--Dr. Abayomi Ajayi, Medical Director, Nordica Fertility Centre, Lagos, Nigeria
Medical Director, Nordica Fertility Centre, Lagos, Dr. Abayomi Ajayi, speaks to Sola Ogundipe on the challenges of male factor infertility as a result of declining sperm quality. He proffers available solutions and and treatment options. Excerpts:
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| Dr Ajayi with winners of the maiden Nordica Media Merit Award |
Sperm counts have
dropped over the years. What is regarded as normal sperm count is going down,
even the World Health Organisation, WHO is aware of this.
We are seeing more
men who are having bad sperms, weak sperms and abnormal sperms, and there is a
real need to explore a suitable intervention to meet the growing proportion of
men that need help in this direction.
Initially normal sperm count was 40
million per ml. Then it reduced to 20 million per ml, now it is 10 million per
ml and still going down. Over the last 10 years, we have seen a 30 percent
decline in the sperm parameters of men who presented at Nordica Fertility
Clinic, Lagos. That’s an average of 3.3 percent every year and it is as severe
all over the world.
A man can father a child up till age of 70 and for those
who are fertile they remain fertile but everybody’s sperm count reduces
eventually and there are other reasons especially environmental factors.
The
cells of men divide more than cells of women. That is why we reproduce into
older age and people are saying that may actually be where the problem is from
because with the division can come mistakes and probably that is why sperm
count is getting worse by the day.
But as bad as things appear, there is hope.
The first step of any successful treatment is the proper diagnosis of the male
infertility cause.
Although IVF is taking care of the problem of
low sperm count and poor motility, it can only work when there are
some sperm to be got from the man, but even if there is none,we can go to the
testes to get it. But there are some cases that even then you are
not going to get anything, so donor sperm may have to be used.
While there are
efforts to develop artificial sperm in the laboratory from stem cells, it is
still experimental, but there are so many technologies to manage sperm
problems. We know sperms contribute to the quality of the embryo, so if there
are poor sperms, the quality of the embryo will be bad and there
may be no pregnancy at all, or the pregnancy will be lost through miscarriage.
The poorer the quality of the sperm, the higher the number of abnormal embryos
from the IVF procedure. Now there is technology to check the DNA of the sperm
so we can check the sperms with damaged DNA.
The only thing the man contributes
to fertilization is his DNA and if that code is already damaged, he will not be
giving anything viable.”
