LIVE CHAT with the fertility Expert, Prof. Giwa-Osagie

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Prof. Giwa-Osagie Featured Guest on HALA Magazine

Hello, I am Prof. Frank Osato Giwa-Osagie and I am available NOW (from 3.30 – 5.30pm) to answer your questions regarding fertility and difficulty in conceiving. Good afternoon.

Wednesday, 4th July, 2012, 3.30pm

ASK YOUR QUESTIONS USING THE “COMMENT BOX” BELOW

Question: I’m 28yrs & been married for about 18months…my husband and I have been trying and are still. We have done some tests including scans, Hcg, sperm check and all, after trying for about a year. While mine came out just fine…our doctor, told us that my hubbie has low sperm motility and advised we go for IUI if we don’t want to waste any more time. This really got me worried and upset…What is your opinion Sir? Thank you  –Chinwe C. E, facebook friend

 Answer: About 30 to 40 percent of couples find that there is something wrong with the male partner during investigation for inability to conceive. From what you have said your partner should be examined for varicose veins of the testis and infections should be excluded by doing a culture of his semen, these are two causes of low sperm motility. It is important to note that it takes three months for sperms to mature from the time you start giving treatment to improve sperm count. During this interval IUI can result in pregnancy particularly by a technique known as “Swim up”, this increases the motility of the specimen which can then be used for the IUI. Simple life style precautions should also be taken such as no cigarette smoking, no tight underpants, reduce alcohol to not more than one bottle of beer a day and getting as much as 6 hours of sleep a day and getting exercise such as walking and swimming can also help.


Question: Please what are the chances of artificial insemination? –Temitayo O, facebook friend

Answer: Artificial insemination is the introduction of sperms into the female genital tract. So the sperm is injected through a syringe into the neck of the woman’s womb. It is done during the woman’s fertile period. Two types are artificial insemination are done: using donated sperms (Donor Insemination, DI) and using the husband’s sperm AIH.

DI is reserved for cases where the man’s sperm count is 0 and cannot be improved or very rarely if the man has some abnormalities that makes it not advisable to use his perm. If the woman is fertile, the pregnancy success rate can be as high as 50 to 60 % within 6 cycles of trying. A more usual success rate will be in the 40 to 50 % range within 6 months of trying for donor insemination.

The other form of AI uses the husband’s sperm (known as AIH). This is normally used where the sperm count is low, where the sperm motility is low, or where there is evidence that there are anti bodies against sperm being secreted at the neck of the woman’s womb. Semen sample is treated by a procedure known as “swim up” which selects the motile part of the semen for insemination. As little as 0.5ml of semen can be injected into the neck of the womb or the woman’s uterus using ICSI, and this is done during the woman’s most fertile time. The pregnancy rate of husband’s sperm insemination is of the order of 20 to 30% within 6 cycles, which is less than that of donated sperm, DI. This has led to the comment than when the sperm count is low or motility, there is something else wrong making the woman not get pregnant hence the rate is higher when you use donated sperm

THANK YOU for asking your questions and I enjoyed answering them. Good bye, Prof. Frank Osato Giwa-Osagie

 

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  • vida krumeh
    July 4, 2012 at 3:38 pm #

    what are the possible challenges that can hinder a matured single from conceiving

    • Prof. Giwa-Osagie OON. COL
      July 4, 2012 at 4:16 pm #

      First thing is to know that for pregnancy to occur it involves a male and female partner there can be factors in both partners that cause infertility. E.g. the woman may not be releasing egg every month, i.e. failure to ovulate, this means there will be no egg for the sperm to fertilize and therefore the woman cannot get pregnant. The tubes that conduct the eggs from the ovaries where they are produced to meet the sperm may be blocked i.e. Tubal blockage. When there is Tubal blockage the sperm cannot meet the egg to fertilize. A woman may have abnormality of her womb uterus so that the womb is not a suitable place for the embryo to grow, for example she may have fibroids that are making the womb irregular, and the lining of the womb may be thin because of frequent D &Cs. The womb lining and the woman’s womb may be damaged by infections such as tuberculosis or gonorrhea or Chlamydia. These infections will result in a womb/tube that is not suitable for a baby to grow in. The woman may be secreting antibodies against her partner’s sperm so that when the sperm meets the secretions of the woman’s womb the sperms are killed by her secretions. These are some of the things that could go wrong with the woman.

      In the man, they may be no sperm being produced at all, because the man was born like that such that his testis are shriveled up or tiny and cannot produce sperm. This could be because the testis may still be within the abdomen, called Un-descended Testes. He may have picked up some infections that damaged his testis tubes such as Gonorrhea or Chlamydia and Syphilis. The man may not be producing enough of the hormones required to produce healthy sperms like the male hormone, Testosteron; or too much Prolactin; or too little LH or FSH. He may have varicose veins of the testis leading to low sperm count & motility. Some of them maybe due to environmental factors like too much alcohol, cigarette smoking & obesity in both the man & woman, exposure to chemicals that get to the reproductive systems and affects egg/sperm production.

