THERE is currently an increase in infertility in Zimbabwe owing to a myriad of factors ranging from anatomical, environmental, dietary/weight and physiological factors, reproductive health experts have warned.
By Michael Gwarisa
Infertility, which is defined clinically as failure to conceive after 12 months or more of regular unprotected sexual intercourse affects approximately 48.5 million couples globally. Data from a cross section study by consultant Obstetrician, Dr Mugove Madziyire et al which explored “The causes of infertility in women presenting to gynaecology clinics in Harare, Zimbabwe” shows that half of the causes of infertility are due to or include male factors while almost half of the causes are female factors constituted by tubal blockage, anovulation and a mixture of the two.
Speaking during a Media training on infertility that was organised by Merck Foundation in collaboration with the First Lady of Zimbabwe Dr Auxillia Mnangagwa and the Zimbabwe Union of Journalists (ZUJ), Dr Madziyire said contrary to the general belief that infertility affects only women, were men needed to get checked together with wives for possible infertility related issues.
There is usually more stigma on male infertility with most men not recognising that they are equally affected by infertility. There is an accepted fact that men are core to reproduction, nobody doubts that and then there is this neglected fact that men can be core to infertility problem and this is so much in men believing themselves because there is so much ego regarding male infertility as most men want to measure their men-hood by the ability to reproduce.
“Infertility is very prevalent in Sub Saharan Africa where it can go to up to 25 percent in the reproductive age groups which is 25 to 45 years. Let’s educate the men and lets encourage them to come with their wives to be checked for the causes of infertility and they get tested jointly,” said Dr Madziyire.
He added that reproductive systems between men and women are basically similar and whatever causes infertility in women does that in the ovaries whereas in men, it affects the gonads or testicles. He also said anything which affects production of hormones from high up in the brain increases chances of infertility, for example stress, obesity and some of the problems, men are actually born with them where at the puberty stage, they do not go through some of the common characteristics such developing pubic hair, having early morning erections etc.
“We can have other problems which damage the gonads (testes), these could be chemicals, radiation and one of the things which should be watched out for is the environment the scrotum is exposed to. The scrotum is where the testes are. Generally, in men and all other animals, the testes are in a hanging position so that the temperature can be low and sperms can only be produced in lower temperatures than the rest of the body.
“We need to make sure that the testes are not exposed to higher temperatures. High temperatures come in the form of tight fitting underwear or hot baths and sometimes just other toxins like radiation. Drugs can also affect the environment where sperms are produced, they cause what are called Free radicals, and these are chemicals which destroy sperms. There is much interplay of things in the environment which we need to advise men to watch for. Some testicles may even be damaged through radiation treatment for cancer and general exposure to radiation.”
Meanwhile, dietary issues have also been identified as some of the leading causes in infertility in men owing to the growing consumption in starchy foods, alcohol among other unhealthy diets. Leading a sedentary or inactive lifestyle coupled with exposure to toxic environments in the work place, foods and the environment, have also been identified as leading risk factors to infertility in men.
Dr Pasca Chinwada, a Physician and senior Registrar at Sally Mugabe Hospital said Non-Communicable diseases (NCDs) especially cardiovascular diseases, diabetes, cancer and chronic respiratory ailments were also contributing factors to infertility and male potency. Separate studies have shown that either type 1 diabetes or type 2 diabetes could have detrimental effects on male fertility, especially on sperm quality, such as sperm motility, sperm DNA integrity, and ingredients of seminal plasma.
“If you look at the Zimbabwean situation, NCDs account for 33 percent of deaths as of the statistics from 2016 which represents a 12 percent increase from the figures that were published by the World Health Organisation in 2008. Hypertension is the commonest NCD in Zimbabwe, accounting for 33 percent cases as of 2016m, compared to 23 percent in other low income countries, with Hypertension related NCDs contributing most to the deaths,” said Dr Chinwada.
He added that Zimbabwe now has a doubling of diabetes cases over the past decade with 1 in 10 cases and is now ranked third in Sub-Saharan Africa on the per- person cost of diabetic care.