
Has
your wife experienced repeated miscarriages, especially within the
first three months of pregnancy and you are still trying to achieve a
pregnancy that she could carry to term?
As a man, if you answer an emphatic
‘yes’ to this question, it may be time to focus on yourself because,
experts say, the repeated miscarriages — medically known as abortion —
may be due to the fact that your sperm is defective. If this is the
case, you need medical attention; otherwise, your desire to have a baby
may be a mirage, especially if you are over 40 years of age.
Generally, physicians say between 20 and
30 per cent of all women spot, bleed or suffer cramps during their
first 12 weeks of pregnancy, while about 10 per cent miscarry.
Gynaecologists warn that a good number of women miscarry unknowingly,
thinking that their period was late or heavy.
Though a woman may suffer miscarriage
for many reasons, gynaecologists say the commonest reason for a
first-trimester miscarriage is a genetic defect in the embryo. Experts
say about three in every five early miscarriages are thought to be
connected to foetal abnormality, which may have been as a result of
abnormality with the woman’s egg or the man’s sperm.
The Medical Director of Nordica
Fertility Centre, Dr. Abayomi Ajayi, says the abnormality may be a
combination of the problem with the man and the woman. He describes such
miscarriages as the nature’s way of preventing the birth of a baby with
a birth defect.
This genetic error is a random event
which happens by chance, experts say; and it occurs because a
genetically abnormal egg or sperm gets fertilised.
Having a miscarriage is an unpalatable
experience; but when it happens repeatedly, it’s bound to have
psychological and emotional effects on, not just the woman but her
husband also. The situation is even worse if the couple has been trying
for a child.
Ajayi says that though every woman has
some chromosomally abnormal eggs and every man produces some
chromosomally abnormal sperm, when a man has high volume of abnormal
sperm, his wife may continue to experience miscarriages even if she has
the best eggs in town.
“The quality of the man’s sperm can
sometimes be the cause of recurrent miscarriages,” Ajayi warns; “hence
the advice for men to do a sperm test to be sure.”
Beyond the problem of miscarriages which
may deny couples the timely opportunity to raise a family of their own,
experts say couples who have had regular unprotected sex for 12 months
and have been unable to achieve pregnancy should ascertain that the man
has not been firing blank sperms.
Ajayi notes that when a man is planning
to raise a family, finding out that he is infertile can be a big shock
to him. Yet, experts say, male infertility is much more common than we
may think.
Physicians say if couples have been
trying to conceive, it is no longer ‘fashionable’ to conclude that the
woman is the cause of the problem, as the man may actually have zero
sperm count.
Fertility specialists contend that about
one in 20 men is sub-fertile; and male infertility may be significant
in half of all infertile couples. “About one third of all in-vitro
fertility procedures are performed for male infertility,” they note.
An online portal, abc.net.au,
proffers that male infertility is diagnosed when tests have been done on
both partners and reproductive problems are identified in the male
partner.
“Those tests might include a physical
examination and analysis of the man’s sperm, looking at their number,
movement and shape. Doctors might also carry out blood tests to
determine hormone levels, and do genetic investigations or testicular
biopsies,” the portal says.
Ajayi adds that for roughly two-thirds
of infertile men, those tests will reveal an underlying problem with the
number, quality or movement of sperm. “In specific terms, such sperm
lacks numbers, speed and the ability to engage,” he says.
Treatment options
Experts say though there are specific
techniques that fertility specialists can use to combat male fertility
issues, the best approach depends on the type of infertility and its
severity.
Ajayi notes that one of such techniques
which has been proved to work when tackling male fertility is the
procedure called Intracytoplasmic Morphologically Selected Sperm
Injection, aka IMSI.
The Nordica boss explains that IMSI is
especially indicated in severe derangement in sperm parameters, and is
therefore recommended for men with very low sperm count that is less
than two million and with less than 20 per cent motility.
The process is also recommended for men
whose partners have had recurrent abortions within the first three
months of pregnancy. “This is to exclude the contribution of damaged
sperm,” Ajayi explains.
Again, IMSI is recommended in a
situation where the woman has had two failed cycles, and where the man
has low rate of spermatozoa with normal nucleus.
Ajayi warns that ageing affects men,
just as it does the women; and that by the time a man is 50 years old,
he is likely to develop abnormal sperm. IMSI, he says, can save the day,
as the technology enables the fertility specialist to “help” the man
achieve what, otherwise, he might not, naturally.
And even where a couple has a good
number of eggs but there is poor fertilisation, expert say, IMSI is the
technology of choice because, “compared to its forerunners, it is the
most effective treatment to date in tackling male factor infertility.”
Fertility experts enthuse that the IMSI
technique involves selecting the best quality sperm cells from a sample
provided by the male partner, and injecting them directly into the eggs
retrieved from the female partner, thereby increasing the probability
that these sperm cells will fertilise the woman’s eggs.
Indeed, a work by a group of seven researchers, published in the March edition of the Reproductive Health
journal, states that several studies demonstrated that IMSI provides
positive results in couples with severe male factor infertility or
repeated Intracytoplasmic Sperm Injection (ICSI) failures.
The study leader, Roberto Marci, notes
that in a study of 332 couples where the cause of infertility was due to
the male factor, “A trend towards better laboratory and clinical
outcomes was detected in the male factor infertility subgroup when IMSI
was applied.”
The researchers depose that this
technology that is used in analysing sperm enables fertility specialists
to effectively detect and bypass ‘deranged’ sperm. They are therefore
able to fertilise a healthy egg with healthy sperm and thus enable
couples to have children of their own.
Marci reveals that, “In the IMSI group,
fertilisation rate and live birth rate were slightly higher and the
miscarriage rate tended to be lower when compared to the ICSI group.
“This is because IMSI involves examining
sperm under a high-magnification microscope — about five times more
powerful than standard laboratory equipment — to select those with a
shape and size that indicate good genetic quality. And it seems that
this high-magnification technology really does work,” researchers
affirm.
Again, in a study done by Italian
scientists involving 446 couples, in which the male was infertile but
the woman had no perceivable fertility problems, the pregnancy rate
among the couples that used IMSI was 32.9 per cent, compared to 26.5 per
cent among the couples who used ICSI.
The scientists report that men who have
tried and failed to become fathers through at least two previous IVF
attempts were twice as likely to succeed through IMSI than through
another round of conventional fertility treatment.
Ajayi counsels men to realise the fact
that it takes two to tango; and that they should not think that it is
unmanly to seek fertility treatment when their wives have been confirmed
fit to conceive yet can’t.
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