While it is generally agreed that it takes two to have a baby and every couple is expected to be in optimum health to have babies, medical experts claim men are having more fertility challenge now. Sperm concentration in men is said to have decreased by a third since 1990s while sperm count is said to have decreased by half over the past 50 years.
Studies are also showing genetic abnormalities in sperm particularly in older men. For men therefore, quantity, quality and motility of spermatozoa are seen as important factors in fertility.
Since the male factor is a prominent cause of infertility in couples, sperm donation has become vital in assisted conception treatment.
A study by the Society for the Study of Male Reproduction stated that "a male factor is solely responsible in about 20 per cent of infertile couples and contributory in another 30 to 40 per cent."
According to experts, even when sperm numbers are great, a high proportion of men may have DNA damage that significantly impairs the chances of natural conception. Besides, male sperm deteriorates with age the same way it does for women.
Studies have also shown that if a man has poor health, smokes, drinks too much or has a bad diet, it's very likely his sperms are also going to be unhealthy.
Indeed, investigation by Saturday PUNCH showed that sperm has become a commodity in high demand in Lagos. The Chief Consultant and Head, Obstetrician and Fertility Department, Eko Hospitals, Dr. Adegbite Ogunmokun, said fertility problem, based on recent experience, had tilted more towards the male factor.
He said, "If 10 couples come in, there will be problem with the male in six of them, using our parameter of 20 million sperm per millimetre. But 10 to 15 years ago, maybe about four out of 10 men would have problem."
Our correspondents, who visited some fertility centres in Lagos, learnt that more men are having low sperm count, thus necessitating the need for more volunteer donors. But because donors are scare, fertility clinics offer as much as N50,000 to men who are interested in selling their sperm.
They also pay more when sellers have special features that the beneficiaries are looking for.
Like blood sellers, investigations show that many people in Lagos, especially students, now sell their sperms anytime they need money.
A student of the University of Lagos, who identified himself as John, said he had sold sperm to a few fertility centres in Lagos. John said he had been funding his education for the past two years with what he earned from selling his sperm.
John said he was introduced to the programme by a friend and that he had in turn brought in two other friends to 'business'.
"I've sold to a number of fertility centres. The money has really helped me to stay in school. It takes care of my tuition and some other personal needs," John said, with a measure of satisfaction.
"It's cool money, really and I'm also doing a service to mankind by helping out some people in need. Even friends that I introduced to it have not turned back since then."
An employee in a Lagos fertility clinic, who identified himself as Olufunsho, told Saturday PUNCH that some women would pay any amount to get a sperm seller with the features they want.
He said, "We pay N50,000 here but there are times when women come in and request that, at all cost, they must get a tall man. The person can earn more when they make such requests, especially if we don't have any that fits the profile in our bank.
"There was a time a woman came and requested that we get a tall man for her at all cost. I showed her the samples we had, but she did not like the profile. She said she was not satisfied with the heights. And we were unable to get what she wanted from the sellers that came at the time.
"The sellers that came then were either AS, or positive with hepatitis B or had low sperm count. We had up to twelve sellers that came and we were unable to get anybody. In such cases, we could offer a lot more when we find the right person. Sometimes, such people are also in a position to negotiate for what they want."
However, subsequent drops attract lesser amounts of money for the same seller.
To sell sperm, the person, according to Olufunsho, must stay off sex for five days. He undergoes some tests to confirm that he is not HIV positive and that he also has healthy sperm among others.
He said, "If the same person is still interested and we still need him, he would repeat the screening process again. We pay N10, 000 per ejaculation for other subsequent ones. With my own discretion, if the quality of the sperm is good and we have somebody who needs something that matches perfectly with that seller, we may reduce the probation period, but the sperm must be very good.
"Although that is the protocol, it could always be amended when there is nothing wrong with the person. Even if someone ejaculates the first time and in twenty minutes time, he does the same, it is still going to be good, but not as good as the first one."
At the various fertility centres where our correspondents posed as potential sperm seller, the clinic workers made keen attempts to have them start the process immediately, by leaving blood samples for tests.
On one occasion, a clinic worker told one of our correspondents that he was willing to waive the two to five days' probation period of abstinence, after our correspondent said he wished to "sleep over it."
