Fertility Gynaecologist Dr. Deo Explains Infertility

Infertility is a medical condition affecting a growing number of couples worldwide. The good news is that in many cases it can be successfully treated. In this #WellnessWednesday session Gisèle Wertheim Aymes discussed infertility with specialist Dr. Tebogo Deo.

Dr. Deo is a Reproductive Medicine Sub-specialist, and Fertility Gynaecologist. She trained at the University of Cape Town in South Africa and the University of Warwick in the United Kingdom. She also holds a B.Sc. from Rhodes University and MBCHB from MEDUNSA.  Dr. Deo is currently completing her MA in Pastoral Studies. 

Infertility is a medical condition

Infertility is a medical condition that requires an accurate diagnosis and the right treatment. It’s defined as failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse; or due to an impairment of a person’s capacity to reproduce, either as an individual or with his/her partner.²   If the woman is older than 35, she and her partner should seek an evaluation if they have not been able to conceive after six months.³

It’s estimated that globally, infertility affects 8–12 % of women who are 20–44 years of age.¹  Physiological causes in men account for 20–30 % of cases of infertility and physiological causes in women for 20–35 %,  25–40 % of cases are due to issues in both partners. In 10–20 % of cases, no cause was found.¹

Infertility does not mean you can’t fall pregnant or have a baby. Rather, you require medical assistance to do so, as infertility is a medical condition that can be treated.

Why are more couples experiencing infertility?

In recent years, the number of couples seeking treatment for infertility has dramatically increased. This is due to many factors including the postponement of childbearing in women. It is a medical fact that a woman’s fertility begins to decline in her 20s and significantly deteriorates after age 35. The chance of conception for a woman older than 43 is very low. As increasing numbers of women postpone starting families until after 35, many require reproductive assistance.

Dr. Deo stressed, “It’s not necessarily just a man’s issue or a woman’s issue,  it is a couple issue. We need both of them together to understand this.” 

Other causes

All of the steps during ovulation and fertilization need to happen correctly in order to get pregnant. Dr. Deo says that sometimes, issues that cause infertility in couples are present at birth, and sometimes they develop later in life. This can affect one or both partners.

Male infertility

Causes of male infertility may include abnormal sperm production or function. It can also be a result of problems with the delivery of sperm and overexposure to certain environmental factors. These include cigarette smoking, anabolic steroid use, marijuana, alcohol, and certain medications. Cancer can also impact fertility.³

Female infertility

Causes of female infertility may include ovulation disorders. Uterine or cervical abnormalities, fallopian tube damage or blockage and endometriosis. In addition, early menopause, pelvic adhesions (bands of scar tissue from pelvic infection, appendicitis, endometriosis, abdominal or pelvic surgery) can also cause infertility. Cancer is a factor.³

“Tubes may be blocked as a result of diseases like TB,  chlamydia and endometriosis .Fibroids can also  be a cause, particularly those close to the tubes. They may cause infertility.”

Watch your weight!

Dr.Deo explained that carrying excess weight can also influence the condition. And yes, “if you are more than 40, you may find that your ovarian reserve, meaning the number of eggs that you have, are diminished. And as a result of that, you may not be able to fall pregnant. Men who are overweight may not be able to produce a lot of sperm. This is due to their male hormone being converted into the female hormone by the fat cells. That’s why they develop man boobs and this usually results in poor sperm production”.

Get help early on

The long-term inability to conceive a child can evoke real feelings of loss and devastation in both partners. Infertility often creates one of the most distressing life crises a couple will experience together. Coping with the multitude of medical decisions and the uncertainties that infertility brings can create emotional upheaval for most couples.

“We work with counsellors, like social workers, as well as psychologists. This is very stressful, and I think maybe that’s one of the reasons why I’m also doing my pastoral studies, because it can be spiritually draining. We have to have a holistic approach to the partners. We are very upfront with the information, especially the financial toll that it can take on the person and the emotional toll.”

Treatments available

Fortunately, newer and more successful techniques for infertility treatment are developed continuously.  Many people delay fertility treatment because they fear the costs associated with in vitro fertilisation (IVF). IVF is where sperm and egg are placed together in a lab until they form an embryo which is then implanted into your uterus.

Other options

However, there are a number of treatment options other than IVF that can improve the chance of conceiving. A specialist will recommend the treatment based on the cause of your fertility issues, your age, and your preferences. Some women may have to have surgery to fix a uterine condition, such as endometriosis, fibroids, or blocked fallopian tubes.

The bottom line

There’s only one way to know for certain what the exact cause of a couple’s fertility challenges is, and that is an initial consultation with a fertility specialist.  With advances in medical science infertility can be addressed.  Couples must empower themselves with knowledge about the options that are available.  Importantly, they should continue with their journey towards parenthood.

WATCH THE INTERVIEW

The video interview contains the full dialogue of this interview, and you can watch it below.

 

 

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