The most pleasant occurrence in any marriage is perhaps the cry of a new born child. It not only binds the couple together but brings the hope and joy of leaving a legacy behind after one’s departure to the great beyond.
However, most marriages are being plagued with the inability to deliver of a child. This not only breeds rancor within the family but the woman is often blamed and is said to have eaten up her children in some cases; especially in the African society.
To make matters worse, the couples involved often don’t know where the problem really is emanating from or how to tackle the problem of infertility heads-on.
This article aims at having a critical look at what infertility is, and the various causes of infertility in marriages as well as medical solutions rather than just according blames.
WHAT IS INFERTILITY?
Infertility is the failure of pregnancy to occur a year or more after marriage when couples are not using any family method and actually puts effort to having children.
It is a very serious matter.
Infertility or inability to have a child several years after living together could be (a) primary or (b) secondary.
In some cases of infertility, the woman has never missed her period; let alone carrying a successful pregnancy. This situation of no pregnancy since years of marriage is known as primary infertility.
Secondary infertility is the situation where the woman has missed her period before or has even had a child or two before now but all of a sudden getting pregnant becomes an issue. Such difficulty of having a child or becoming pregnant after having had one or two children eliminates congenital situation (where a woman has no womb) like Testicular Feminization Syndrome. This form of infertility tells that the problem doesn’t originate from birth.
Who Is Responsible – the Man or the Woman?
It is no news that in the traditional African Society (like in Nigeria) that the woman is often blamed for inability of the couple to produce a child. This ought not to be the case. Both the man and the woman could either equally be responsible for the inability to produce a child.
Cases abound where the woman is sent for diagnosis and the man refuses to go saying that he has impregnated several women before he got into the marriage. It is true that most women have involved themselves in promiscuous activities before settling down in marriage but the fact remains that most men have had more sexual partners than their spouse.
So, men should share the blame as well.
However, according blames don’t resolve such issues.
CAUSES OF INFERTILITY
Infertility could be caused by a host of activities. It could be a) congenital (that is from birth) or (b) acquired (later in life). Let me expatiate.
INFERTILITY IN MEN: Congenital Causes
The testes of every normal man developed in the lower part of the abdomen. With time, towards the time of birth of any male child, the two tests usually migrate by downward movement into the scrotal sac where they stay in order to be away from the damaging effect of the body heat.
In the Scrotum, the testes are completely shielded or insulated from the effects of the body temperature. Heat sensation is known to stall the process of spermatogenesis, hence, the special scrotal temperature which allows optimal performance of the two testes.
It has however been observed that in some number of normal delivery, certain male babies are delivered without the testes in the scrotal sacs. This is a condition known as Congenital Un-descended Testes or Orchidopexy. It could be either one or the two testes that are involved.
This anomaly can be corrected if the child in question is taken to hospital as soon as he can withstand the stress of operation. It is advisable to carry out this operation between the ages of 5-8 years before the child gets to puberty. After puberty, the operation is as good as useless. After puberty, the testes would have become permanently damaged where-ever they are and any operation would be aimed at forestalling malignancy (cancer) that might occur if left in abnormal positions in the abdomen.
Aside undescended testes; there are certain cases where the testes may fail to develop. This may involve only one or both testes.
In the long run, all these cases will cause infertility in males as sperm cell may not be produced. However, if only one testis is involved, one is reassured that the spared testis can still perform the job of the two.
The condition of undescended testes (bilateral or otherwise) is usually an accidental discovery. It is usually discovered while the mother baths the child and finds the scrotal sac to be empty or during routine medical examination by a doctor.
INFERTILITY IN MEN: Acquired Causes
- Sexually Transmitted Diseases (STDs): This accounts for the highest percentage causes of infertility in men. Usually, STDs when discovered on time could be cured by a specialist but with unchecked proliferation of drug hawkers, the timid populace is wrongly advised to patronize such concoctions and antibiotics with the notion that it can cure all STDs.
What happens is that the victims get temporary relief but the damage goes on as the disease will go ahead and destroy your sperm producing cells. Please, take no concoctions in the cure of any STD. No matter how insignificant it may appear to look, always consult a medical expert.
For a man to impregnate a woman, about 40 million sperm cells are required. When the sperm cells fall below 20 million, the condition is known as moderate Oligospermia while below 5 million is called severe Oligospermia. The condition of zero sperm cell is known as Azospermia.
Low sperm count, though very difficult to cure, is still much curable. It is Azospermia that is usually incurable. One should not wait for the condition to reach this terminal stage.
- Incessant Heat: In the Scrotal sac, the testes are protected from the temperature of the body. The temperature of the scrotal sac is conducive for maximal performance. Subjecting the testes to undue strain by exerting sustained pressure of heat sensations will affect its functionality resulting to complications of infertility.
