Male infertility a public health problem
Published On April 29, 2020 » 1293 Views» By Times Reporter » Features
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LIKE in many parts in the world, Zambia is witnessing a changing life style which affects fertility and has seen increased demand for Assisted Reproductive Technology (ART).
Traditionally, infertility has been thought of as a female problem to sort out her reproductive health problems.
However, research shows how male reproduction has received less attention and the rise of male infertility has proved to be a challenge.
A Consultant Obstetrician /Gynaecologist, describes infertility as the inability for a couple to achieve a pregnancy despite regular unprotected sexual intercourse for at least 12 months.
Zambia Association of Gynaecology and obstetrician president Swebby Macha said infertility affects about 10-15 per cent of couples.
Dr Macha said both female and male factors contribute to infertility with about 40-50 per cent female factors and 30-40 percent male factors.
The United Nations Population Fund (UNPF) recognizes reproductive health, including having a baby, as a human right.
Dr Macha said infertility is a reproductive health, social and emotional issue which has seen one in five patients in the gynecology outpatient clinic present problems of infertility.
He said that the causes of infertility in males can result from abnormal sperm production or function such as infections with mumps, impaired transport of sperms due to sperm tube blockage or scarring.
“Repeated sexually transmitted infections (STI) such as gonorrhea and chlamydia and life style problems such as smoking, alcohol, drugs and emotional stress, can also cause infertility problems in men,” He said.
In Africa, infertility still remains of great concern and a challenge among couples which often leads to divorce or men engaging in polygamy and extra marital affairs as women are often blamed.
Male infertility is the male’s inability to cause pregnancy in a fertile woman.
With no current treatment to improve sperm function, the burden remains on the woman to under-go different fertility treatments including in-vitro fertilization (IVU) treatment.
Dr Macha said investigations in male infertility includes conducting a semen analysis.
He said treatment options in infertility depends on the cause, duration of infertility, age of partners and personal preferences.
Additionally he said life style changes such as quitting smoking and alcohol and reducing weight can also be advised.
Much research remains to be performed on the topic of male infertility, as many cases still receive an “unknown cause” diagnosis.
Male infertility usually occurs because of sperm that is abnormal, inadequate in numbers or problems with ejaculation.
And a medical practitioner based in Ndola, said a number of men have started coming through, to seek treatment for infertility.
Sebastian Chinkoyo, a consultant obstetrician-cum-gynecologist at Ndola Teaching Hospital said from the majority of cases seen, 20 per cent are due to male or a combination or both.
Dr Chinkoyo, in an interview, said for women who come with their male partners, the first investigation looks at semen analysis which is tested in the laboratory to see if production of sperms is normal.
“Some encounters have seen some men present low sperm count or no sperms at all and these are referred to the urologist for further investigation,” Dr Chinkoyo said.
He noted that infertility in men can be caused when sperms are not produced in the testicles or the tubes are blocked.
Dr Chinkoyo explains the importance for couples to seek treatment together as the perception for infertility still look at women being at fault.
“There are cases when during investigations both couples present low infertility, a situation that is difficult to achieve pregnancy,” He said.
According to the British Broadcasting Corporations (BBC), a clinical senior lecturer in reproductive medicine at Dundee University in Scotland, said doctors are trying to solve the mystery of male infertility.
Sarah Martins da Silva was also included on BBC’s 100 most inspiring and influential women of 2019 because of her work to solve the problem of male infertility.
Further research shows that male infertility accounts for 40-50 per cent of infertility due to deficiencies in the semen.
And Dr da Silva, said sperm count levels have fallen to 60 per cent in the last four decade.
“If we don’t do anything to address the loss of sperm count, then we could potentially in 40 years to 100 years be in a position where sperm count will go to zero,” observes Dr Silva.
Dr da Silva explained how societal expectations have left women to sort out their contraception and getting pregnant, and if we don’t talk about it and no further research is done, society is headed for real battle to get anywhere.
She also said that it is unfair for women to be doing medical treatment using IVF because of male health problems.
Despite so much awareness on infertility, the lives of most women still endure the pain of not conceiving as all blame is apportioned on them.
IVF involves fertilizing the egg externally from a woman and transferring it back into the uterus to implant, a process that aids a woman to conceive.
Her research team focuses on how the sperm works with a particular focus on the function of the sperm- specific calcium.
Deficiency of calcium in sperms has a greater effect that may affect sperm motility.
The aim of the research on male infertility is to develop a tablet that a man can take to improve on his sperm count.
The research also intends to help and move things in terms of the burden of fertility and reproduction on women who will see new treatments and new options for infertile men.
Couples must understand that with male infertility, to achieve pregnancy, sperm health depends on various factors, which include quantity, movement and structure.
To reach and fertilize an egg, sperm must move wriggling and swimming through a woman’s cervix, uterus and fallopian tubes.
Dr da Silva’s research on male infertility is still going on as many cases still receive “unknown cause” diagnosis.
“Sperms can be considered abnormal because of unusually short life span, low mobility and abnormalities of sperms which may be due to inflammation of the testicles, swollen veins in the scrotum and abnormally developed testicles,” Dr da Silva explained.
Today assisted reproductive technology (ART), commonly referred to as IVF, is now available in developing countries.
However fertility clinics with advanced services are still concentrated in private clinics which still remain a barrier for most couples that cannot manage.
Last year, the Government announced its intention to introduce fertility clinics in all provinces of Zambia in a bid to enhance reproductive health services.
This will greatly improve fertility in both men and women.

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