Source: Tanzania Daily News
ALMOST 20 per cent of women in child bearing ages in the country are at risk of having problems with their fallopian tubes due to increased abortion.

Speaking exclusively to the 'Sunday News', Fertility Specialist and Medical Director of Dar InVitro Fertilisation (IVF) and Fertility Clinic, Dr Edward Tamale Ssali said that abortion contributes almost 30 per cent in causing a woman's fallopian tubes to be blocked or to become nonfunctional.

"Controversial as it may be but teaching our girls and boys sex education can help them avoid sex and wait till marriage.

We also need to teach them to stay with one sex partner which helps in avoiding sexually transmitted diseases. If abortion can be reduced, tubal diseases can be controlled, these are preventable problems.

Also most of terminations are carried out by non professionals making complications even worse," he explained.

Dr Ssali said that people in all age groups are affected depending on what is causing the problem in that particular couple and in magnitude, women with fallopian tube problems account for 45 per cent, sperm problem 20 per cent where a man's sperm is very low or poor, woman's eggs 25 per cent and womb problem 10 per cent usually due to fibroids or post fibroid operations (myomectomy).

According to website, tubal disease, one of the many causes of female infertility, is a disorder in which the fallopian tubes are blocked or damaged. Scar tissue, infections and tubal ligation are often causes of tubal disease.

Shedding more light on IVF, Dr Ssali said it involves mixing the sperm and a woman's egg in a glass container or tube and wait for fertilisation. This process takes place outside the woman's body.

After 2-3 days an embryo (potential baby) would have been formed and the transfer into the uterus can then be carried out using an embryo catheter.

"We transfer this embryo into a woman's womb and potentially can become pregnant. The pregnancy is similar to that conceived naturally and has no added risks compared to that conceived naturally.

In natural conception, a sperm enters a woman's uterus, gets into the fallopian tube where it finds an egg, enters the egg, an embryo is formed and this embryo travel for 7-10 days and implants into the womb and the woman misses her period becoming pregnant," he explained.

Women who need IVF include those with blocked tubes or non functioning tubes, men with low sperm or no sperm to ejaculate, women with no uterus and have to rent another woman's to grow a baby for them (surrogate), women with poor eggs or no eggs usually women who are in menopause.

Others are women with recurrent miscarriages, unexplained infertility of long standing, couples who want to have sex selection undergo a procedure called PGD (preimplantation genetic diagnosis), couples who are having children with sickle cell for example in our part of the world, paraplegic men and women who have chronic endometriosis and cannot become pregnant. Infertility is the inability to have children and factors are many.

Erectile dysfunction syndrome (EDS) is the inability to sustain an erection thus causing the man not to be able to have sex normally.

The fertility expert said that the major cause for this, in 80 per cent of cases, is psychologically related. Men need to be counselled to find out what might be leading to this.

There is a long story in every case but can be sorted out, with talking and some medical support while other causes include diabetes and renal failure. "This may come as a surprise to many but there are cases when a man has no sperm and it requires sperm donation.

It is very rare in our African setting but we see about two cases a year in our clinic. The woman has to consent to have a sperm donation; we do not do it on demand," he explained. IVF services both in Africa and abroad are very expensive and often not provided by the government.

The fertility specialist said that due to limited resources, he was doubtful if African governments can subsidise the services. He said that even if they were to built their own centres, there was every likelihood that the challenges will be too many for it to work well in a public sector setting.

He said that presently the government had provided a licence and it was his view that if more patients were referred there, less foreign exchange would be flowing out of the country.

The Ministry of Health and Social Welfare Chief Medical Officer, Dr Donan Mmbando told the 'Sunday News' that infertility in the country was a big problem and that the government was aware of it. "We appreciate the difference IVF can make.

At the moment we have no plans on having a centre of our own but we appreciate the differences being made by our partners," he said.

Another fertility expert, Dr Sifat Baharoon said that more awareness was needed to be raised to the men because unlike what many people know, not all infertility issues are from women.

Dr Baharoon said that he had noticed among the patients that he reviews at his clinic, and as is the African culture, the society tends to put all the blame of infertility on women.

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