Thus in all cases of sustained heat sensation, e.g. high fevers, malaria, typhoid, the use of hot water for bathing and wearing of tight nylon pants, the functional efficiency of the testes are impeded. This account for the reason why long distance automobile drivers, e.g. Luxury Bus drivers, tanker drivers, trailer drivers and lorry drivers are almost always having severe Oligospermia. The constant heat and pressure effects on the testes as they sit down and drive such long distances usually causes drastic reduction to the rate of sperm production.
It is thus advisable that all men, as soon as they are in the comfort of their homes, tie wrappers, put on pyjamas or go without pants so as to allow the testes freedom of movement in the scrotal sacs.
- Varicocoele: Blood is supplied to the testes by so many blood vessels and is in the same manner drained by so many veins. In some cases, the blood vessels become dilated leading to damaged valves of the blood vessels. This leads to blood being pooled into the scrotal sac causing heat sensations in and around the testes with subsequent Oligospermia.
In a normal man, the left testis hangs lower than the right one. However in cases of Varicocoele, the different positions of the testes are so pronounced that it may affect the movement of the individual. The scrotal sac appears as if it’s housing a bag of worms. This condition does not call for medical attention unless there is an underlying disease. It is true that this condition will not result to infertility but it does cause sub-fertility.
- Torsion of the Testes: This is the condition when the blood vessels supplying blood to the testes become twisted around each other thus obstructing free blood flow to the testes. Torsion of the testes brings about severe pains and immediate swelling of the testis involved.
To remedy this condition, immediate treatment is needed. Any wasting of time could lead to irreversible damages to the testis involved. Treatment is by operation aimed at untwisting the torsioned vessel in addition to use of strong pain killing injections.
Note that torsion of the testis usually occurs in abnormally positioned testes. The normal ones seldom undergo torsion.
- Obstruction of the Urethra: This is the condition that occurs in certain cases of badly treated gonorrhea where stricture may occur in the urethra. This condition usually leads to obstruction of the passage of the sperm during ejaculation and hence infertility.
INFERTILITY IN WOMEN: Congenital causes
In certain women, there is failure in the development of the reproductive organs during the formative stages. These women are therefore born without some reproductive organs. We will analyze the anomaly presently.
- Women borne without womb: This is a very rare case and women with such conditions can never become pregnant since there is no womb for the baby to grow. These women don’t have fallopian tubes. The good news is that they have a blind ending vagina and can at least enjoy normal sexual intercourse.
- Failure of the womb to mature: In certain women, the womb might fail to grow to full size at puberty. These women have small sized womb (Hypoplastic uterus). Although these women have wombs, they cannot carry the pregnancy to completion. They will always experience frequent miscarriages or abortions.
- Women Born without vaginal openings: These women lack a vaginal opening as the outside is covered with a thin skin. The condition is known as Adrenogential syndrome. It is however treatable as a hole could be created to re-establish continuity with the inner opening of the vagina.
INFERTILITY IN WOMEN-Acquired
Urinal Tract Infection (UTI)
UTI forms a major cause of infertility in women of reproductive ages. UTI include badly treated STDs which have moved from the acute stage to the chronic stage and eventually causes blockage of the fallopian tubes.
One should always consult a specialist when you have infections so as to avoid later complications. Manifestations of infection in the vagina always include foul smelling vaginal discharge and could be accompanied by itching.
Other causes of infertility in women could include:
Badly positioned womb-it has been observed that the mouth of the womb is always nosing forward and downwards, so that when the sperm is ejaculated into the vagina, the sperm cells will easily penetrate the womb to reach the fallopian tube for fertilization to take place.
In some women, there is an anomaly in the position of the womb. The mouths of the wombs are nosing up-wards leading to a condition where ejaculated sperm in the vagina always pour away at the end of sexual intercourse. The sperm cells are unable to locate the womb and remain in the vagina where they die off.
Women of reproductive age have their menstrual cycles occurring every 22-35 days. Below and above these dates are regarded as pathological conditions but it is important to note that irregularity does not mean different calendar dates in 2 or 3 months cycles. Irregular periods are described when each menstrual cycle varies widely from the others, e.g. August-28 days, Septermebr-40 days, October-24 days, etc. These cycles could be described as irregular.
The state of anxiety could be the only problem behind some women’s inability to become pregnant. Anxiety, as a cause of infertility is quite difficult to cure as it is more of a subconscious or psychological problem.
Having known the causes of infertility, it now rests on the couples involved to find solution to the problem. According blames never helps. You could also research more on the issues treated on this article.
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