Solutions to female sterility will simply be a call to understand and address the root causes.
As I mentioned before, fertility impairment may be as a result of problems in the couple.
Where the issue is solely with the woman, the solution to the problem will be directed accordingly.
Generally, a female who approaches a doctor for fertility treatment will undergo at initial stage, extensive history telling to the doctor and the doctor will examine the patient thoroughly.
Investigations will certainly follow. Such investigations may include hormone profile which may pin-point where the error lay. Other investigations may include detailed ultrasound scan of the pelvis and abdomen. This will help analyse the reproductive system of the woman.
Depending on the history, the woman may undergo HSG (Hysterosalpingogram). HSG will outline the different layers and structure of the vagina, womb (uterus) and fallopian tubes. An alternative to HSG is laparoscopy and dye test. The objective is the same: to clearly see how the uterus and fallopian tubes look like.
In some cases, genetic testing may be called for especially if the woman shows the appearance of such illnesses as Turners.
Starting with the indirect causes, the woman can do a lot to help her fertility. If obese, lose weight. Stop smoking. Stop alcohol, marijuana and other dangerous substances that impair health as well as fertility. Avoid radiation except if necessary to heal some other ailment.
A woman who is about undergoing chemotherapy or radiotherapy can have some of her eggs frozen by her fertility doctor so she can use such eggs to conceive in future when her chemotherapy or radiotherapy treatment is over and done with. This same advice is applicable to the man to freeze his sperms.
What about those conditions that relates directly to female reproductive systems? Surely, polycystic ovarian syndrome (PCOS) is very disabling as it may be associated with diabetes
and obesity as well as abnormal body hair growths. The doctor may advise a regime of weight loss but will certainly address the risk of diabetes and abnormal hair growth with medications. The doctor is more likely to suppress the PCOS with powerful medications.
Rarely in modern times is surgery required that cut into the ovary to repair PCOS.
Pelvic Inflammatory Disease (PID) will require appropriate antibiotics. Similarly, STI will be dealt with by use of suitable antibiotics after the result of an investigation that is called high vaginal swab had been taken.
Where an anti-sperm antibody (where the woman’s cervix is hostile to the presence of sperms) is suspected as the cause, artificial insemination (IUI) may be advised or be undertaken. IUI may also be used for circumstances where sex is impossible as a result of fear gripping the woman during sex (Vaginismus). IUI may also be suitable where a case of impotence in the man is the cause. Of course the fertility doctor would have assessed the suitability of the couple for IUI and the couple be advised accordingly.
If everything else fails so much that natural conception is not possible, then the couple can approach fertility doctor for other forms of assisted conception. This will include in-vitro fertilization (popularly called IVF). Assisted conception comes in various forms depending on the reason for choosing the IVF method.
In summary, infertility is a serious disorder. It comes with severe social stigma and has harsh implications for the sufferer. Marriages may end; relationship and friendships may be dissolved because of sterility. In particular, women suffer a lot. They often erroneously get blamed for a fault which may not be their own. Pushed out of wedlock, women may suffer insecurity as a result of being denied the security provided by money, land and matrimony.
This is especially true in African and Nigerian context.
That said, because women has a “window of opportunity” to reproduce in their younger age group between ages 20-say 40, they should take advantage of and be conscious of this phase in their lives. Delay in having children may not only be disadvantageous but risky as old age is often not compatible with labour.
I am not under any illusion as to the complex nature of human infertility. It’s on this basis that we are organising a free public health seminar on infertility
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