INFERTILITY: A GLOBAL IMPASSE

The birds of the air, fish of the sea, every seed-bearing plant and all animals from Adam, flourish, bear fruits and continually multiply in number. Man is not left out in this reproductive network. Hence, the consideration of reproduction as one of the basic characteristics of all living things. The power of reproduction is purely divine and does not require human energy. This is evident from creation when God created man, blessed him and gave him the mandate to increase and multiply (Gen.1: 28). But how do we reconcile this fact with the problem of infertility and the countless complications resulting from it.

In our society today, the scourge of infertility is on the increase with the causes and blames always being attributed to the female folk. Infertility primarily refers to the biological inability of a person to contribute to conception. The NICE guideline defines infertility as the failure to conceive after regular unprotected coitus for a period of 2years in the absence of known reproductive pathology. It may also refer to the state of a woman who is unable to carry pregnancy to full terms.

Reproductive endocrinologists, doctors specialized in treating infertility will consider a couple infertile and eligible for treatment if;

-         a woman under 35years of age has not conceived after 12months of contraceptive-free coitus. Twelve months is the lower reference limit for time for pregnancy (TTP) as stipulated by the World Health Organization (WHO).

-         A woman over 35years has not conceive after 6months of contraceptive free sexual intercourse. These time intervals appear to be reversed. This is an area where public policy trumps science. The idea is that for women beyond age 35, every month counts and if made to wait another 6months to prove the necessity of medical intervention, the problem could be worsened. The corollary to this is that by definition, failure to conceive by women under 35years is not regarded with the same urgency as those over 35years.

Sub-fertility is said to occur in a couple that has tried unsuccessfully to have a child for one or more years. This implies that they are less fertile than a typical couple. Endometriosis or polycystic ovarian syndrome could cause sub-fertility. Infertility can occur in primary and secondary episodes. Couples with primary infertility have never been able to achieve conception. Whereas, those with secondary infertility have problems with achieving conception again after having conceived in the past. It is worthy to note that secondary infertility is not present if there has been a change of partner.  If there is a change in partner, then a new couple is created with its own chance of being fertile.