THE World Health Organisation (WHO) describes infertility as “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.’’
Medical experts, however, say that infertility could be of two kinds. The first is primary infertility — infertility involving a couple who have never had a child – while the second is secondary infertility, which is failure to conceive following a previous pregnancy.
The experts also note that infertility may be induced by infections in the man or woman.
Dr Joshua Zaman, a gynaecologist at the University of Abuja Teaching Hospital, Gwagwalada, however, says that endometriosis could be a leading cause of infertility among married women.
He explains that endometriosis is also a leading cause of chronic pelvic pain which is common among women.
“Endometriosis is a female health disorder that occurs when cells from the lining of the womb grow in other areas of the body like the ovaries, fallopian tubes, bladder and bowel.
“This can lead to pain, irregular bleeding and problems in getting pregnant; it occurs in six to 10 per cent of reproductive age women,” he says.
Zaman, however, observes that some women with endometriosis may not have any symptoms, adding that for others, the symptomatic pain can be mild or severe.
“The tissues swell up during the menstrual cycle in a similar way and start causing pain and formation of scar tissues within the uterus,’’ he says.
Zaman says endometriosis affects about 10 to 15 per cent of menstruating women between ages of 25 and 44 years, adding that the condition is also noticeable in some teenagers.
The gynaecologist concedes that the exact cause of endometriosis has not been established, adding that its trend among members of the same family, however, tends to suggest that it is a hereditary disorder.
Zaman stresses that there is an increased risk of its occurrence in women who had their first menstrual period prematurely and those whose menstrual cycles are short and heavy.
He says that women who had their first menstrual period below the normal age — 12 to 13 years – have a higher tendency to suffer endometriosis.
He says that others at risk include women who had their first child after 30 years of age, women who have never conceived and those who have had multiple pregnancies.
Zaman says that some of the signs and symptoms of endometriosis include painful menstrual period in women over the age of 30 years and abnormal menstrual cycles with variations in blood loss.
Others include pain during sexual intercourse, chronic lower abdominal pains which may radiate to the groins, hips and thighs, among other parts of the body.
Nevertheless, Zaman says that the diagnosis of endometriosis is based on a comprehensive review of the history of the pains and other associated symptoms, vaginal examination and specialised investigations such as ultrasound examination.
He, nonetheless, insists that the only definitive way to diagnose endometriosis is via laparoscopic surgery.
“Laparoscopy also can remove visible endometriosis lesions but it is not 100 per cent effective in relieving the pain as with medical therapy.
“The modality of treatment can be medical, surgical or a combination of both techniques, and this is decided on after considering factors like the patient’s age and the nature of her complaints, among others,’’ he says.
Sharing similar sentiments, Dr Maureen Ume, an obstetrician with the National Hospital, Abuja, says teenage pregnancy could predispose teenage girls to have unsafe abortions, which could cause infertility later in life.
She adds that unsafe abortions could also result in infections and tubal blockage, thereby leading to infertility.
“Bilateral tubal blockage, with its own complications, is the leading cause of the high rate of infertility and ectopic pregnancy,’’ she says.
Ume, therefore, urges parents and guardians to properly sensitise their daughters and wards to the socio-medical effects of indulging in sexual activities early in life.
Wikipedia, the online encyclopedia, says that another major cause of infertility in women is the inability to ovulate, adding that malformation of the eggs could also thwart efforts to get pregnant.
“Other factors that can affect a woman’s chances of becoming pregnant include being overweight or underweight, as well as age-induced factors, as female fertility declines after the age of 35.
“At times, it can be a combination of factors, and sometimes, a clear cause is never established,’’ Wikipedia says.
Expressing concern about the growing rate of infertility among women, Dr Philip Njemanze, a neurosurgeon, warns that the excessive use of cosmetics can be a contributory factor to infertility in a woman.
Njemanze, who is the Chairman of Global Profile Alliance, an NGO, says that most imported cosmetics contained “Polysorbate 80’’, which could be harmful to the female reproductive organ.
He says that the skin absorbs up to 60 per cent of the chemicals in cosmetic products, which it comes in contact with, directly into the bloodstream.
“Polysorbate 80, also called ‘Tween 80’, is a sticky synthetic compound, a non-ionic surfactant and emulsifier often used in foods and cosmetics.
“It is used in soaps, mouthwash and other cosmetics such as lipsticks, cream, powders and other make-up tools used to enhance a person’s appearance,’’ he says.
Njemanze expatiates that a study carried out in 1993 by Slovakian researchers raised concerns that ‘Polysorbate 80’ might decrease fertility, as it is used to deliver certain drugs or chemical agents across the blood-brain barrier.
“ In the study, it was discovered that ‘Tween 80’ can prolong the oestrous cycle, decrease the weight of the uterus and ovaries, while causing damage to the lining of the uterus.
“Such severe deformities to the ovary can lead to infertility,’’ he adds.
Njemanze particularly decries the rate at which most Nigerian women use cosmetics, especially makeup kits.
“Our ladies need to be mindful of how they use these cosmetics; they must ensure they read the prescriptions sleep properly and avoid heavy use of these cosmetics,’’ he warns.
Njemanze, nonetheless, underscores the need for increased public enlightenment on the issue, saying: “It is absolutely important that we educate the people on these things.’’
Also speaking, Hajiya Jummai Abdul, a nutritionist at Wuse General Hospital, Abuja, encourages couples to eat natural foods that can enhance fertility.
Abdul maintains that the consumption of complex carbohydrates like whole grains such as whole wheat bread, brown rice, corn meal and white rice, could help to enhance fertility.
“Besides, plant protein such as peas, beans and peanut; full fat dairy products like ice cream and full fat yoghurt; fresh fruits and vegetables such as oranges; and citrus fruits, strawberry, leafy vegetables are high in folic acid, an important nutrient for pregnant women to prevent birth defects.
“The consumption of Avocado nuts, sesame seeds and pumpkin seeds could also enhance fertility,” she adds.
Abdul says that women with overweight or underweight problems are also inclined to having fertility problems, saying that “ the normal body mass index is 19.
“Also, exposure to heat, particularly for men who are in the habit of placing laptop computer on their laps, can cause fertility problems.
“Moreover, too much intake of coffee and alcohol can also induce fertility problems,” she says.
All in all, experts underscore the need for people to adopt sound lifestyles that could enhance fertility, while avoiding habits and things that could provoke infertility problems.

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