Thread by @DrSeunO

"come and be going, come and be going. You cannot do retirement in my son's home" her mother in law was screaming at her. She was crying in a corner of the room
Her husband seated on the couch, head in hand. #medicstoriesbydrseuno

This isn't the first time and she knew it won't be the last. It is a cross she might have to bear, bear for the rest of her life. The funny thing is SHE IS NOT AT FAULT.
#medicstoriesbydrseuno

Kemi and Femi have been married forb5 years now. The first 3 years of their marriage has been blissful. Last 2 years, that is a different story. Mama came into the picture #medicstoriesbydrseuno

"does this woman think, I don't want to have a child of my own, a mini me to leave on this earth when l pass on to the great beyond" she soliloquise
#medicstoriesbydrseuno

"get up, I say get up" mama was dragging at her arm. "you have not reach your destination oo, my son's house is not for retirement after doing all your olosho and wasting all the benefit of your body"
#medicstoriesbydrseuno

"MUM, mum it's enough, leave the poor girl alone" Femi spoke for the first time.
"it is God that create children. He will do it in
his own time" he continued.
"we are trying, and God will answer our prayer soon" he assured his mother.
#medicstoriesbydrseuno

"abegii, make I hear word, yen yen yen. It is not God that make children. Children are made when you, you my
son carry your penis and put it a woman with benefit, a woman with eggs, useful eggs, not this one that has wasted her usefulness" mama countered
#medicstoriesbydrseuno

"NO ooo, she has not seen a resting spot, she will leave today. She should go and continue her uselessness somewhere else. Not in your house, not under my nose, infact over my dead body" mama screamed at her.
#medicstoriesbydrseuno

"what did I do wrong? Where have l taken a wrong turn? This was the same woman that welcomed me with joy into her family, she is the one shouting at me now and her son, my husband just called me Poor girl" she muttered
under her breath
#medicstoriesbydrseuno

She was reaching her breaking point. For more than a year, she has endured this ridicule, this harassment. Anytime mama came visiting, she would go through this until she leaves. Her husband wasn't helping. He can't stand up to his mum and make her understand

No today will not be that day, today is the last of it. This nonsense must end. "To bá má fo, ní ko fo. Tó bá má
faya, ni kò faya"
#medicstoriesbydrseuno

"Femi is the problem, Femi is the reason why I haven't given you a child màmá" she started to say

Màmá turned sharply to face her
"ngwanu, kilo sọ̀ , what did you say?" mama asked
"your son is the reason why I have not gotten pregnant" she replied with more confidence.
"will you stop lying, so this is the new tactic. You are no longer begging àbí"
#medicstoriesby@drseuno

"you want to be bold àbí, you want to be a bold lier" mama shouted at her
"she's correct Mum" Femi dropped the bombshell
"I'm the problem, I'm not fertile, the doctor have confirmed it and we are working on it. All the while she has been protecting me" he continued

"she shielded me like a mother does for her children, her babies. I'm her first baby. So yes mum, your son is the reason why you are not yet a grandmother" femi
said and sat down.
#medicstoriesbydrseuno

Infertility is a common problem amongst people. It is said to affect about 15% of couples in the USA and 1 in 7 couples in the UK. (I don't have Nigeria figures ).

Sadly in the Nigeria setting, it is largely believed that it is solely a woman's problem. This is a cultural belief that has transcended time. Despite the increase in awareness, girl child education. You still see woman been
harrased as the cause of the infertility.

It is now established that a man can be the reason behind the infertility face by couples. Infact the incidence of male infertility is on the rise globally.

Common factors that have been associated with male infertility includes:

1) Idiopathic (meaning no cause for the infertility, this makes about 40-50% of all male infertility).

2) Primary Hypogonadism, also called;Testicular Failure (30 to 40%).

3) Varicocele (40%)

4) Exposures; scrotal exposure to heat (hot tubs, saunas) toxic Chemicals, Pesticides.

5) History of Testicular surgeries or injuries

6) Orchitis (meaning Testicular infections) this can be from STls, mumps or tuberculosis.

There is also a list of chromosomal abnormalities that can cause male infertility. Chromosomal abnormalities likes Klinefelter Syndrome, Cystic Fibrosis.

At what point should a couple consider the possibility of infertility?
The definition of infertility is inability of a COUPLE to CONCEIVE after a year of regular unprotected sexual intercourse.

Let me explain that definition better.

REGULAR-3 to 4 episodes of sexual intercourse per week.

UNPROTECTED: No use of contraceptive methods; pills, barriers, No pull out game.

1 year: 88% of couples conceives in
their 1st year and 98% in their second
year of desiring children

There is a caveat to this definition, the caveat is in women who are close to or above age 35. For these women, the time duration is shortened to 6 month. This is due to the increase in incidence of babies born with chromosomal abnormalities in women age 35 and above.

Another thing to note is when do the couple start counting 1 year. It is counted from the time the couple desires to have a child and actively working at it, it is not when they got married.

I cannot but emphasis this, INFERTILITY IS A COUPLE PROBLEM, not one person problem. And it is to this that
when visiting a doctor. It is advisable that
they go together. #medicstoriesbydrseuno

So what should a man expect when they visit the doctor on account of infertility.
A detailed history is taken, this history will span from childhood to the current age of the man. It will span any childhood illness especially mumps, tuberculosis.

Age of puberty will also be ascertained, secondary sexual characteristics and when they appeared will be asked. Mental health will also be assessed.

The sexual health of the man is also asked for, history of STIs, UTls, how they were treated (traditional
or orthodox, prescription or self-medicating)

A history of sexual partners both past and present, any conception in those relationships

A social history is also taken, use of alcohol, cigarettes, recreational drugs, prescription medication
A past medical history is also taken, things as simple as chronic sinusitis can associated with syndromes that has
infertility as one of its symptoms.

The doc will perform a detailed examination, don't be surprise if your doctor is checking your eyes out when you are complaining of infertility Problems with the pituitary gland can cause infertility and visual field defects

Examination of thyroid gland, the penis, dermatological changes in the hair or fat will also be noted. The testis is assessed for size, texture.
The epididymis and vas deferens is assessed. Veins in
the scrotum is assessed for varicocele.

A rectal examination is also performed to assess the prostrate gland for structure, texture and nodules.

At the end of all this, investigation will be conducted. The test is SeminalFluid Analysis (SFA).
2 SFA are done 2 to 3 month apart. If the 1st is suggestive
of infertility, a second is conducted 3 months apart to ascertain. If the 1st is OK, there is no need for a second.

Doing 2 SFAs allows for the evaluation of 2 generation of sperms. It takes the testis an average of 72 days to
produce a new generation of sperms

Based on the result, the man is diagnosed and categorised. This will define the treatment modalities

So be educated, not all infertility are female related, stop the harassment, the discrimination. Check yourself out. BE HEALTH CONSCIOUS.

Make I go back to my banana tree and observe twitter street again.
#medicstoriesby@drseuno