Epidemic! 1 Out of 3 Nigerian Couples Infertile-Dr. Ekeh, Fertility Specialist

Dr. Norbert Ifeanyi Ekeh is the Medical Director of Regenesis Fertility Specialist Hospital. In this chat with FRANCIS OGBONNA, the consultant outlines the causes of infertility among other things. Excerpts…

Can you please introduce yourself?
My name is Dr. Nobert Ifeanyi Ekeh. I am the Medical Director of Regenesis Fertility Specialist Hospital. I Holds a MBBS degree from the University of Nigeria, Nsukka and did my residency & membership (obstetrics & Gynecology) in the UK, before relocating in Canada, where I worked as a consultant obstetrician and Gynecologist until I returned to Nigeria over five years ago to found this clinic.  

Why did you chose to specialize in providing fertility related remedies and not the general practice?
I was working as a general obstetrician & Gynecologist in Canada until my visit back home in 2005. I happened to attend a programme at the Redemption city and while there it got to the time of prayers and when Pastor Enoch Adeboye called for those who wanted the fruit of the womb, it was as if almost everyone who was at that meeting trouped forward. I know that fertility has always been an issue all over the world, at least one (1) out of six (6) couples have fertility issues, but from my experience since I returned back to Nigeria, it has been like 1 out of 3 need help medically. It is an epidemic in the country now.

What could be the cause?
For females, recent studies and consultations in Nigeria have shown that 1 out of 10 ladies who have fertility challenges are as a result tubular diseases. There is also hormonal in-balance. But the most common reason for delay in child birth is late marriage. When women marry late it has a way of impeding their chances of having babies.

How old is late?
Medically speaking, if you are 40 and above as a lady, the chances of you becoming pregnant are medically low. 40 years is more like the cut-off age for ladies. The worse thing is that even when you do achieve conception, you are more likely to miscarry. ¾ of women above 40 who achieve pregnancy miscarry those babies. It is as high as that. So it is like a double edged sword-first you find it difficult to achieve conception and when you do, the chances of you loosing the baby is very high.

What are the things that block these tubes?
Mostly Pelvic infections; one episode of pelvic inflammatory disease alone has the capacity to reduce a lady’s chances of becoming pregnant by 33%. Just one episode can result in blocking such a lady’s tube. The terrible thing in that these ladies might not even know they are infected until they are diagnosed. It might be subclinical. Infections like Gonorrhea and Chlamydia, if not detected on time and treated immediately, they result in chronic inflammatory cases and when that happens, taking-in becomes difficult.

What about for males?
The male aspect is almost epidemic in Nigeria. The main cause is low sperm count. For example in this fertility clinic now, after we opened shop, we screen a few young men who wanted to donate sperms for us and we had to screen about 20 before we could get one that had more than 15 million sperm per mill or 20million sperm per mill.

What are the causes?
The causes are very many, but the major culprit is industrialization. Studies have always been carried out over the years, but recently some students decided to look at and compare between times and they found out that in the 1940, sperm counts of the average man was up to 116 million sperm per mill, and then it dropped to about ten years later to 60 million sperm per mill. If it continues like this, which means in another 50 years it will be zero. It is a huge problem and it was linked to the industrial revolution of 1920.

What aspect of industrialization is responsible for this?
The lead cause is fuel (or hydrocarbon). Eating foods grown with fertilizers as well is not helpful, because it produces too much estrogen in the body. Men are not supposed to have too much of that in the body, unlike in women. Increase in estrogen in men for a while reduces, the sperm counts in men. But in Nigeria, in addition to the above there is a lot of environmental pollution, like generator fumes and use of insecticides and they are all by-products of fuel. When you spray these insecticides and breathe it in over a period of time, it makes your sperm count to reduce over time.

Are pelvic inflammatory diseases also a problem for men?
Not really. If you have say Gonorrhea, it suppresses you sperm count immediately, but as soon as it is treated, it is reversed, unlike in the ladies.

What about alcohol in-take?
Alcohol probably does, but only when taken in excess. They all add up; cigarette smoking is part of it. If you wear tight pants or you use a lot of hot baths, if you see how God created us, you will see that it is hanging out, because of the temperature. So if you see people who drive long distance on a regular basis-like truck drivers who sit for a long time with hot engines below, their sperm counts are usually low. There are many causes, but for this environment, the main cause is environmental pollution.

So what happens when a couple discovers they are not capable of producing unaided, what do they do?

The proper thing is see a fertility expert; they would proffer solutions for you…

Causes of infertility summarized

For Women:

·       STDs for women, which blocks their tubes
·       Marry late…40 is the cut-off age

For men:

Its low sperm counts as a result of the following:

·       Exposure to fuel fumes (exhaust fumes or smoke like it is called in local parlance);
·       Exposing you genitals (scrotum) to too much heat like-
                              I.            Wearing tight pants (or undies)
                           II.            Taking hot baths, like using spa baths
                        III.            Sitting at a spot for long eg. Truck drivers who sit on hot engines for several hours.
                       IV.            Eating foods grown with fertilizers
                          V.            Other environmental pollution