Infertility: Stigma lifting, but more needs to be done

Infertility: Stigma lifting, but more still to be done (Photo: iStock)

“I was mourning, mourning the loss of a baby that I will never hold, mourning the mother I could’ve been and crying for my womb. I had, had another miscarriage after struggling to get pregnant for 5 years,” says 38-year-old *Stacy Wairimu

Stacy struggled to conceive, and the pressure from womb watchers became even worse.

Womb watchers are people who keep asking women when they are getting pregnant.

“2 months after our wedding people would ask, so when are we having the baby the shower. At first it didn’t bother me because I knew I would conceive once ready. But that never happened as planned,” she says

After one year of trying to conceive, Stacy knew something was not right. That is when she started seeking medical intervention.

“I tried everything, even IVF didn’t work. My body went through so many changes. After the 3rd miscarriage I told my husband, I can’t do it anymore. I can’t prepare myself psychologically and physically for a baby and then I do not get to hold the baby, I couldn’t do it anymore,” she says

Apart from psychological distress Stacy had to deal with insensitive comments from womb watchers.

“People would say I had several abortions when I was younger, others said I started using contraceptives when I was younger so my womb can’t conceive. The funny one was that I don’t want to lose my figure. Really figure?” she adds laughing

After her 4th miscarriage Stacy conceived. She had her rainbow baby.

“I was so scared, during the whole pregnancy, even at 9 months I was still scared, thinking I might lose the baby. But I finally went home with my baby girl,” she says

Roseline Mueni a 32-year-old, struggling to conceive says that she has PCOS that has contributed to her infertility.

PCOS is polycystic ovarian syndrome. It is a hormonal disorder which may cause ovarian

enlargement and small cysts to line the ovaries

“I was so stressed, I had PCOS, my tubes were blocked, there was pressure from in laws to conceive,” she says

Roselines says that she stopped enjoying sex and it was all about conceiving.

“Sex now become like work, every time I had sex with my husband, in my head I was just thinking is this the time I will conceive. It reached a point I resented sex, it was like a task. I hated it,” she says

Roseline hasn’t conceived yet, but she’s still hopeful. She says if push comes to shove, she will try surrogacy or even adoption.

Dr Saudah Farooqui Consultant Obstetrician and Gynecologist at Nairobi West Hospital says infertility

Is not being able to get pregnant (conceive) after one year or longer of unprotected sex, or

inability to conceive after 6 months of trying for women over 35 yrs of age.

Dr. Farooqui says that there are many causes, some may be hormonal, structural, environmental, infections.

“The symptoms include: Irregular periods, lack of periods, long menstrual cycles, abnormal discharge and/or foul smell from vagina and pain during sex, she says

On treatment Dr. Farooqui says that treatment varies Depending on the reason for the infertility. For hormonal issues evaluation and necessary medications for structural issues surgery may be necessary.

Dr, Farooqui adds that there’s an increase in awareness and taboo and stigma is lifting alittle so people are talking about it more but we still have a long way to go

“Secondly it may be on an increase due to environment, diet, radiation etc things that were very different before eg pollution, excessive fast food intake in this day and age,”she says

polycystic ovarian syndrome

Dr.Farooqui says polycystic ovarian syndrome may cause infertility. Most women with PCOS do not ovulate.

“Assisted reproductive technology helps. Many patients have success with oral medication,” She says

The symptoms include: acne, obesity, excessive hair growth which is more male pattern, and prolonged menstrual cycles (long periods without menses).

“Treatment includes, some weight loss especially is the patient is obese, as low as 5% loss of body weight can help markedly, investigate for other hormonal and endocrine abnormalities and treat accordingly. Treatment is tailored per patient,” she adds

Dr. Farooqui says there is no known prevention for PCOS but having a healthy lifestyle helps. She advises on seeing a gynecologist early on to manage symptoms and prevent progression of other associated

metabolic abnormalities.

Male infertility is a disease of the reproductive system that makes a person unable to have children. Male infertility means that a man has a problem with his reproductive system.

Health System Specialist Junior F. Mukudi says there are many biological and environmental factors that can impact male fertility. Possibilities include Azoospermia where Your infertility can be related to your inability to produce sperm cells.

Another possibility is Oligospermia which The production of low or poor quality sperm.

It could also be Varicocele: A varicocele is a swelling of the veins that drain the testicle. It's the most common reversible cause of male infertility.

Infections such as epididymitis and orchitis can also cause testicular damage and affect fertility.

The man could also suffer from Ejaculation issues. in Retrograde ejaculation occurs when semen enters the bladder during orgasm instead of emerging out through the penis.

 “Symptoms of male infertility include Problems with sexual function for example, difficulty with ejaculation or small volumes of fluid ejaculated, reduced sexual desire or difficulty maintaining an erection (erectile dysfunction),” says Mukudi

Other symptoms include: Pain, swelling or a lump in the testicle area, recurrent respiratory infections, inability to smell. Abnormal breast growth (gynecomastia).

Mukudi says treatment for male infertility depends on the cause. If a specific reason for infertility is discovered, it sometimes is possible to treat. A variety of treatment options are available and include hormonal therapy, surgery to correct blocked tubes, and treatment of infections or underlying medical conditions.

“Low sperm count refers to the number of sperm in semen while erectile dysfunction refers to the inability to get or maintain an erection firm enough for sex. Low sperm count can be treated,through, surgery, medication, hormal replacement and assisted reproductive technology” he says

 

SIDEBAR 1

Treatment for infertility, low sperm count is available, says expert

According to Health systems specialist Junior F. Mukudi, Low sperm count treatment may include Surgery. For example, a varicocele can often be surgically corrected or an obstructed vas deferens can be repaired. Prior vasectomies can be reversed.

It also includes Medications as Certain medications can improve sperm count and motility.

Another form of treatment Hormone replacement or medications in cases where infertility is caused by high or low levels of certain hormones.

One can also opt for Assisted reproductive technology (ART). ART treatments involve obtaining sperm through normal ejaculation, surgical extraction or from donor individuals, depending on your specific case and wishes

In women, Health systems specialist Junior F. Mukudi Treatments for infertility include: Medications: Fertility drugs change hormone levels to stimulate ovulation.

Surgery: Surgery can open blocked fallopian tubes and remove uterine fibroids and polyps. Surgical treatment of endometriosis doubles a woman’s chances of pregnancy.

Men can take Medications: Medications can raise testosterone or other hormone levels. There are also drugs for erectile dysfunction.

They can also go for Surgery: Some men need surgery to open blockages in the tubes that store and carry sperm. Varicocele surgery can make sperm healthier and can improve the odds of conception.

Some treatments cut across both of the genders including Intrauterine insemination (IUI): A healthcare provider uses a long, thin tube to place sperm directly into the uterus.

Another treatment flr both genders In vitro fertilization (IVF): IVF is a type of assisted reproductive technology (ART). It involves harvesting the eggs at the end of the stimulation and placing sperm and eggs together in a lab dish. The sperm fertilize the eggs. A provider transfers one of the fertilized eggs (embryo) into the uterus.

They can also do Intracytoplasmic sperm injection (ICSI): This procedure is similar to IVF. An embryologist (highly specialized lab technician) directly injects a single sperm into each of the harvested eggs and then a provider transfers an embryo into the uterus.

Finally is Third-party ART: Couples may use donor eggs, donor sperm or donor embryos. Some couples need a gestational carrier or surrogate. This person agrees to carry and give birth to your baby.