  • vida krumeh
    July 4, 2012 at 3:40 pm #

    i dont really know how to check my safe and unsafe days. however i have between a 25-26 days menstrual circle days

    • Prof. Giwa-Osagie OON. COL
      July 4, 2012 at 4:23 pm #

      A woman’s fertile days are those days when she is likely to have an egg matured and ready to be fertilized. This is usually 14 days before the next menstruation is to start.

      So if you go two days on each side of that day, e.g in a 26 days the 10, 11, 12th days will be the most fertile days, so those are the days she should have intercourse if she wants to get pregnant

  • ONYINYE O.
    July 4, 2012 at 3:59 pm #

    Infertility seems to be a popular problem. How can a single in her thirties who is not yet married prepare to avoid this problem?

    • Prof. Giwa-Osagie OON. COL
      July 4, 2012 at 4:29 pm #

      Infertility averagely affects between 7 and 15 % of the population during the productive years so it is quite a common problem in the society. A woman can preserve her fertility by avoiding things like unplanned pregnancy and abortion, injection of hormones that can affect hoe the ovaries’ function, avoiding becoming obese, taking frequent gentle exercises and eating the right balanced diet. If she is to be having sex before she marries, she must take precautions to avoid pregnancy to avoid abortions which can damage the womb. She would also reduce her chance by sticking to only one partner which would reduce the risk of STDs. By this steps the chance of problems will be reduced when she want to have a baby.

      There is some logic these days that before marriage, people should do a sperm count, HIV test and other tests so that they go into marriage and expectation of pregnancy with their eyes open. It is important to state that being a virgin is no guaranty of no problem. There could be infections not related to sex; or she could be born with a defect/mal-formation within the womb; or she could be producing too much of the male hormone and be hairy with irregular periods. This days the number of woman having children over 30 are high because of career and it is important to complete the period of child bearing b4 40 because of the risk associated in having abnormal babies when u r over 40.

  • mike
    July 4, 2012 at 4:20 pm #

    Good day sir,

    What are the alternatives available to a man with low sperm count in search of a baby?

    • Prof. Giwa-Osagie OON. COL
      July 4, 2012 at 4:33 pm #

      First is to find out why he has a low sperm count. If it is due to infection, the infection should be treated then it should be found that the sperm count will start rising. It is important to note that it take about 3months for the sperm to mature. If he has low male hormones he can be given some tablet to increase his male hormones. If he has varicose veins in his testis, they can be removed surgically. If he smokes cigarette he should stop and if he drinks more than one bottle of beer he should reduce it by half or be told to stop. If he wears tight underwear pants he should stop it and wear less tight fitting underwear pants. If the count is low because the hormones that stimulate are low, he could be given those hormones by injection example LH and FSH so that the principle is if you can find a cause then you treat the cause.

  • peggy sanunu
    July 4, 2012 at 4:27 pm #

    how do i check my fertile and infertile period?

  • patricia sackey
    July 4, 2012 at 4:34 pm #

    i hav been having unprotected sex for a couple of months and i dont seem to get pregnant,i also hav short mensturation.wat could the problem be?please help

    • Prof. Giwa-Osagie OON. COL
      July 4, 2012 at 5:03 pm #

      By definition we do not say somebody is infertile until they have had unprotected sexual intercourse for more than 12 months. This is based on the statistical observation that about 80% of couples will achieve pregnancy within 12 months of having regular unprotected sex. Simple step include noting now the regular days of your period so you can count the first day of your first period to the first day of the next which is known as the menstrual cycle. Once you know that, you can work out your fertile period which is usually 14 days. You can also try to observe your cervical secretions to see whether at a particular time the secretions are clear, watery and elastic indicating when u are most fertile- by making these observations, you can achieve pregnancy without medication.

      If after all this you don’t get pregnant, your husband can do a sperm count after three days of abstinence. If you observe that the number of days from the first period to the first day of the next differs by more than 3days, this is regarded as irregular menses which could be delaying your pregnancy. This could be treated and you can regulate your intercourse to occur during your most fertile time.

  • nene
    July 4, 2012 at 5:27 pm #

    Pls how does one with fibriod achieve pregnancy?

    • Prof. Giwa-Osagie OON. COL
      July 4, 2012 at 5:38 pm #

      Fibroids are very common in black women. In a study of women in Lagos done at the LUTH and the Advanced Fertility Centre where 548 cases where studied fibroid was found in up to 40% of those who complained of infertility and about 15% of those who did not complain of infertility.

      If the fibroid is near the tube it can compress the tube and block the tube. If the fibroid is on the inside of the womb it may lead to repeated miscarriages because any embryo that implants on the fibroid is not implanting on healthy womb. It has also been cited that maybe some fibroid contain or produce some chemicals that do not support pregnancy. They are so common that the fact that someone contains fibroid does not mean they are infertile.

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