Gynaecologists Give Insight Into The Causes Of Infertility After First Childbirth
Women experiencing secondary infertility are advised to seek early medical intervention to ascertain the cause, as experts also noted that those who have had miscarriages and vaginal infections must also seek proper treatment.
According to the Maternal health experts, women who have miscarriages and vaginal infections without going to the hospital to get proper treatment are at risk of experiencing infertility, even after having first child.
The experts noted that women experiencing secondary infertility must seek help in a hospital with specialist care that will be able to evaluate them properly, establish the cause and offer them appropriate treatment.
Aside from incomplete miscarriage and poorly treated vaginal infections, the experts also identified fibroid surgery, and ectopic pregnancy, among others as other causes of secondary infertility.
They, however, warned that poorly managed miscarriage is often very dangerous, noting that it could lead to an infection that might cause severe damage to the womb.
Secondary infertility, according to WebMD, means an inability to conceive or carry a baby to full term after having conceived naturally and given birth in the past.
The cause of secondary infertility can be traced to either partner.
Speaking in an exclusive interview with PUNCH Healthwise, a Consultant Obstetrician and Gynaecologist at the Family Health Department, Federal Ministry of Health, Abuja, Dr. Kamil Shoretire, said infertility could be caused by many factors in women and men.
Shoretire stated that miscarriage can profoundly affect the health and wellbeing of the mother, either from the complications of the process itself or from the complications arising from the treatment and management of the condition.
For those who survive a dangerous miscarriage, the gynaecologist says, there can be untold complications afterward, including infertility.
Giving insight into the causes of secondary infertility, the gynaecologist explained,
“Whatever will cause the fallopian tubes to be diseased or blocked will be a major factor in the women.
“This includes pelvic infections, complications of surgery on the womb, low sperm count following complicated pelvic surgery on the man, external factors such as toxins in food, alcohol, etc. that will affect egg production in the woman.
“At times a woman’s age above 40 years can lead to failed attempts to get pregnant due to poor egg release. In some cases, there is no responsible factor.”
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Shoretire identified complications of cesaerean section, fibroid surgery, incomplete miscarriage, ectopic pregnancy, a ruptured organ in the abdomen(Tommy), and repair of a ruptured womb as other causes of secondary infertility.
Speaking further on the causes, the maternal health expert said,
“The tubes of some women may have been tied in family planning procedures but still seek pregnancy.
“Others are the poor treatment of vaginal or pelvic infections or mismanaged post-surgery period. Poor compliance with medication after surgery.”
Explaining more on why women who have miscarriages should seek appropriate care, the gynecologist said, “It is always good for women who had a miscarriage to go to the hospital where the experts are and they will be well taken care of.
“Apart from treating them, the experts will also counsel them. They will tell them the possible causes of the miscarriage and what to do in preparation for the next pregnancy.”
The gynaecologist noted that by going to the hospital, the women will be well educated and enlightened to know about the condition itself.
Miscarriage, the loss of a pregnancy before 20 weeks, is a common event, occurring in an estimated 15 percent of all pregnancies, according to the American College of Obstetricians and Gynecologists.
In a 2019 article published in PMC journal, titled, ‘Causes and Prevalence of Factors Causing Infertility in a Public Health Facility’, the authors said infertility affects roughly 10 percent of the world’s population.
The authors noted that the problem of infertility has become universal now, and thus, understanding the causes is the first step in solving this issue.
“In the population coming to a public sector tertiary care centre, the incidence of primary infertility is more than secondary infertility. Increasing age of marriage influences the causes with unexplained infertility and male factors more commonly seen as the age of marriage increases.
Female factor remains the main cause of infertility followed by unexplained causes. Male factor is a significant cause of infertility with semen parameters being affected by age and by consumption of tobacco and alcohol,”
the authors said.
Speaking in the same vein, an Associate Professor and Consultant Obstetrician and Gynaecologist at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu State, Dr. Uche Agu, urged women that have fibroid to stop patronising quacks and traditional homes for treatment to avoid exposing themselves to the risk of infertility.
Warning against the dangers of seeking help in unorthodox places and taking local concoctions, the gynaecologist said,
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“The problem with fibroid comes from people who are not experienced. They could injure the lining of the womb and the woman may not see her menses again. They may have complications. Those who have their tubes inadvertently removed, may not be pregnant again.
“Some will even take those local concoctions and will never see their menses again. Some may take the concoction and it will knock off their ovaries and they will never see their menses.
“Some of the local concoctions get the fibroid matted together and by the time they come for surgery, it becomes difficult to operate. I have seen cases like that.”
The maternal health expert, however, stressed that surgery is the best treatment option for women who have fibroid and want to achieve pregnancy.