The worker said, "What is there to think about? After all, you already said you're not married. You can leave your blood sample for testing while you go ahead and think over it."
Investigation showed that fertility centres want sellers between 18 and 45 years of age and expect them to abstain from sex, two to five days before giving sperm sample, depending on the centre.
Other conditions to be met by potential sperm sellers include testing negative to HIV, syphilis, hepatitis B and C, sickle cell and some other sexually transmitted diseases. Tests are also carried out to determine the count, morphology (shape) and motility of the sperm cells.
In addition, fertility centres claim to also place a high premium on average intelligence, education and lifestyle. Although, Saturday PUNCH learnt that such claims are not always true as more emphases are actually placed on height and other physical attributes.
"It is not immediately that we pay. We prefer AA genotype because it can be given to anybody, unlike AS that cannot be given to just anybody," Olufunsho added.
However, an employee in another fertility clinic in Lagos, Akin, said sperm sellers could get paid within a week of starting the process. This is possible only if they satisfy the conditions.
He said, "If the motility is good, the count is good and you're okay, then, you can produce for us. If everything is okay, within a week, you can get your money."
A 2012 study into the reproductive health of 26,600 men in France, warned of a sperm crisis worldwide. It said that sperm concentration has decreased by a third since the 1990s. The study found a continuous 32.2 per cent decrease in sperm concentration over a period of 17 years.
During the European Society of Human Reproduction and Embryology annual conference in London in July 2013, some experts, critical of the study's validity, said it did not completely represent the situation in certain areas, particularly the developing world.
However, a fertility expert at Mother's World Care, Ikeja, Lagos, Dr. Margaret Olusegun, said the situation is similar in Nigeria.
She said, "A man should have a good count, up to 40 to 50 million sperm per millimetre of semen upward. But you find that these days, men have more challenges with fertility than women.
"Although, I don't have the statistics, men are the ones with more challenges now, even though they are the ones who drive out their wives if they can't bear children."
Olusegun explained that good sperm should have "at least 50 per cent motility (activeness) because sperm cells can be active, sluggish or dead."
"For morphology (shape) too, which could be normal or abnormal, sperm should have upward of 50 per cent normal cells. And there should not be bacteria growth," she added.
Ogunmokun described low concentration of sperm as "Oligospermia." He, however, said a sperm count with a minimum lower limit of 20 million sperm per millimetre of semen would still be considered normal. But he added that any sperm concentration of less than 20 million per millimetre of semen could be categorised as mild, moderate or severe oligospermia, depending on the count.
Ogunmokun said fertility problems could be with the man, the woman or the two of them.
Saturday PUNCH learnt that the demand for sperm has made the fertility business a lucrative one. Many of the fertility centres in Lagos have facilities for sperm preservation, where it's freezing costs about N50, 000 per quarter.
Ogunmokun said, "After collection, the semen is processed and seminal fluid and all other things are removed. The sperm is put in little bottles and placed in special containers called dewars, connected to a power source. It is stored at very low temperature and there must be an indicator for monitoring should there be a change in the condition."
He, however, added that there must be a standby generator in a place like Nigeria, where power supply is unstable, as sperm can be frozen for decades.
"Although, there are many other reasons why people freeze sperm, someone living far away from his wife can decide to freeze his sperm for the wife's use while he's away. Also, someone going for cancer treatment can freeze his sperm before starting the treatment since such treatments affect sperm production," he added.
Ogunmokun said fertility centres focus more on university undergraduates to ensure that sperm donors have a certain degree of intelligence.
He said, "The current practice is to actually recruit sperm donors and the focus is on undergraduates. The focus is on students because they should be able to provide their ID cards so that background checks can be done."
According to Ogunmokun, the perceived increase in the number of men with low sperm count is as a result of infection and lifestyle habits like sitting for too long and wearing of tight underwear.
He said, "The testes are not supposed to be too close to the body because of the higher body temperature. The testes are naturally colder, so people who travel long distances or sit in traffic for long can be prone to infertility."
Ogunmokun advised that men should "exercise appropriately, take good nutrition, avoid tight underwear, premarital sex, cigarette and alcohol to try to prevent low sperm count."
However, Olusegun identified good hygiene as key to the prevention of low sperm count, saying, "Our environment is too contaminated."
Report culled from Saturday Punch
0 comments: