Posted on Leave a comment

MALE INFERTILITY TREATMENT IN KENYA AND THEIR COSTS IN 2022

What is Infertility

This is when a couple is unable to conceive after having frequent and unprotected sex for a year. Half the time, the cause for an infertile couple’s difficulty in conceiving will be the male factor.

With infertility in men in Kenya being on the rise, today we look at some of the treatment options available locally thanks to the Fertility clinics and Fertility Doctors located in the country.

Common Causes of Male infertility include:-

  • Obstructive Azoospermia

    in this case, sperm are being produced normally in the testes, but there is a blockage or obstruction in the male reproductive tract that prevents the normal transport of sperm through the post-testicular ductal system. Azoospermia can be caused due to several conditions including sexually transmitted disease, retrograde ejaculation, scrotal trauma/injury, scar tissue, cystic fibrosis, hernia surgery and vasectomy.

Treatment options for obstructive azoospermia include:

  1. surgical correction of the obstruction, or
  2. IVF/ICSI with sperm retrieval from the epididymis or testes through testicular sperm extraction (TESA)
  • Poor Sperm Health 

This is the leading cause of male infertility. A semen analysis is the test done to evaluate the quality of sperm.

  1. Oligospermia – Low sperm count. This is defined as low sperm concentration in the ejaculate. As per WHO the sperm count in a semen sample should be above 15 million sperm per milliliter, anything below can be diagnosed as oligospermia.
  2. Asthenospermia – Poor sperm motility. Motility is the forward swimming motion of sperm. When sperm motility is poor, fewer sperm are able to reach the egg, making conception less likely to occur.
  3. Poor sperm morphology refers to the size and shape of sperm. Abnormally shaped sperm may have difficulty fusing with the egg, thereby decreasing the chances of successful fertilization.

Treatment options for poor sperm health:

  1. Dietary supplements designed to improve sperm count, motility and morphology such as Fertilaid, Motilityboost, Countboost.
  2. ICSI/IVF
  3. IUI
  • Retrograde Ejaculation

Retrograde ejaculation occurs when the semen is redirected to the urinary bladder instead of ejaculating via the urethra. This happens when the bladder sphincter does not function properly, forcing semen to enter the bladder.

Even though retrograde ejaculation is harmless, it can cause male infertility. Retrograde ejaculation may be also caused due to usage of certain medications, congenital conditions, injury or surgery.

Treatment option

  1. IVF/ICSI with sperm retrieval from the epididymis or testes through testicular sperm extraction (TESA)
  • Varicocele

Varicocele is a condition occurs when the veins enlarge within the scrotum. It might cause male infertility. Pooled blood in the enlarged veins affects the temperature in the scrotum to increase than normal, it affects the ability of the testes to produce sperm resulting in decreased sperm count, decreased motility and poor morphology.

Treatment option

Varicocelectomy is a treatment option available to treat varicocele. It is a small microsurgical procedure in which all the swollen veins are tied off while preserving the normal blood vessels. In many patients this can result in a dramatic increase in sperm counts and motility.

Approximate costs for the different treatment options

IVF Type in Nairobi, Kenya City Approximate Cost (Kenya Shilling – KES)
Normal IVF Cycle Nairobi 400,000 KES
Advanced IVF Cycle/ ICSI Nairobi 500,000 KES
IUI Nairobi 60,000 KES
Dietary supplements Nairobi 10,000 KES

I hope this helps you in understanding the treatment options available and deciding on the best option for you on your fertility journey.

Some other topics that could interest you are:

Steps to take when struggling with infertility

Heat and Male infertility

What is a Semen Analysis/sperm test

Why dietary supplements are a great treatment option for infertility

 

 

 

Posted on Leave a comment

Damaged Sperm Plays a Role in Repeated Miscarriages

Recurrent or repeated miscarriage is defined as the loss of three or more pregnancies before 20 weeks of gestation.

For decades, miscarriage was believed to relate to the woman’s ability to carry a pregnancy to term. However, recent studies have revealed that frequent miscarriages can be associated with poor quality of sperm. Recent studies have shown that, compared to healthy couples, women with recurrent miscarriages have male partners whose sperm shows increased levels of DNA damage.

In addition to having a reduction in serum testosterone and estrogen levels, these men have reduced total and progressive sperm motility and atypical sperm morphology. Furthermore, the levels of reactive oxygen species (ROS) in the semen samples of these men are significantly higher than those in healthy counterparts.

