There are many reasons why fertility in humans is lower compared to animals as mentioned in my previous article on the subject of infertility. I will highlight these factors today, starting with the one we are all familiar with: stress.
Several factors have been blamed for this situation in men. It has been well documented that modern life can have a negative impact on reproduction. Many sperm banks in Europe, America and here in Lagos get medical students or other professional students to donate their sperms.
It is not unusual for good donors with high sperm counts on one occasion to have a poor sperm count on the next, e.g. if the donor is having an examination. There was a case in the University of California where a donor’s sperm count went literally to zero.
It was only a close interview that revealed that this student was going through a bout of depression thinking that his life was falling apart. There are cases of infertility with low sperm count from the husband. When the couple goes on vacation, the wife gets pregnant because of the change in the environment, which may eliminate the male stress factor and improve the chances of conception.
There are several factors in the environment that have a terrible effect on the sperm. To make the situation worse, many of these substances have not been thoroughly documented, researched or accounted for. In a village in China, for instance, as early as in 1920, they discovered that fertility was on the decline and the women were not getting pregnant.
Suddenly in 1930, the sterility was reversed and the people started having children again. The villagers thought that the curse placed on them had been lifted. It was later they realised that this happened because of the change in their cooking oil.
The use of cheap crude cottonseed oil for cooking caused the sterility in their men. It was found that the crude extract has the chemical called gossypols that causes male sterility. It is now being used as a male contraceptive.
A good number of these have been discovered by accident while there are several out there that are yet to be discovered. There are possibly many herbs or fruits that contain gossypol-like substances that the Nigerian population eats and we do not know about.
A lot of food intolerances have been found to lead to intestinal auto-intoxication that end up with toxins in the testis. The same goes for food containing heavy metals.
Sexually transmitted diseases
Research shows that about 10 per cent of human infertility is caused by tubule obstruction, and this is usually, although not always, caused by infectious diseases transmitted sexually. One-third of African men are sterile because of epidermal obstruction caused by sexually transmitted diseases.
For example, gonorrhoea causes irreversible tubal blockage. Our observations are in agreement with those of other scholars that indicate gonorrhoea, chlamydia and trichomonas as the most common of the several sexually transmitted diseases.
Chlamydia is regarded as a silent poison because it may show no symptoms in 70 per cent of female and in 50 per cent of male. It has a very long incubation period and if left untreated causes tubal blockage, early miscarriages and ectopic pregnancy.
This type of infertility caused by sexually transmitted diseases requires the most complex medical treatment, which includes the use of new methods of assisted conception or reproductive technology.
Human destiny and fertility
About 25 per cent of infertility is partly due to some of the reasons given above. The remaining couples suffering from infertility that cannot be explained need not be pessimistic. The new infertility technologies of IVF, GIFT, ICSI, PESA, microsurgery with TESA, and most recently blastocyst transfer, pre-implantation genetic diagnosis, Mayr modern medicine therapy and embryo receptivity protocols can help most if not all infertile couples conceive.
What is assisted reproductive technology?
This refers to the process of solving seemingly impossible or difficult infertility problems with new technology. Such technology usually involves the complex handling of human gametes consisting of the sperm and egg in order to achieve conception and subsequent pregnancy, leading to the delivery of a healthy baby.
There are several problems that can be helped with the new technology. They can be considered as those with male, female or even unexplained infertility.
Low sperm count and also the congenital absence of the sperm duct can be helped by the new technology. In this situation, men who were born with missing sperm ducts, today, are now able to have children of their own by ART procedure.
This occurs in 10 per cent in most cases of infertility. This female may go through a menstrual cycle but she is not ovulating, that is, not producing eggs. The process of ovulation is complex and involves secretions of several hormones in the brain, hypothalamus, pituitary and the ovary as well as other related endocrine glands like the thyroid gland, adrenal, pancreas and the parathyroid.
These endocrine glands secrete hormones, which work like the orchestra in a symptom to cause ovulation. If any of these hormones should play out of tune, ovulation will not occur. It is now possible to control this process externally by administering various hormones to the patient. This is done after a careful analysis of the patients’ hormonal status and deficiencies.
The tubes that carry the egg to the site of fertilisation may be blocked or restricted in their movement. This may result in failure to conceive, even though the patient may be ovulating normally. Blocked tubes occur in about 20 per cent of infertility cases. The cause is usually from previous infections. Sometimes, the woman may not know she had these infections. Even a simple appendicitis when young can lead to a scarring around the area of the tube which can interfere with the pickup mechanism of the eggs from the ovary.
An x-ray called “hysterosalphinogram”, which is a slightly painful but non-surgical procedure which does not require hospitalization, can determine if the tube is structurally sound. Most recently, there is a virtually painless procedure that is able to determine whether the tube is structurally intact. It is the use of ultrasonography with saline infusion. It is called hysterosonography.
This includes cervical hostility. In this situation, the woman’s cervix recognises the sperm as a hostile foreign body (antigen) and immediately produces antibodies to kill the sperm. Invariably, most of the sperm cells are destroyed just at the cervical entrance and do not pass beyond the cervix. This condition can be detected by examining a swab of the sperm removed from the cervix after intercourse.
It is called post coital cervical sperm analysis. There are a number of other immunological factors that can affect pregnancy, conception onto the implantation of embryo.