United Nations Educational, Scientific and Cultural Organisation and Merck organised an Africa Research Summit in Addis Ababa, Ethiopia to address the state of research capacity empowerment in Africa for healthcare.

I gave a lecture on the access to healthcare in the management of untreated infectious diseases with the focus on sexually transmitted diseases and revealed the new therapies available for this disorder that affects a large number of people.

I addressed issues relating to infertility in both men and women. Infertility is the inability to get pregnant after a year of unprotected sexual intercourse. About 10 per cent of couples in the United States are affected by infertility.

Both men and women can be infertile. According to the Centre for Disease Control, one-third of the time, the diagnosis is due to either female infertility or it is linked to male infertility. Other cases of infertility are due to a combination of factors from both partners.

For approximately 20 per cent of couples, the cause cannot be determined (unexplained infertility). When the overall statistics are done, it projects that the male factor is 50 per cent and the female factor is also 50 per cent. This is very important as in the African environment, including Nigeria, the blame is always on  the female partner.

There is a worldwide emotional epidemic of infertility. Today, 25 per cent of couples are infertile. Even in India, which has a case of severe overpopulation, the most common reason for a visit to the doctor is infertility.

In Nigeria, infertility, which used to be a small area of gynaecology practice, has now become a huge discipline with several doctors devoting their clinic solely to the subject.

Human ability to get pregnant decreases with age, which explains why only one per cent of teenagers are infertile, while a large majority of infertile couples are in their thirties. It is well documented that from our teenage years, when the last thing we wanted was a child, to our mid-thirties when we are finally secure enough to start a family, our ability to conceive decreases almost by 25 per cent.

Research shows that in the past 30 years, infertility has increased and those over 30 have the most problems.

If you are in your thirties, you have been working to establish yourself in your profession and now, you are casually reading this magazine because you are thinking of starting a family, you should realise that there is a 25 per cent chance that you will not be able to do so without medical intervention.

Other factors that may make it difficult for you to get pregnant include abnormal organs, immunological factors and a malfunctioning of the body system.

The dramatic increases in infertility over the last 30 years has been blamed on various factors, including increases in sexually transmitted diseases, environmental toxins in our food, such as heavy metals in fish; environmental pollution , particularly in the oil-producing geographical zones, declining sperm count due to absorption of toxic substances and even the increased tension and anxiety of modern life.

Prof Oladapo Ashiru Medical ART Center

Professor Oladapo Ashiru

The level of reproductive toxins in the oil-producing regions is worrisome, especially when it affects those who are in their offices or the spouse at home whose partner is in the oil fields

In all other animals, except humans, the desire to have sexual intercourse is timed to correspond exactly with that moment when the female is ovulating or producing eggs that can be fertilised.

For instance, a dog or a rabbit. Once the female is ovulating, seeks out the male. After intercourse, the female is usually heavy with multiple pregnancies.

Humans, however, desire to have sex at any time, regardless of whether there is an egg that can be fertilised in the woman and it makes us reproductively more inefficient than other animals.

We know that in all species, there is a very short window, in fact, a matter of days during each month that the female is fertile and can get pregnant with intercourse. The timing of sex is therefore very important, if a species is to have an efficient and high fertility rate.

In humans, women go through a period of 14 days when the follicle in the ovary develops. This starts from the first day of menstruation until the egg is sufficiently mature and ready for ovulation. Once the egg is released at ovulation, there is another 14-day period that it can be fertilised.

If intercourse occurs at the right time, then the embryo grows and implants in the uterus or womb. If intercourse occurs at another time other than the ovulating period, it is very unlikely that the woman will get pregnant in that cycle or month.

Animals go through what is described as an ‘oestrus’ cycle or ‘heat’. Humans go through a menstrual cycle. Apart from other hormonal variations, one significant difference between human beings and animals is that the female sex hormone, oestrogen, which increases just before ovulation in animals, is the trigger factor for their sex drive. This hormone is responsible for producing eggs. In other words, animals do not desire to have sex unless there is an egg to be fertilised in the womb.

In humans, the desire for sex is much more complex and it is driven by the male sex hormone, testosterone. This is unique in the animal kingdom and it is especially a human phenomenon. The small amount of oestrogen that the female makes is enough to generate a sexual drive in her. It is only a few females that recognise the slight increase in the sex hormone around the ovulation period to enable them deliberately initiate sex at the appropriate time to get pregnant.