Today I will conclude the infertility topic and hopefully I will be more consistent. Thank you very much.
Baba Oloye was a big man to the core. Mere looking at him you could guess as much. He was huge, fat and had a big pot-belly which was as pendulous as that of a pregnant woman. He had money and he bragged about it. His business was booming and everyone was lobbying for his attention. Anything he wanted, he got. "Owo lo ma je" was his favorite phrase. He even paid for the title given to him in his town.
Whatever money could buy, Baba Oloye had. He had many 'tear rubber' cars, state of the art facilities. He built so many houses as if to release a statement to people that he was rich. Women were at his beck and call, throwing themselves at him at the slightest opportunity. The fact that he had four wives did nothing to deter them. Many of them were trying to be wife number five.
There was however only one thing that eluded this man. He had no child to call his own. He always had children in his house because he believed in the Yoruba adage that says "ori omo lon pe omo wa'ye" none of his wives had ever conceived.
He had been nonchalant about the child issue. He had always believed the problem had to be from his wives. Only women could be barren. After all he had "passed a lot of pregnancy tests" when he was much younger though he did not have money to afford a family then. He would just have to marry another wife. Daz all. Even his mother had advised him as much. Probably his wives were witches who had vowed not to give birth on earth. He had visited his prophets and babalawos who have promised him that he would soon be a father. He just had to offer some sacrifices and give a lot of alms. They would help him ward off the evil spirits preventing the children from coming.
He however got the greatest surprise of his life when he had accidentally bumped into his ex-wife Asake whom he had sent packing with the help of his mother due to her childlessness so that he could marry his latest wife. Asake was heavily pregnant!!! He could not believe his eyes. Could he be seeing correctly? He had been told that Asake was "Ako Aja" ( male dog). How come she was pregnant. He had tried to dodge her but she saw him and sarcastically showed him her baby bump and told him God had blessed her. He felt as though the ground should open and swallow him up.
That got him thinking. How could it be. He could not count the number of girls that he had impregnated while in school in those days. He had insisted they aborted the pregnancies. He was not ready then both financially and emotionally to have children. He was too smart for those girls who wanted to trap him with pregnancy. He was 100% "kampe". He could never be barren. But what was preventing his wives from getting pregnant. Could it be....... God forbid bad thing. But how come even Iya Biliki who was said to be giving birth like a pig had not even conceived since he snatched her from her husband over six years ago. Na wah o.
All these thoughts were driving him crazy and he decided to see his doctor. At least "make he no come die before death go come sef" . He had seminal fluid analysis done and when the result was out it was just as he feared, he had low sperm count. Low sperm "kini" . The doctor however gave him a ray of hope. He would need further tests and if it was due to infections, he would be treated and he could start having children. However, if nothing could be done, there were many other options offered. That was when he calmed down. At least, " owo lo ma je".
DISCUSSION
As earlier discussed in part 1, 33% of infertility is due to male factor. The following are the risk factors for male factor infertility.
- Complete absence of sperm (azoospermia)
- Low sperm count (oligospermia)
- Abnormal sperm shape (teratozoospermia)
- Problems with sperm movement (asthenozoospermia)
- Sperm that is completely immobile (necrozoospermia); the sperm may be alive and not moving, or they may be dead
- Problems with sperm delivery, due to sexual dysfunction, an obstruction, previous vasectomy, or retrograde ejaculation (semen not coming out)
- Problems with erections or other sexual problems
- The most common cause of male infertility is varicocele. A varicocele is a varicose vein found in the scrotum. The extra heat caused by the vein can lead to low sperm count and impaired sperm movement.
- Current or previous infection of a sexually transmitted infection
Risk factors for male infertility include:
History of prostatitis or genital infection
Testicular trauma or torsion
History of precocious puberty (puberty occurring at a young age) or delayed puberty (puberty occurring at an older age)
Exposure to toxic substances or hazards on the job, such as lead, cadmium, mercury, ethylene oxide, vinyl chloride, radioactivity, and X-rays
Cigarette or marijuana smoking
Heavy alcohol consumption
Exposure of the genitals to high temperatures (as in wearing nylon pants)
Hernia repair
Undescended testicles
Prescription drugs for ulcers or psoriasis
DES taken by mother during pregnancy
Mumps after puberty
. age (over 40 , men too have biological clocks)
Symptoms of male infertility.
There may be no obvious symptom.
Diagnostic tests
- A general physical exam by a urologist
- Semen analysis
- Specialized semen analysis, including genetic testing of the sperm (looking for the presence of antibodies) and evaluation of immobile sperm (to see if they are dead or alive)
- Blood work to check hormone levels, usually of Follicle stimulating hormone and testosterone but sometimes also Luteinizing hormone, Estradiol or prolactin
- Genetic karyotyping if recurrent miscarriage is a problem
- Ultrasound
- Post-ejaculatory urinalysis (urine testing), to check for retrograde ejaculation
- Testicular biopsy
- Vasography
Treatment
Includes:
- Treatment with antibiotics, in cases of infection
- Surgical correction, in order to remove a varicocele, reverse a vasectomy, or repair a duct obstruction
- Medications or fertility drugs to improve sperm production
In cases where the above treatments are unsuccessful, or when the cause for male infertility is unknown or untreatable, Sperm donation, In Vitro fertilization treatment, or Adoption may be suggested.