Sperm DNA plays an important role in placenta formation. A healthy placenta is necessary for fetal survival. Thus, it is obvious that increased sperm DNA damage can impact pregnancy outcomes by negatively affecting placental health.

Also, a low level of testosterone can negatively impact sperm health by altering spermatogenesis (the process of sperm cell production and development). This can lead to structural and functional abnormalities in sperm, which then can increase the chance of recurrent miscarriages.

What are the frequent sources of ROS in semen?

Production of ROS in sperm cells can be induced by several factors, including:

  1. excessive consumption of alcohol can increase the level of certain metabolites that are responsible for increased ROS production.
  2. smoking can induce ROS production by increasing lipid peroxidation and reducing cellular antioxidant levels.
  3. Varicocele, which is defined as an enlargement of the veins in the scrotum. Men with varicocele have higher numbers of sperms with chromatin-related abnormalities, which can be due to increased ROS-induced oxidative stress.
  4. Bacterial or viral infections in the male reproductive tract can increase the production of ROS.
  5. Obesity is considered an important trigger of ROS production in sperm cells, which is most probably due to an increased rate of metabolism. The high level of ROS in obese men can impair spermatogenesis, leading to deterioration in sperm quality.
  6. Aging is another important factor associated with increased ROS production and reduced antioxidant capacity. The resultant oxidative stress can impair sperm DNA integrity, leading to the production of poor-quality sperm.
  7. Certain environmental factors, such as air pollutants, can increase ROS production in sperm cells, which can subsequently reduce sperm quality and quantity.

Can Antioxidant Male Fertility Supplements Protect Sperm?

Studies have shown that taking dietary supplements with antioxidants, such as Fertilaid, Countboost, Motilityboost , can reduce ROS damage to sperm. Antioxidants protect against ROS-caused oxidative stress and can keep DNA in sperm healthy.

In conclusion

Damaged sperm are far more involved in recurrent pregnancy loss than previously thought. Protecting them from too many reactive oxygen species can not only help you get pregnant in the first place—it may help you carry your baby to term.

Source:

  • Jayasena CN, Radia UK, Figueiredo M, et al. Reduced Testicular Steroidogenesis and Increased Semen Oxidative Stress in Male Partners as Novel Markers of Recurrent Miscarriage. Clinical Chemistry. Published Online January 2019. http://clinchem.aaccjnls.org/content/65/1/161
  • Science Daily. 2019. Recurrent miscarriage linked to faulty sperm. https://www.sciencedaily.com/releases/2019/01/190104103950.htm
  • fairhavenhealth.com
  • https://www.news-medical.net/medical/authors/sanchari-sinha-dutta-
Posted on Leave a comment

AZOOSPERMIA

AZOOSPERMIA

Every day we have at least one man reach out to us indicating that they have azoospermia and they need help. They are usually feeling completely defeated. Almost always they do not even understand what the condition is and what options they have in their desire to father children. Hopefully this blog will shed light on the matter and restore hope to the many men/couples here in Kenya who have azoospermia as the cause of their infertility.

What is azoospermia?

Azoospermia is the medical term used when there are no sperm in the ejaculate.

It can either be:

  1. “obstructive,” where there is a blockage preventing sperm from entering the ejaculate,
  2. “non-obstructive” when it is due to decreased sperm production by the testis.

Obstructive Azoospermia

Here, testicles make normal sperm, but something keeps them from getting out.

Obstructions mostly occur in the vas deferens, the epididymus or ejaculatory ducts.

Problems that can cause blockages in these areas include:

  • Trauma or injury to these areas.
  • An infection in your reproductive tract, such as epididymitis and urethritis
  • Inflammation.
  • Previous surgeries in the pelvic area.
  • Development of a cyst.
  • Vasectomy (planned permanent contraceptive procedure in which the vas deferens are cut or clamped to prevent the flow of sperm).
  • Cystic fibrosis gene mutation, which causes either the vas deferens not to form or causes abnormal development such that semen gets blocked by a buildup of thick secretions in the vas deferens.

