Dr Abayomi Ajayi
When Peter and his wife, Rose, visited a fertility clinic after months of inability to conceive, the first routine tests showed that he had poor sperm parameters and they were informed that they would not be able to conceive naturally because – even though Rose’s fertility was fine –Peter’s sample was found to have severely low sperm count.
The recommendation was to try IVF with ICSI. Both were surprised by the diagnosis, and the next few weeks were a rollercoaster of emotions involving internet searches to find out more about male factor infertility, and to learn more about severe oligospermia. Within a few months of the initial referral, the couple started treatment.
Peter was at a house-warming one weekend and somehow, they got talking about infertility treatment. He was surprised to learn that the host and at least two other guests at the event had successfully battled infertility with a male factor. Before the end of the party, they had shared experiences and also obtained recommendations to other fertility specialists and clinics.
While no two infertility scenarios are the same, and no two clinics approach cases the same way, it actually helps to seek another opinion or option if you have been trying for a while without luck. For Peter, the message was clear. He needed another opinion and so he followed up on one of the recommendations from the encounter.
Since the initial recommended course of action didn’t prove successful, it made sense to consult other clinics specialising in IVF/ICSI treatment. The physicians and staff at the recommended clinic focused solely on improving fertility.
With caring professionals up-to-date on all the latest advances in reproductive technology, Peter and Rose tried one more time and were well rewarded with a healthy baby boy. The medical doctors and staff at the new facility understood the essence of the emotional rollercoaster of infertility.
There are several reasons why you may want to investigate your fertility treatment options elsewhere. Given your diagnosis a second opinion is often warranted and many physicians will encourage you to examine alternatives.
But then, being partnered with a fertility specialist, doesn’t guarantee instant success. In fact, with IVF, more than a few cycles are usually necessary to become pregnant.
While the basic approach to treatment, such as IVF, is similar, certain protocols may vary from clinic to clinic. In-clinic labs may do things in a different way, and there may be a difference in the timing, medication, dosage, or any number of things that could make the difference for you. The world of fertility is very much geared towards women, despite research revealing 40-50 percent of fertility issues occur on the man’s side.
While the main tests for men who are struggling to conceive include semen analysis (which measures the sperm count, mobility and motility), fertility clinics offer a much wider set of tests – but it might be a challenge for some couples to realise this.
So there is certainly the need to talk more about infertility in men. Typically after the wedding, the next big thing is the race to get pregnant. But if after some time there is no luck, you are compelled to go to the doctor to seek help. The common assessment at this point is a semen analysis test.
Male fertility problems include poor sperm quality, low sperm count or blockages in the tubes of the reproductive system. Treatment options for poor sperm quality include artificially inseminating the man’s partner with a concentrated sample of the man’s semen. So what do you do when you’re told that you have lazy sperm or too few sperm, but to keep trying anyway, or to go for donor sperm?
You would probably seek a second or third opinion, and chances are that you would obtain the same assessment. It only goes to show that there are many instances couples are unable to conceive naturally because of male factor infertility. Now, even when a problem has been established with the man, the woman has to get tested too.
When investigating infertility, you would quickly realise that it is often a challenge that you need to cope with as a couple, not individuals. You also need to learn to talk about this challenge, particularly to those who can help you, and also talk with those who share your challenge. There would always be other men in the same boat as you that you could form friendships and confide in each other.
Going to the specialist enables you to get the right information, even though the fertility ecosystem is geared up more for coping with women than men. But the important thing is that this is a shared problem.
One of the reasons that it is encouraging for men to talk about their infertility is because there is no downside, provided you talk to the right people. We all know someone with fertility issues, we might just not be aware of it.
If you could offer one piece of advice for anyone on a fertility journey, it would be to talk to someone. Sharing about your situation with friends and family, whilst difficult, helps you to process how you are feeling and enables you to find others living through similar challenges. The challenge of male fertility isn’t going to go away unless you start the conversation.
Dr. Ajayi is the MD/CEO of Nordica Fertility Centre
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