could be  a male factor or even a female factor.

5-      ALCOHOL AND SMOKING- This has been shown to decrease sperm quality and affect egg quality in the female.

6-      UTERINE FIBROIDS-in the past it was said  that fibroid does not affect fertility but its been shown the it does. As much as fibroid can co exist with pregnancy it release some fluid that makes the uterus unfavorable for implantation

Step by step guide on treatment options for infertility-

Male factor-such as severe asthenospermia,oligospermia,hyperviscousity states, auto-immune disorders like antisperm antibodies, cystic fibrosis and infections. The treatment with intrauterine insemination  could suffice after a course of appropriate antibiotics with anti oxidants.

Female factors-

ANOVULATION-sometimes the release of eggs may be the only problem a woman may be having and the the need to stimulate the woman may be the only remedy.Some of the conditions include polycystic  ovarian disease. Another condition called luteinized unruptured follicular cyst may be recurrent and the woman has follicle every cycle but the eggs don’t get released. Again here some hormonal manipulation may be helpful to help release the eggs.

Tubal blockages- the common investigation carried out for this condition is called the hystetosalpingogram popularly known as HSG. When the blockage is in the fimbrial end hydrotubation also popularly known as flushing may help. Blockages located anywhere else is not amenable to hydrotubation. IVF would be the treatment option.

Uterine factors-

Cervical stenosis or cervical mucous hostility- intrauterine insemination would suffice.

Endometrial atrophy-hormonal therapy will suffice.

Uterine fibroid- myomectomy would suffice

UNEXPLAINED INFERTILITY

An intrauterine insemination should be done first at least for 3 cycles then if no solution IVF should be sort after.

On no condition should IUI be done in cases of bilateral tubal blockage. IUI is a simple less expensive procedure that can be done at the time of ovulation. It involves washing the sperm and placing the washed sperm in appropriate media into the uterus. In this case by-passing the cervical area and its many problems while reducing the debris in the sperm.

Call 08098229484 08023229484  if you have more questions.

INFERTILITY A RISING SCOURGE IN OUR ENVIRONMENT.

MALE FACTOR-
Up to 15 percent of couples are infertile. This means they aren't able to conceive a child even though they've had frequent, unprotected sexual intercourse for a year or longer  2-3 times a week for about a year. In up to half of these couples, male infertility plays a role.
Male infertility is due to low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm. Illnesses, injuries, chronic health problems, lifestyle choices and other factors can play a role in causing male infertility ,herbs consumption may play a significant role for this male factor infertility.
Over time infertility has been present but a lot of emphasis was on female factor infertility rather than male factor. Understanding that our environment is a male dominant culture type.
this has led to many women going to perform investigations for what they didn't need.
male factor contributes up to 50% of infertility cases. the reason this is so may be because in most cases of infections men are usually quite or may not show symptoms. This rising cases of infertility has become a major concern. Sperm motility and count seem to be more important than the morphology, all this parameters are important in their own way
we would analyze  a sperm test and explain the possible causes  and treatment options we can employ to seek solutions. Important to note that sexual performance is not usually affected in most cases and the quality of the sperm may look normal in the eye .microscopic examination will reveal in detail what we are dealing with.
what is sperm analysis? This is  a simple test that involves the ml/;e producing ejaculate into  a wide mouth sterile container. this usually should be the first test to be done in an infertile couple but unfortunately in our society(Africa)its usually the very last to be done. the sperm is most preferably to be collection by masturbation.

The male reproductive system

The male reproductive system is made up of the testes, a system of ducts (tubes) and other glands that open into the ducts. The brain plays an important part in the control of the male reproductive system.

A side view showing the main parts of the male reproductive system

The pituitary gland and the hypothalamus, located at the base of the brain, control the production of male hormones and sperm. Luteinizing hormone (LH) and follicle stimulating hormone (FSH) are the two important messenger hormones made by the pituitary gland that act on the testes.

Two messenger hormones act on the testes

The testes (testis: singular) are a pair of egg-shaped glands that sit in the scrotum next to the base of the penis on the outside of the body. The testes make sperm and the male sex hormone testosterone. It takes about 70 days for sperm to become mature and able to fertilize an egg.
When released from the testes, the sperm spend two to 10 days passing through the epididymis where they gain the vital ability to swim strongly (become ‘motile’), and to attach to and penetrate (get into) the egg.
At orgasm, waves of muscle contractions transport the sperm, with a small amount of fluid, from the testes through to the vas deferens. The seminal vesicles and prostate contribute extra fluid to protect the sperm. This mixture of sperm and fluid (the semen) travels along the urethra to the tip of the penis where it is ejaculated (released).

SRERM ANALYSIS AND  MEANING.
COLOUR-
gray opalescent  normal
gray opaque-infective
yellow opalescent-infective
yellow opaque-infective amongst other causes

PH- Usually 7.2 tending more to alkaline

MOTILITY-At least 40% of the count should be motile with 32% showing fast progressive linear motion. This parameter is very important in determining fertility.