Non-obstructive  Azoospermia

Here the testis are not producing sperm as they should be. Causes of these include:

  • Genetic causes. Certain genetic mutations can result in infertility.
  • Hormone imbalances/endocrine disorders, including hypogonadotropic hypogonadism. hyperprolactinemia and androgen resistance.
  • Ejaculation problems such as retrograde ejaculation where the semen goes in to the bladder
  • Testicular causes include:
    • Anorchia (absence of the testicles).
    • Cyptorchidism (testicles have not dropped into the scrotum).
    • Sertoli cell-only syndrome (testicles fail to produce living sperm cells).
    • Spermatogenic arrest (testicles fail to produce fully mature sperm cells).
    • Mumps orchitis (inflamed testicles caused by mumps in late puberty).
    • Testicular torsion.
    • Tumors.
    • Reactions to certain medications that harm sperm production.
    • Radiation treatments.
    • Diseases such as diabetes, cirrhosis, or kidney failure.
    • Varicocele (veins coming from the testicle are dilated or widened impeding sperm production).

How will Azoospermia be treated?

Treatment will definitely depend on the cause, but for any given patient, the best treatment is a customized approach based on many factors, such as partner’s age and reproductive function, physical exam findings, blood test results, long- and short-term family goals and even finances. Depending on the suspected causes, many treatments may be available. If there is a blockage (or history of vasectomy), reconstruction might be the best treatment for some men. In others, removing offending agents such as medications or recreational drugs might be the first step. Sometimes there may be hormonal abnormalities that need to be addressed, and in some men, treatment could increase sperm production. In some men, surgery to fix anatomical abnormalities or varicoceles can be pursued, and in others the best option is to go directly into the testicle to attempt retrieval of sperm that could be used for ART(assisted reproductive technology).

I had a semen analysis showing azoospermia — what should I do?

  • the first step would be to get a repeat semen analysis at a lab that has a lot of experience doing semen and sperm tests, because results can vary a lot from test to test and lab to lab. Also, having small numbers of sperm can change the management/treatment options drastically, so the first step should be getting proper confirmation of the finding.
  • After confirmation of the diagnosis, step 2 should be seeing a fertility doctor specializing in male infertility.

Sources:

John Hopkins Medicine “The Evaluation of the Azoospermic Male: American Family Physician: “Epididymitis and Orchitis: An Overview.”

UCSF: “In Vitro Fertilization,” “Intracytoplasmic Sperm Injection.”

Reproduction, Fertility and Development: “Causes of azoospermia and their management.”

The Urology Clinics of North America: “Obstructive Azoospermia.”

Clinics: “Obstructive azoospermia: reconstructive techniques and results.”

Indian Journal of Urology: “Surgical Sperm Retrieval: Techniques and Their Indications.”

 

 

 

 

 

Posted on Leave a comment

HEAT AND MALE INFERTILITY

Sperm are sensitive to high temperatures. Sperm cells tend to die when exposed to too much heat. Continuous exposure to higher temperatures can cause sperm production to be lower, or cause the production of abnormally shaped sperm cells resulting in male infertility. Testicles are located outside of the human body because the ideal temperature for sperm production, and thus for male fertility, is about three to four degrees below the ideal human body temperature.

Overheating can be due to reasons that are internal such as in the case of a high fever. It can be also due to factors that are environmental or physiological. Activities such as cooking, grilling, motorcycling, sauna, and cycling can cause heat production. Using laptops and cellphones for long durations can also result in overheating. Physiological factors include Varicocele (enlargement of the veins within the loose bag of skin that holds your testicles), late descended testicles and obesity.

To promote male fertility and healthy sperm, avoid these 5 hot situations;

  1. Avoid spending prolonged periods of time in hot tubs and/or Jacuzzis.

Sitting and soaking in hot water will raise the body temperature, which can have a negative effect on male fertility.

  1. Don’t wear tight-fitting pants or underwear.

When you wear tight jeans, pants or briefs, you’re putting your scrotum in a tight environment that can trap heat in the testicles, and especially during the hot months when you may already be overheated. Wear boxers or loose pants made from natural fiber like cotton.

  1. Do not sit for long periods of time without getting up.

Sitting, whether for work, for long driving trips, or just to watch television, can also trap heat around the scrotum, which is not beneficial for male fertility. Take breaks to stand and walk around.

  1. Avoid prolonged bike rides, especially in the heat.

Tight biking shorts, combined with long periods of sitting on a bike seat, may cause friction and pressure on the testicles. This can cause the testicles to become overheated, too. Men should wear loose shorts and take shorter bike rides or take breaks during longer rides.

