Oladapo Ashiru: Infertility is Avoidable

In the past, when it comes to infertility, the blame is often shifted to women only even though fertility experts have acknowledged that male infertility is rampant. In a media chat with the Pioneer of the In Vitro Fertilisation (IVF) technology in Black Africa, Professor Oladapo Ashiru, who is one of the Trustees of the Association for Fertility and Reproductive Health (AFRH) and the Secretary General of the International Federation of Fertility Societies, he addressed reduction in fertility rate in Nigeria and declining male sperm which consequently may result to a surge in infertility. Stressing that infertility is avoidable, he also highlighted the challenges, some causes, and the preventive measures against infertility. Ayodeji Ake brings excerpts

As an expert with decades of experience, how can you charge the experts and the fertility-challenged persons?

The message for the experts is that Nigeria has come a long way in the field of reproductive healthcare in terms of caring for infertile couples. From when it was just one IVF clinic at the Lagos University Hospital, pioneered by Prof. Giwa Osagie and me, we now have about 200 in the country today. We are at the same level in a competitive way with the global standard. As a member of the global body. I know that our standard is very competitive. My recommendation to the practitioners in this field is that they need to keep the standard high and think of the ethics of the profession, and they have to improve their standard and make sure that they are caring for those who want to have babies, and they have to deal with them with a lot of empathy and goodness. Once those are put in place, our standard will remain in global competition. I like to tell my patients that what we are doing to them here is the same they would get in other parts of the world, and that’s where we are in Nigeria today.

For the patients, it is important to know that when they discover the fertility problem, they need to read about it. They shouldn’t just take what their doctor told them about; they should also endeavour to go on the internet to read and digest it. Most of this information is on the internet. They should read ahead of their appointment so that they can be well-informed. When they come to me, because they have read and are very informed, they throw questions at me while providing clarity to their questions.

There is a rise in the infertility rate. What are drivers?

It is true. There is a decline in the fertility rate. Some of the countries of the world have reached a level in their development that replacing their population will be very difficult. In Africa, we always believe we have a high fertility rate and population, but we are also approaching a process where there would be a problem if we take caution now. We have done some publications where we have found out that the male sperm is declining in Nigeria. When we have a decline in male sperm, consequently, there would be a problem of infertility, and usually, we blame the female. But it’s more now, 50 per cet in males as well.

Some of the causes include infection (sexually transmitted disease), and the number two that is now becoming prominent is environmental toxins. Things that we eat that have heavy metals in them, things we put on our bodies, and things we inhale. For example, a man who works in the paint industry may have issues with infertility if he doesn’t protect himself. A woman who drives barefoot all the time for years without putting on slippers may absorb some heavy metals and will have problems with fertility. Both sexes need to be careful in these areas. Things that we put on our bodies, we have to check them. For those in the oil-producing areas, the oil poses are very toxic.

As the pioneer of IVF technology in black Africa, what are the challenges despite the advancement?

One of the biggest challenges we have in this country is the cost of production. We don’t manufacture any of the products – drugs and equipment. We have to import them into the country. The only way the government can help is to remove tax on fertility products because of the global decline. We ask that the country help in the productive process, and we should encourage the pharmaceutical industries to locally produce the drugs, so that they can be more affordable. Currently, those who want to have babies through IVF need a bundle of money. Global IVF cost is about $5,000, but it’s cheaper in Egypt or South Africa, for about $3,000 to $4,000, because they are producing those things in their country. So, when we calculate in naira, it’s expensive, and it’s because we have been trying to manage it. With all the inflation, it’s getting difficult.

There are still misconceptions about IVF. How can you address them?

In IVF, there is no doubt. IVF is real, and it’s permitted by the Almighty. Because if it’s not permitted, I can’t do it. He is the one who provides the knowledge to do everything.

What are the preventive measures?

Infertility is avoidable. Don’t have an infection, do a lot of health hygiene about your reproductive system, keeping your sexual organs clean. Take care of your underwear regularly. Make sure that you don’t expose yourself to environmental toxins as aforementioned. If you want to use insecticide in your room, when the room has been sprayed or fumigated, you should stay away for about four to five hours before returning to the room. Pesticides should be avoided. If you are in an area where pesticides are being used, use a mask. Taking artificial sweeteners damages the sperm. Smoking and many other things are not healthy. Flushing of the toilet is a danger. When you want to flush the toilet, some developed countries ensure that the toilet is closed before flushing because the fumes that come out are toxic and can contain small bacteria that can cause infertility.