Leading fertility specialists have identified lifestyle choices, delayed childbearing, and untreated infections as major factors driving rising cases of infertility among young Nigerian couples.
The maternal health experts pointed out that, unlike in the past when infertility was largely associated with older couples, people in their 20s and early 30s are now battling infertility.
Speaking exclusively with PUNCH Healthwise, the physicians explained that late marriage, excessive alcohol consumption, smoking, obesity, and prolonged exposure to environmental toxins are significantly affecting reproductive health in men and women.
A new report published by the World Health Organisation indicates that around 17.5 percent of the adult population – roughly one in six worldwide – experience infertility.
The global health body in the report called for greater policy prioritisation of infertility.
Also, the Association for Fertility and Reproductive Health says there are about 12 million infertile persons in Nigeria, which is almost 10 percent of the total population.
While stating the reasons, the immediate past President of the Association for Fertility and Reproductive Health, Prof. Preye Fiebai, said many young men are experiencing low sperm counts, while young women are battling ovulatory disorders linked to hormonal imbalance, untreated sexually transmitted infections, and polycystic ovarian syndrome.
According to him, a shift in social behaviour and lifestyle patterns has worsened the situation.
Fiebai said that while Nigeria has a high fertility rate, infertility is also commonly seen.
“Young couples are experiencing infertility, and the numbers are increasing by the day. There are many reasons why people find it difficult to conceive. The cause may be from the man, from the woman, or from both of them. These are the common reasons couples struggle to get pregnant, and both male and female factors can be easily detected when proper evaluation is done.
“For the man, we are seeing a very high prevalence of male factor infertility. The issue may be with the sperm. It could be that the semen contains no sperm cells at all — what we call azoospermia,” he said.
The AFRH president explained that while some men may ejaculate normally, the semen may contain no sperm cells.
“The sperm count could also be low, the sperm motility (movement) may be low, or the number of sperm cells with a normal shape can be low. These are the common issues we encounter in men.”
The fertility specialist said different reproductive issues can affect fertility in women.
He said, “Infections affecting the female reproductive tract, especially those resulting from untreated sexually transmitted infections, are major contributors. Poor hygiene, unsafe abortion, and complications from pelvic infections can damage the fallopian tubes. Obesity also impacts fertility, and increasing body weight reduces the likelihood of conception.”
Aside from these, Feibai explained that late marriage was contributing to infertility among young couples.
“Another thing is that in our society today, many men and women are getting married later in life. Unlike before, when the average age of marriage was in the 20s, many women now marry after 35 due to career and other personal factors. Age reduces fertility, especially for women, because the older a woman gets, the lower her chances of conceiving. So age-related fertility decline is now a significant factor.”
He, however, said that while several factors may be responsible for infertility, there are some cases referred to as unexplained infertility.
“In some cases, after carrying out all necessary tests, we still do not find any specific cause. That situation is what we call unexplained infertility, meaning the cause is beyond what routine investigations can detect,” the don said.
Fiebai said lifestyle habits such as maintaining a balanced diet with adequate nutrients, avoiding risky sexual behaviour that exposes a person to genital tract infections, and regular exercise to maintain a healthy body mass index can help promote fertility.
“So lifestyle modification, including exercise and appropriate health-seeking behaviour, is important. People should seek care at hospitals where proper diagnosis and treatment can be given, instead of engaging in self-medication or patronising unqualified drug sellers, which worsens the situation,” he said.
Also speaking, a renowned fertility specialist and Managing Director of Nordica Fertility Centre, Lagos, Dr. Abayomi Ajayi, highlighted the importance of early fertility assessment and timely medical intervention.
Ajayi said that while there is unexplained infertility, many couples who certified themselves okay without conceiving for years may not have subjected themselves to proper investigations.
“There is a condition called unexplained infertility. However, I always advise caution when people say, “They told us nothing is wrong.” Sometimes, the reason that conclusion was reached is because the right investigations were not completed,” he said.
According to him, for infertility assessment, four basic tests must be done: Semen analysis for the man, Pelvic scan, HSG (Hysterosalpingogram) – an X-ray to check if the fallopian tubes are open and examine the uterus, and Hormonal blood tests to determine if the woman is ovulating properly.
“All four must be completed before saying there is ‘no cause found’. Some people may do only a scan and then conclude ‘there is no problem,’ but that is not accurate. Once these four key tests are done, about 85% of infertility causes can be identified. The remaining 15% is what we call unexplained infertility, and even then, treatment options still exist,” Ajayi said.
He, however, urged couples to avoid self-medication and seek professional evaluation when conception delays beyond one year
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