Manuel Ntoyai @manuel_ntoyai
Is there a sperm crisis in Kenya? This is the big question as male infertility — a matter talked about in hushed tones because of its sensitivity and a culture that often blames the woman in a childless marriage – becomes a reality.
To accuse a man of shooting blanks is a near sacrilege. And when that is the reality, the discussion is avoided like the plague. A man should not be subjected to the stigma of the inability to sire a child and the burden of a couple’s failure to have children is often borne by the woman.
According to Kenya Fertility Society, two in every 10 couples suffer from infertility with 4.2 million Kenyans requiring medical help to conceive.
Recent studies show that men are responsible for between 30 and 40 per cent of infertility cases.
Causes of male infertility include exposure to high temperatures, smoking, excessive alcohol consumption, obesity, sexually transmitted infections and even wearing a tight pair of trousers or underwear.
Genetics can also be to blame. Men who have an extra X chromosome (XX instead of XY) are likely to be infertile. There are also cases where some men produce anti-bodies against their own sperm.
Male infertility can be classified as non-obstructive — where the man has a low sperm count (Oligospermia) — and obstructive, where there is zero sperm count (Azoospermia).
According to the World Health Organisation (WHO), sperm count is considered lower than normal if there are fewer than 15 million sperms per millilitre of semen while the normal sperm quality is over 20 million sperm cells per millilitre. Anything below 10 million is considered a severe form of sub-fertility.
Reproductive Health Network Kenya programmes officer Nelly Munyasia says one of the causes of male infertility is high temperatures which can affect sperm production.
People who work in steel industries, welders, long distance drivers or motorbike riders are particularly at risk. Men who wear tight pants (a fashion trend among young people) also candidates for infertility.
Lifestyle practices such as smoking, poor diet, excessive consumption of alcohol, using saunas and hot tubs can also lead to male infertility.
Obstructive causes include sexually transmitted infections, TB infection of the sperm ducts, diabetes and obesity.
Despite the stigma associated with male infertility, cases of men visiting health clinics for sperm analysis are reportedly on the rise.
“Sperm count is conducted in a specialised laboratory by a specially trained laboratory technician. Sperm is collected by masturbation after a three day abstinence and the specimen must be delivered to the laboratory within one hour,” says Munyasia.
The analysis test costs between Sh1,000 and Sh2,000 depending on whether tests for infection and antibiotics to treat it are included.
About 85 per cent to 90 per cent of patients are treated with conventional methods, including advice about timing of intercourse, drug therapy to promote spermatogenesis, and surgery to repair damaged reproductive organs.
About three per cent of patients make use of more advanced reproductive technology such as In Vitro Fertilisation (IVF).
“Most people keep trying drugs because the cost of IVF is too high for most people.
More awareness about male fertility is also necessary to reduce stigma and the tendency to point fingers at the women every time a couple fails to produce children.
One way to to boost the awareness campaign is to incorporate fertility lessons in the health and sex education of the youth, including in the school curriculum.
According to Dominic Kimita, a programmes officer with Network for Adolescent and Youth of Africa (Naya), there is need for change in approach to sex education.
“It is important for schools to offer sex education especially fertility awareness. One of the things that should be addressed is that fertility is not just a female but also a male problem,” he says.
Sex education can help young people avoid some of the causative factors such such as STIs.
“It is important to involve young people in sexual and reproductive health rights services (SRHR),” he says.