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Doctor’s Appointment: Infertility – a gender neutral struggle

Published:Wednesday | April 20, 2016 | 12:00 AM

Approximately ten to 15 per cent of couples worldwide have infertility issues. This means, therefore, that more than 80 million people around the world are infertile. While infertility, rates vary among different countries, Jamaica is in line with worldwide statistics at 15 per cent.

But what is infertility and when is someone - whether male or female - considered infertile?

"Infertility is defined as the failure to achieve or cause pregnancy after regular, unprotected sexual intercourse," Dr Vernon DaCosta, head of the Hugh Wynter Fertility Management Unit, said on the TV programme 'Doctor's Appointment' on Sunday.

Dispelling the common myth in our Jamaican culture, that when a couple has difficulty conceiving, automatically it is the woman's fault, the host of the show, Dr Sara Lawrence, stated, "It is such a misconception".

Dr DaCosta then noted that causes of infertility may not necessarily be from the woman's side and, in fact, infertility can involve both partners.


The reasons for infertility can involve one or both partners


n In about one-third of cases, the cause of infertility involves only the male.

n In about one-third of cases, the cause of infertility involves only the female.

n In the remaining cases, the cause of infertility involves both the male and female, or no cause can be identified.


Causes of male infertility


- Various problems resulting from genetic defects such as cystic fibrosis.

- Trauma from injury.

- Prior infections such as mumps.

- Enlarged veins in the testes which increase blood flow and heat, compromising sperm quality, shape, and amount.

- Sometimes men will find that their testicles are undescended - no sperm production.

- Health problems such as diabetes, hypertension or premature ejaculation, semen entering the bladder instead of travelling through the penis during ejaculation.

- Overexposure to certain drugs, toxins and chemicals such as pesticides, radiation, tobacco smoke, alcohol, marijuana and steroids (including testosterone).

- Some cancer treatments can impair sperm production, sometimes severely. Removal of one testicle due to cancer may also affect male fertility.


Causes of female infertility


- Ovulation disorders, which hinder the ovaries from releasing eggs.

- Other underlying causes may include excessive exercise, eating disorders, injury or tumors. There may also be uterine or cervical abnormalities, or abnormalities in the shape or cavity of the uterus.

- Benign tumors in the wall of the uterus (uterine fibroids), which are common in Jamaican women, may rarely cause infertility by blocking the fallopian tubes. More often, fibroids may distort the uterine cavity interfering with implantation of the fertilised egg.

- Scar tissue from previous pelvic surgery may pose fertility issues as well

- The level of thyroid hormone, too much or too little, can interrupt the menstrual cycle or cause infertility.

- Fallopian tube damage or blockage, caused from pelvic inflammatory disease, usually a result of sexually transmitted infection, endometriosis or adhesions.

- Another common problem is Endometriosis, a very painful disorder which occurs when endometrial tissue implants and grows outside of the uterus, often affecting the function of the ovaries, uterus and fallopian tubes.

Dr DaCosta also mentioned early menopause - which occurs when the ovaries stop working and menstruation ends before age 40.

Although the cause is often unknown, certain conditions are associated with early menopause. These are immune system diseases, radiation or chemotherapy treatment and smoking. Like in men, cancer treatment can impair female fertility. He also cited a woman's age as a significant factor to fertility, but pointed out that freezing of eggs can be an alternative to delaying pregnancy.


Infertility can cause psychological/emotional stress


Infertility, though not a disease, can exert immense emotional stress and frustration on individuals and couples. Given the cultural realities of the Jamaican society, where it is felt a woman is only complete when she bears a child, unreasonable pressure is brought on couples, and women who fail to conceive. Women, in particular, face brutal and disparaging names and comments about their womanhood.

A guest on the programme, entrepreneur Heneka Watkis-Porter, outlined her own fertility challenges and emotional struggles following failed fertility treatments. Now at a place where she acknowledges that though having a child is still important, not having one does not make her less of a woman.

In response to the Jamaican situation, Dr DaCosta suggested that couples may consider assisted reproduction methods such as IVF, and surrogacy. He also advocated adoption, being a godparent or fostering a child. He reiterated that women and men can live fulfilled lives without children.

- 'Doctor's Appointment' airs on Sundays on TVJ at 5:30 p.m.. Questions may be emailed to: