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What Couples Need To Know
Dr. Abayomi Ajayi is a fertility specialist. He is a Consultant Obstetrician and Gynaecologist. He is the MD/CEO of Nordica Fertility Centre, a foremost fertility centre in the country with outlets already in Surulere and Ikoyi, in Lagos and in Abuja and Asaba. He is known for his high sense of professionalism in providing fertility, assisted reproductive technology, reproductive health. The centre is among the top ranked in providing solutions to infertility in waiting couples and putting smiles on their faces by helping them have healthy babies.
Dr. Ajayi held a briefing, a few days ago and enlightened couples on things they need to know to enable them have babies this year and beyond. Below are excerpts, so read and get enlightened!
“There are a lot of people facing infertility and one of the things we need to do is that we need to equip ourselves with the knowledge to be able to achieve their heart’s desire this new year.
“And so the first thing to look at is probably by defining what infertility is, which we all know is the inability of a couple to achieve and to have a baby after one year of trying despite regular and unprotected intercourse.
“But now, if we’re going to look at that, then we have to look at the age of the woman because a woman’s ability to have children is predicated on the age. And so that will probably guide almost all the decisions that would be made.
“We know that naturally women have about a 20 to 95% chance of getting pregnant per cycle when she’s less than 30. And the same woman when she becomes 40 has less than 5% chance of getting pregnant. So if age is one of those, which is probably the easiest part, age is something that we can easily determine since it’s fixed. So anybody who wants to have a child should bear that in mind. And that’s why even for the definition of infertility, we take that into cognizance that the woman is less than 35 years. We can wait for one year if she’s over 35 then six months is enough.
“For people who want to conceive spontaneously because that should be the first way and the natural way to conceive. Three things I would like them to be mindful of, of course, that for you to conceive it means sperm was injected into the vagina and then finds way to the cervix and then finally finds way into the tube where fertilization takes place. Therefore, there’s no other way to have a baby, if you’re going to have it naturally than to have regular intercourse. There are no two ways about that it’s regular unprotected intercourse.
But these days that the majority of these young people live apart, and also with the “Japa” thing the husband is in Australia, the wife is in Nigeria, that also makes things a little bit more complicated. So that sometimes this unprotected regular intercourse is just not present. And of course, like we said, we started with the age as a woman gets older the more difficult it is. So, when you’re making the plans, either you want to go to “Japa” or whatever, it’s better that this age thing is taken into cognizance.
“And then the other thing is the knowledge of Ovulation. People must be aware of Ovulation. Why Ovulation? What is a Ovulation? Ovulation is a period in which an egg is produced during the menstrual cycle. Now, why is it important? If an egg is not released, then the sperm cannot meet with the egg. So it’s important for women to understand this Ovulation and how to detect whether they Ovulating or not. So for people who don’t live together, then this becomes very, very important. If they’re going to start timing intercourse that this helps them regularly. Maybe at this point, let me also say that when we say regular intercourse, we mean intercourse should be between two to three times in a week.
“So for those who are now going to time intercourse, why is Ovulation important? Because that’s the fertile period. And this fertile period, unfortunately, with Ovulation, most of the tests that we use for it cannot determine a hundred percent. Is either just before ovulation occurs or after ovulation for all the tests that we have right now. But if we look at it, your ovulation occurs 14 days before your next menses.
But now the problem is how do I detect that? And then we also know that your fertile period is about five days before your ovulation and then until the day of your ovulation. So it’s important if anybody’s going to have timed intercourse that they get this right.
“Now how do I determine whether I’m ovulating or not? The general rule will say that if you have regular cycles or your menses are regular, mark my word you are likely to be ovulating. Especially when you have regular cycles and now you have some other symptoms around the time that you’re ovulating. Like we say, they can notice the vagina discharge might become copious and slippery like the egg. These might be things that might be suggestive that you’re ovulating. Also mark my word suggestion. I didn’t say that it’s sure that you’re ovulating.
“If you have abdominal pain, especially one-sided abdominal pain, it could also suggest that you’re ovulating. If you have symptoms like breast tenderness, moodiness around that time, that could also suggest that you’re ovulating. Now we used to do what we call the BBT. This is Basal body Temperature, of course we know that in this environment that can be very tricky because of malaria and all this sort. We don’t really pay so much attention to it, especially now that there are so many other things that can be used that can be accepted from the get go. There is no method that will give you 100% proof. So now there are also online calculators. I think there is one on our own website as well and then also there are kits that you can use to know whether you are ovulating or not. These kits usually measure the LH in the urine and we tell you that when they have the LH surge then you know that within 24 -36 hours you are likely to Ovulate. So, you see that most of these things are still really rough. And then you could also go to a hospital and then they can retrospectively tell you whether you are ovulating or not by doing serum progesterone. But like I said Ovulation can be detected and predicted. it’s not 100 guaranted.
“I’m not sure whether you are watching now that there is something on Netflix “we are what we eat” and it can’t be put better. The same thing is that our fertility depends on what we put into our mouth. So, because we know that fertility is dependent on our weight, our BMI, the kind of food we eat and then exercising. Those are things that have helped you to stay fit and at the same time stay fertile. And then of course but also the big thing is the habits, our habits. We know that having an unhealthy sexual habit of course we can come across sexually transmissible infections which might not cover tubes or even knockoffs ability to produce sperm. We know that weights also affect. If we become obese, weight affects both the man and the woman and it does not make you not to produce good eggs and also the sperm count. We’ve done a study here where we saw that even in the sperm, what we call the DNA fragmentation index is increasing obesity than people who have ideal weight.
“And of course, diet, we talk about diets reaching antioxidants, like folate and Zinc, Vitamin C. And this, immediately, what goes to mind will be the vegetables, the nuts. Walnuts are a very good source of antioxidants. Of course, there’s also the Bitter Kola. Avoid trans fats, like in butter and some of those vegetables that we’re using now. Avoid refined carbohydrates; cakes, sugar, soft drinks. Put fibres into the food, of course, vegetables, and so on. And then we can substitute our protein from animal to plant protein. And those are some of the things. Avoid caffeine, if possible, and don’t drink more than 1 to 2 cups, if you want to have a baby on your own. And of course, no! no!! no!!! Also be with recreational drugs. Smoking is a no, no, no, as well, because smoking makes your ovaries age, like about, makes you almost 10 years ahead of your age. Then recreational drugs, cocaine, all the lights, marijuana, and so on and so forth.
“Now, one other thing I want to talk about is sexual position, because there’s been a lot of myths about that. There’s no evidence that there is any particular sexual position that encourages spontaneous conception.
But there are some things about lubricants that can disturb conception. The oil -based lubricants, including the very popular KY Gel, might not be encouraged. The water-based lubricants are better than oil-based lubricants when it comes to trying to conceive.
“I think for anybody who wants to conceive in 2024, those will be the things that I will advise them or recommend to them. But if you have tried for more than 12 months, even if you are less than 35, you can do all these things. They’re like home remedies. But if you are over 35, after trying for six months, please, you need to see a doctor preferably a gynaecologist so that we can start the investigations on time to know whether we need more than the home remedies. And at least they will start with the investigations. And then, principally, they will do the seminal fluid analysis. They will do an ultrasound scan. They will try to see your tubes by doing HSG. And then they will see whether you are relating or not by doing your hormonal analysis. Those four tests are very important. They will detect up to about 85% of the causes of infertility. And then the others, we might need to do more advanced tests, like sometimes laparoscopy. And then because that’s where all these things, like endometriosis comes in. Because sometimes, it is endometriosis that might be causing this problem. What we call unexplained infertility, sometimes it’s when the DFI in the sperm is high. We have talked about DFI earlier on. But sometimes it’s just the age. So those are also causes of what we call unexplained infertility, which the doctor now can investigate and therefore, they recommend how to solve them. And depending on the age, this will start from Intrauterine insemination to IVF.
“We all know that there are so many spin -offs from IVF now that we can use, including If you want to select the gender of a baby, you want to select the genotype for people who are two years married, then they need to select the genotype of the baby. And also, when you are even pregnant, we can try to see the chromosomes of the baby by doing what we call non-invasive prenatal testing to be sure that the babies are normal.
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