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Apr 25

One in six couples struggle with infertility – Trinidad & Tobago Express Newspapers

Testosterone Comments Off on One in six couples struggle with infertility – Trinidad & Tobago Express Newspapers

To mark Infertility Awareness Week which runs from April 23-29, Consultant Gynaecologist and Medical Director at Trinidad &Tobago IVF and Fertility Centre, Dr Catherine Minto-Bain is shining the spotlight on the common but frequently misunderstood medical condition. She is also busting the myth that testosterone therapy boosts fertility. The truth, says

Minto-Bain, is that this form of therapy whether in the form of tablets, gel or injections drops fertility. We need to talk about infertility more, said Minto-Bain. Usually the causes of the problem can be found and there are a range of treatments that can work. However, infertility is surrounded by embarrassment, shame and fear, especially in T&T.

Developing countries such as ours have higher rates of infertility than first world countries. Minto-Bain suspects that one in six couples who are trying to get pregnant in T&T may be dealing with infertility. Because many are having unwanted babies and some couples are choosing not to have children, the couples who are actually struggling to get pregnant because of infertility are often overshadowed.

Half of the couples that visit the TTIVF have more than one problem causing infertility, said Minto-Bain. The number one cause behind infertility is the male factor - low sperm counts, poor sperm swimming and poor sperm shapes. Poor sperm quality which stops pregnancies is also very common but is often missed because they dont show up on basic sperm tests.

Erectile dysfunction and couples having difficulties having sexual intercourse for a variety of reasons can also contribute to infertility. Then there are female-related problems such as eggs being lower in quality (which is a frequent problem), and running out of eggs prematurely in life which is common among women of colour. Polyps and scar tissue can also stop pregnancies. Another major factor is age-related fertility problems.

Infertility is diagnosed when you havent had the baby you want after a year of trying. If the woman is 36 or older, then its six months of trying to conceive, without success.

When couples come to the TTIVF, Minto-Bains focus is on determining whats behind the infertility, this involves a thorough examination of the woman and mans overall health and lifestyle.

In men we do a basic semen analysis or sperm test that looks at the numbers of sperm hes producing, their shapes which gives us an idea of whether they can make a baby or not, their swimming and anything else in the semen that could be causing a problem, explained Minto-Bain. We look at the womans egg numbers and her hormones especially the prolactin hormone which can cause difficulties with the eggs actually coming out, we also do a full blood count, a thyroid check to see if there is anything wrong with the thyroid gland that might be causing an increase in the miscarriage risk or having an effect on eggs. A detailed fertility ultrasound is also done.

Many misconceptions

There are many misconceptions about infertility; it is widely believed that its the womans problem because she is the one who carries the baby. However, it is a couples problem and one that requires the intervention of a fertility specialist, rather than a non-specialist doctor, stressed Minto-Bain.

One of the biggest myths is that male infertility particularly low sperm counts can be easily sorted out through a hormone pill, a testosterone injection or a herbal supplement. While these may not be dangerous to a mans health, they do not cure male infertility.

The danger is that these ineffective treatments waste money and time and when the woman eventually comes to a fertility clinic she is a lot older and her chances of having a family has dropped. So the couple will end up having to spend more money on aggressive treatments, lamented Minto-Bain.

While testosterone is made naturally inside the testicle and is part of the production of sperm - it is a contraceptive.

If you put testosterone into your body from an outside source, be it in the form of a tablet, gel or injection, the body will stop producing testosterone and the sperm counts will drop. A lot of men take many months for the sperm production to come back after testosterone therapy. Testosterone doesnt boost fertility, it drops it, she added.

There are many ways to have the family that you want; the TTIVF provides simple treatments including growing ones eggs with fertility medications, intrauterine insemination and donor sperm.

Some couples choose to adopt an embryo and have an IVF treatment-type cycle where an embryo is put inside a womans womb so that she can grow a baby. The TTIVF is also providing hope to persons with cancer who want to freeze their eggs or sperm.

Although IVF treatment offers persons the hope of finally realising their dream of becoming parents, the fact is that it is very expensive. In many countries around the world, including T&T, governments do not fund fertility treatment.

Personally, I view infertility as a medical condition and as something which I believe healthcare should cover whether its insurance or government paid healthcare. I would love it if an insurance company would cover at least infertility testing, if not fertility treatments. And I would love it if the government could provide a free fertility service through the public hospitals, I would be willing to be involved in setting it up and training medical professionals. T&T has a big problem with infertility, therefore treatment should be accessible to anyone who needs it, said Minto-Bain.

The TTIVF has seen an increase in persons coming to Trinidad for IVF treatment because it is less expensive than in the US or the UK. Since its establishment, 2,500 babies have been born to grateful parents thanks to the clinics intervention - that figure could be much higher, said Minto-Bain.

Fertility is a fast-paced specialty and the consultant gynaecologist couldnt be more excited about the future. Its exciting to look at new changes that are coming and to know that we have all the expertise to run a well-structured clinic that hits all the top-quality markers that you would get in an overseas clinic,said Minto-Bain. When new treatments come in were ready to provide them in T&T, we are on the forefront of whats going on.

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One in six couples struggle with infertility - Trinidad & Tobago Express Newspapers

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