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Maclawrence Famuyiwa
Recently the number of married women seeking medical assistance to be able to conceive is becoming alarming. Thank God, there is the availability of various medical techniques available to help them achieve this. Resultantly, many doctors are finding specialisation in the field of fertility medicine very attractive and exceedingly lucrative.
Worldwide, about five – eight per cent of couples are believed to experience infertility at one period or the other in their reproductive lives. Quite unfortunately, this may be as high as 32% in some African countries. And unlike primary infertility forming the majority of infertility rates recorded in most of these advanced economies, in Africa, majority of the infertility is secondary infertility.
Infertility is defined by the World Health Organisation as “a disease of the male or female reproductive system defined by the failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse”.
Infertility can either be primary or secondary. Primary infertility refers to when pregnancy has never been achieved before by a person while secondary infertility is when at least one pregnancy has been achieved before.
In essence, infertility in marriages may originate from either the wife or the husband and in some cases from both of them. It is estimated that about 48 million couples and 186 million individuals live with infertility worldwide.
Causes of infertility
Many factors may be responsible and, in some instances, the cause of infertility may not be explainable. In females, the commonest causes are:
Tubal disorders – like when the fallopian tubes are blocked as a result of untreated sexually transmitted infections or complications secondary to unsafe abortions, post-partum sepsis, or abdominal or pelvic surgery.
Uterine disorders – this could be inflammatory, congenital, or benign as in fibroid.
Ovarian disorders – common examples are due to polycystic ovarian syndrome and other follicular disorders.
Endocrine system disorders – when there are imbalances of the reproductive hormones.
For males, infertility may be caused by any of the following:
Obstruction of the reproductive tracts which affects sperm ejection – The blockage may be in the tubes that transport semen. Most times, the blockage is due to injuries or infections of the genital tract.
Hormonal disorders – This may come from abnormalities of the hormones from the pituitary gland, hypothalamus, and testicles.
Abnormal sperm function and quality – This is when sperm have abnormal shape and movement. Anabolic steroids for example can cause this.
Failure of the testicles to produce sperm – This may be a result of varicoceles or medical treatments, such as chemotherapy, that affect sperm producing-cells.
Additionally, environmental factors and lifestyles such as smoking, excessive alcohol consumption, and obesity may be causative of infertility. So also, is the exposure to environmental pollutants and toxins.
Why should adolescents in our clime avoid abortion?
Generally speaking, in countries with advanced health care delivery, elective abortion may not cause any fertility issues or complications in future pregnancies. This means that induced abortion is medically safe when done in accordance with recommended guidelines. But, in those in whom a curet is used for the abortion, there is a high risk of scarring of the inner lining of the uterus, a condition known as the abortion Asherman’s syndrome. This condition is associated with difficulty in becoming pregnant later in life but has long been replaced by better methods.
Quite unfortunately, abortion is illegal in many so-called underdeveloped countries. In Africa, only Tunisia, Benin, Mozambique, Cape Verde, and South Africa allow women to have abortions legally and safely under certain conditions. Though, it is believed that both Sierra Leone and Nigeria, in not too distant future may soon join the fray. In countries where abortion is forbidden, the only legal way to have an abortion is when the pregnancy puts the life of the mother in danger or as it is in Zambia; on socioeconomic grounds. Otherwise, access to safe abortion is practically arduous. Even in some so-called advanced countries, like the USA; where there was a constitutional right to abortion, this was recently overturned by the US Supreme Court.
However, when abortion is made illegal it means most women will undergo unsafe abortions that put their well-being and future fertility at risk. Many such women die in the process and many also develop complications such as infection, excessive blood loss, and incomplete abortion which ultimately may affect their ability to have future pregnancies.
Conclusions
Due to the increased occurrence of secondary infertility traceable to unsafe abortions in our clime, it is advisable that adolescents should shy away from procuring abortions from unqualified professionals and better still totally avoid sex till they are married or old enough to take care of their pregnancies, themselves and their babies and if they find this hard, they should always use condoms during any sexual intercourse.
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