  1. Don’t put a laptop computer directly on your lap for long periods of time.

The battery on laptop computers can produce quite a bit of heat. It’s best to place your laptop on a desk or table instead of on your lap.

 

 

 

Posted on Leave a comment

Dealing With the Emotional Stress of Male Infertility

When infertility is discussed, the conversation generally focuses on female reproductive issues. However, male factor infertility is a contributing factor in approximately 50% of couples who are struggling to conceive in Kenya.

Even though men are just as likely as women to feel a deep sense of sorrow or anxiety, they are left to deal with these emotions on their own. Partly because most of the discussion about the emotional experience of infertility is focused on the woman. The man also is left to quietly deal with this struggle on his own given the African culture that requires him to be “tough”.

While it is without question a difficult thing for a man to accept the diagnosis of Male infertility, there are some few things that could help in coping better and also improving his fertility.

Acknowledge Your Feelings

The first step in coping with the stress of male infertility is to simply acknowledge what you’re feeling and to give yourself space to feel those emotions. Be open with your partner and communicate what you’re feeling. It can also be helpful to talk to a third party, such as a fertility doctor, a friend, a counselor, a support group, or a pastor. Keeping something so stressful a secret can eat away at you, but opening up and sharing what you’re going through can help lighten the load.

Take Control

Once you have given yourself some time to process what you’re going through emotionally, you can start taking control of the situation. Some things you can do include:

  • Making an appointment with a fertility specialist.
  • Getting a second opinion
  • Researching as much as you can about fertility
  • Preparing questions for your doctor

At the same time, talk to your partner about what this means for the long term. Research the various fertility treatment options that are available and discuss which ones may be the best for your situation. Also, talk about these treatment options in terms of what you can handle emotionally and financially.

Focus On Your Physical Health

Taking control of your physical health will help improve your overall physical and mental health which will not only help you cope better with the situation but it could also improve your fertility especially if your challenge is poor sperm quality.

Some ideas for taking control of your physical health include:

  • Eating a healthy diet consisting of vegetables, lean proteins, whole grains, and limited processed foods
  • Being physically active/exercising
  • Avoiding cigarettes, excessive drinking, and drugs
  • Achieving or maintaining a healthy BMI
  • Supplementing your diet with dietary supplements designed to improve your overall health and fertility.

All of these and more can help improve your sperm quality while also helping you cope with any emotional stress that you are feeling.

We would love to hear from you. How are you coping with male infertility? Talk to us on info@hannahsorison.com you can also reach us on 0759205704.

 

 

Posted on Leave a comment

WHAT IS HEALTHY SPERM?

Sperm health is the leading cause of male infertility. But what is the definition of healthy sperm?

Semen quality parameters according to the World Health Organization (WHO)

Semen analysis is the basic routine tool that provides information about the male reproductive potential, and is very useful when determining the treatment option for the couple struggling to conceive. The World Health Organization (WHO) has published successive editions of the “Manual for the examination and processing of human semen”.  This manual serves as a guide in andrology laboratories, standardizing the method of assessing semen quality.

 

SEMEN PARAMETERS (WHO 2010)

There are several parameters to take into account in a semen analysis, which can be divided into those that can be evaluated with the naked eye (macroscopic examination) and those that cannot be evaluated with the naked eye (microscopic examination).

Below, we show the requirements that a semen sample must meet in order to be catalogued as normal (Normozoospermia):

MACROSCOPICS FACTORS – (Those that can be evaluated with the naked eye)

Liquefaction

After ejaculation, semen is in a coagulated state and needs to be liquefied in order to be studied. A semen sample liquefies completely in approximately 15-20 minutes at room temperature. If complete liquefaction does not occur within 60 minutes, the semen sample can be subjected to mechanical liquefaction in order to analyze the rest of the parameters.

Viscosity

It refers to the fluidity of the entire sample, which can be normal or high. The methods to reduce viscosity are the same as those for liquefaction. If the sample presents high viscosity levels it may be due to a prostatic dysfunction.

Volume

The normal volume of an ejaculate, after 3 to 5 days of sexual abstinence, is in the range of 1.5 to 6 mL. A lower volume is called Hypospermia, while a higher volume is called Hyperspermia. The absence of semen with ejaculation is known as Aspermia.

