A Consultant Obstetrician, Gynecologist and Endoscopic Surgeon in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State, Robinson Onoh, has identified late marriage and infections as the major causes of the high rate of infertility cases in Nigeria. Onoh who disclosed this during an interview with The Point, maintained that the feasible measures for the prevention of infertility are early marriage, early conception and avoidance of premarital sex.
Onoh explicitly explained that a young girl who gets married early reduces the chance of being infected with sexually transmitted infections, unwanted pregnancy, abortion and developing fibroid.
He maintained that the best period for marriage is 20 to 25 years of for females, while 35 to 40 years would be at high risk of getting infections such as Gonorrhea, Staphylococcus, Syphilis, HIV, Hepatitis, and developing fibroid which affects conception either by its position or by the things they produce.
He advocated that women should not delay marriage and pregnancy, adding that the best birth is early marriage and early conception, saying “when a woman has pregnancy, any fibroid that develops undergoes degeneration and that may not cause much problems.”
The physician extensively discussed major causes of infertility in Nigeria.
His words, “Let me explain a little what infertility is, for us we say that infertility is when a female within the reproductive age is unable to achieve pregnancy not minding adequate sexual intercourse with a healthy husband within a period of one year.”
The Obstetrician enjoined government and churches to provide jobs and functional skill acquisition centers for youths to guarantee early settling in marriage. “Normally, it is expected that every woman if there is adequate exposure to 3 to 5 intercourse within one week, about 85 percent of them will be pregnant. The alarming thing is that there is a high rate of not being able to conceive which is very common especially in developing countries like Nigeria.
“A lot of things could be attributed to that, some of the common things that actually lead to that is the age of marriage. Recently because of the quest for education and riches, young women and men don’t marry early when they are supposed to because culturally a man should acquire enough wealth before marriage. Outside the age of marriage, you find out that there will be chances that the woman or the man may have gotten into multiple relationships and the chances of contracting infectious diseases (STIs) are high.
“There are common things that are peculiar to human beings. I can actually explain further things that may happen, for example, if a young girl happens not to marry on time, she may get unwanted pregnancies and may seek for abortion in an unsafe place and in unqualified hands and in the process of aborting the pregnancy, the tube may be damaged, the cervix even the vaginal wall may as well be damaged and that will cause infertility in future. Sometimes when a woman gets an unwanted pregnancy and takes some drugs, the pregnancy could be trapped in the tubes of the woman resulting in what we call ectopic pregnancy which may require surgery and when the woman is exposed to such surgery, it may affect subsequent conceptions and may even die in the process of the surgery.
“I have to say that the chances of a woman having fibroid increase with age. Ideally, if a woman marries between the age of 20 and 25 years most likely she may not have fibroid but between 35 and 40 years or more the chances of having multiple huge fibroids will be there and this could actually affect conception either by its position or by the substances they produce.
“When we look at the remedies, they are simple because by the time we identify the etiologies then addressing those etiological factors will give a solution to infertility. It is advised that in the olden days, once a woman starts having all physical development she is mature and the young woman will be sent to the man’s house the mother will teach her womanhood then by the time she sees one two three menses the woman will start having children. I think it should be advised that women should marry early between 20 and 25years, the lowest limit of 20 and uppermost limit of 30 years of age because the chances for conception is high and within that period the chances of complications is low. Importantly the woman is mature and the body system is developed to embark on the voyage of pregnancy and childbirth. Within this period she could actually complete her family size without having associated health challenges and the chances of being exposed to sexually transmitted infections will be reduced. This is because you find out that when you go to school most girls in school have multiple sexual partners which are a high risk for STIs. We advise instead of having all these sexual partners the students should be talking about marriage. If a woman can marry between 20 and 30 years, at best between 20 and 25 years, it will actually increase conception and reduce infertility.
“When there is no pregnancy, there is a vacuum in the female body system and something else would occupy this vacuum. That’s why fibroid is common in null parity. A woman who is more than 30 years and there is no pregnancy fibroid could occupy the space of the pregnancy but generally, some people have increased tendencies or chances of developing fibroid while others don’t have the genetic predisposition but one good thing about pregnancy is that pregnancy tends to reduce chances of women developing fibroid. It is advocated that women should not delay marriage and pregnancy because when a woman is pregnant any fibroid within the uterus may undergo degeneration and that may not cause much problem. By the time a woman marries around 35 years we say that she is elderly primigravida and elderly primigravida is regarded as a high risk pregnancy.
“It is expected that every young lady should be aware of her body system because if she is aware of her body system she should know things to avoid. A young lady should also try to have very good body hygiene, ensure that she takes her bath at least twice a day, when she empties her bowl it is advised she should clean backward not forward. These are basic body hygiene that females should keep doing to avoid infection and infertility.
“Importantly, one of the breakthroughs that we have in the medical field is what we call assisted reproduction which has actually put hopes to a lot of hopeless homes. With assisted reproduction, you could pick the best of sperm cells and the best of the ovum and then fertilize them outside and put them inside the womb and the woman could have her pregnancy and have her own baby (invitro fertilisation and embryo transfer) that is the general terms for all forms of assisted reproduction. That is a remedy for many who are cut up with infertility. Assisted reproductions have different forms depending on what the problem is. We could talk about surrogacy like the tubes are damaged, it cannot carry pregnancy but the ovaries are there. You could pick up the eggs, the sperm cells and get somebody who will carry the pregnancy for them. After delivery, she gives back the baby to the owner. But above all, the best and cheapest remedy to infertility is early marriage and early conception.”