COUNT- The total count is the volume of ejaculate x concentration of sperm /ml.  15 million /ml is the accepted value.

LIQUEFACTION-This should occur within 1hr.

VISCOUSITY-tells the consistency of the ejaculate. 1/4 is regarded as normal,4/4 is a highly viscous medium.

MORPHOLOGY- This tells the shape and structure of sperms.4% normal forms is accepted  and can achieve conception.

ANTISPERM ANTIBDIES-This may be present in some cases and its routinely seen. Trauma and surgery may be predisposing factors.

Known causes of male infertility

Sperm production problems	• Chromosomal or genetic causes • Undescended testes (failure of the testes to descend at birth) • Infections • Torsion (twisting of the testis in scrotum) • Varicocele (varicose veins of the testes) • Medicines and chemicals • Radiation damage • Unknown cause
Blockage of sperm transport	• Infections • Prostate-related problems • Absence of vas deferens • Vasectomy
Sexual problems (erection and ejaculation problems)	• Retrograde and premature ejaculation • Failure of ejaculation • Erectile dysfunction • Infrequent intercourse • Spinal cord injury • Prostate surgery • Damage to nerves • Some medicines
Hormonal problems	• Pituitary tumors • Congenital lack of LH/FSH (pituitary problem from birth) • Anabolic (androgenic) steroid abuse
Sperm antibodies	• Vasectomy • Injury or infection in the epididymis • Unknown cause

Its worthy of note that some of this conditions can be treated and fertility outcome have improved. The role of intra cytoplasmic sperm injection has made the very hopeless cases fruitful.
So if you are looking for a child and you have been trying for over a year, seek medical help as soon as possible. We will write a little more on female causes in the next article. Questions or contributions  you can email us naijadoctors@gmail.com,  drchidi@alpinehealthng.com

ONIONS:
PLEASE READ TO THE END
>>>IMPORTANT

In 1919 when the flu killed 40 million people there was this Doctor that visited the many farmers to see if he could help them combat the flu..
Many of the farmers and their family had contracted it and many died.

The doctor came upon this one farmer and to his surprise, everyone was very healthy. When the doctor asked what the farmer was doing that was different, the wife replied that she had placed an unpeeled onion in a dish in the rooms of the home, (probably only two rooms back then). The doctor couldn't believe it and asked if he could have one of the onions and place it under the microscope. She gave him one and when he did this, he did find the flu virus in the onion. It obviously absorbed the bacteria, therefore, keeping the family healthy.

Now there is a P.S. to this for I sent it to a friend in Oregon who regularly contributes material to me on health issues. She replied with this most interesting experience about onions:

Thanks for the reminder.
I don't know about the farmer's story...but, I do know that I contacted pneumonia, and, needless to say, I was very ill...
I came across an article that said to cut both ends off an onion put it into an empty jar, and place the jar next to the sick patient at night. It said the onion would be black in the morning from the germs.
...sure enough it happened just like that.
...the onion was a mess and I began to feel better.

This is the other note.

Lots of times when we have stomach problems we don't know what to blame. Maybe it's the onions that are to blame. Onions ABSORB BACTERIA is the reason they are so good at preventing us from getting colds and flu and is the very reason we should NOT eat an onion that has been sitting for a time after it has been cut open.

LEFT OVER ONIONS ARE POISONOUS
when food poisoning is reported, the first thing the officials look for is when the 'victim' last ate ONIONS and where those onions came from (in the potato salad?). It's probably the ONIONS, and if not the onions, it's the POTATOES.

Onions are a huge magnet for bacteria, especially uncooked onions. You should never plan to keep a portion of a sliced onion. It's not even safe if you put it in a zip-lock bag and put it in your refrigerator.

It's already contaminated enough just by being cut open and out for a bit, that it can be a danger to you (and doubly watch out for those onions you put in your hotdogs at the baseball park!).
If you take the leftover onion and cook it like crazy you'll probably be okay, but if you slice that leftover onion and put on your sandwich, you're asking for trouble. Both the onions and the moist potato in a potato salad, will attract and grow bacteria faster than any commercial mayonnaise will even begin to break down.

Also, dogs should never eat onions. Their stomachs cannot metabolize onions.

PLEASE REMEMBER IT IS DANGEROUS TO CUT AN ONION AND TRY TO SAVE IT TO COOK WITH THE NEXT DAY, IT BECOMES HIGHLY POISONOUS FOR EVEN A SINGLE NIGHT-AS IT CREATES TOXIC BACTERIA WHICH CAUSES ADVERSE STOMACH INFECTIONS BECAUSE OF EXCESS BILE SECRETIONS AND EVEN FOOD POISONING.

Please pass this to all the people whom you love and care about.