 Colour

The usual colour of semen is opalescent white, slightly yellowish. In cases where the colour is altered, it is advisable to study the possible causes. An example of alteration would be the presence of red blood cells in the semen sample (Hematospermia).

pH

This value must be over 7.1. Lower values and a low sperm concentration could indicate efferent vessel dysgenesis, i.e. a blockage of the ejaculatory ducts.

Concentration (Count)

The normal value is 15 million spermatozoa per milliliter of ejaculated volume or 39 million in the entire sample. If these values are not reached we would be talking of Oligozoospermia and, in the most severe cases, of Cryptozoospermia (<100,000 spermatozoa/mL).

Motility (swimming ability)

The percentage of motile and progressive (spermatozoa moving actively) sperm are assessed. Progressively motile spermatozoa must exceed 32%; otherwise, it is called Asthenozoospermia.

Vitality

The percentage of live spermatozoa must exceed 58%. If it were lower, we would be talking about necrozoospermia.

Leukocytes

If the concentration of leukocytes is greater than 1 million per mL of sample (leukospermia) it may indicate a genitourinary infection.

Morphology

In a normal semen analysis, there should be equal to or more than 4% of normal spermatozoa. If the value is below this range, this is known as Teratozoospermia.

Anti-sperm antibodies or MAR test

It indicates the amount of spermatozoa attached to other cells or particles. When more than 50% of spermatozoa are bound to, it may reflect an immune problem.

You can view the supplements we have that help with improving sperm health here.

Bibliographical references

  • World Health Organization. “WHO Laboratory Manual for the examination and processing of human semen” Cambridge: Cambridge University. fifth Edition (2010).

 

Posted on Leave a comment

UNDERSTANDING MALE INFERTILITY

What is infertility?

This is when a couple is unable to conceive after having frequent and unprotected sex for a year. Half the time, the cause for a couple’s difficulty in conceiving will be the male factor. Sperm health is the biggest cause of male fertility issues.

Sperm health is not only important for conceiving, it also plays a role in the health of the overall pregnancy and possibly the baby too.

So how do we measure sperm health?

  1. Sperm count: refers to the number of sperm cells present in a milliliter of semen. Anything below 20 million sperm per milliliter of semen is considered to be a “low” sperm count, also called oligospermia. Severe oligospermia is typically defined as a sperm count less than 5 million sperm per milliliter of semen. Azoospermia is defined as the complete absence of sperm in ejaculate.
  2. Sperm motility is defined as the forward, swimming motion of sperm. In order for a sperm to reach the egg after ovulation fertilization, it must travel quickly through the female reproductive system, which requires a strong swimming action. “Normal” sperm motility is typically defined as 50% of observed sperm, or at least 8 million sperm per milliliter of semen, showing good forward movement. When sperm motility is suboptimal, fewer sperm are able to reach the egg, making conception less likely to occur. Poor sperm motility is called asthenozoospermia.
  3. Sperm morphology refers to the size and shape of sperm. Abnormally shaped sperm may have difficulty fusing with the egg, thereby decreasing the chances of successful fertilization.

Low sperm count can be caused by testicular failure, hormone deficiencies or imbalances, varicocele (an abnormal enlargement of the veins in the scrotum) and/or a blockage in the duct system that carries sperm.

Another key contributor to poor sperm health is oxidative stress. Oxidative stress is a physiological condition that develops when the number of reactive oxygen species (frequently referred to “free radicals”) produced or present in the body overwhelm the “antioxidant” mechanisms the body utilizes to neutralize these unstable compounds. Because our modern lifestyle (stress, poor diet, exposure to environmental toxins) sets the stage for lots of free radical production, sperm cells often live in a continual state of oxidative stress – leading to reduced sperm count, poor sperm motility, and even DNA damage. Some researchers now believe that up to 80% of all cases of male infertility can be attributed to oxidative stress.

Improving sperm health

There is however wonderful news for those of you suffering from less than optimal sperm health! Supplementing your diet with key antioxidant nutrients, such as Vitamin C, Vitamin E, CoQ10, and quercetin, can improve your sperm count, sperm motility and sperm morphology. If you are looking for a way to ensure you get the antioxidant support you need to maximize your sperm health, check out the following Fairhaven Health products: FertilAid for MenCountBoost for Men and MotilityBoost for Men.