Fountain Health On Infertility Awareness Month
Fountain Health, together with Dr Emma Robinson, is raising awareness about infertility during World Infertility Awareness Month [WIAM], recognized every June.
A spokesperson said, “Fountain Health, together with Dr Emma Robinson, OBGYN, seeks to raise awareness about infertility during World Infertility Awareness Month, recognized every June. Infertility is when a couple do not conceive after 12 months of regular, unprotected sexual intercourse.
“The cause may be due to either partner and could be due to structural issues or hormone imbalances. WIAM aims to dispel any negative stigmas surrounding fertility issues, breaking down barriers that prevent couples from seeking help or getting the support they need.
“As an endocrinologist who treats couples dealing with infertility, Dr. Annabel Fountain, Medical Director at Fountain Health, is taking the opportunity to improve understanding of infertility, its risk factors and other issues surrounding the condition.”
Dr. Fountain said, “Infertility is not merely a medical problem but also an issue of social injustice. The negative repercussions of infertility can be profound, especially for women, as they may experience domestic abuse, divorce, social stigma, emotional distress, anxiety, and low self-esteem.”
The spokesperson said, “According to Dr. Robinson as much as 40% of infertility issues are due to the male partner.”
Dr. Robinson said, “Many men are reluctant to provide a sperm collection, but this can now be done privately at home and transported to the lab where an analysis can be performed to rule out male issues.”
Dr. Fountain said, “Globally, more than 48.5 million couples are struggling with infertility, which means that one in six couples has a problem getting pregnant. Of course, making a baby takes two, so both partners must be assessed if the woman isn’t conceiving, and we cannot ignore that women do have a biological clock.”
The spokesperson said, “The female foetus has 4 to 6 million eggs [or ova], and even by the time of birth, this has reduced to 1 or 2 million. This number reduces by about 10,000 per month before puberty, by which time the girl will have between 300 and 400 thousand left.
“Fertility declines more rapidly after age thirty, and by the time they are 40 years old, the average woman will have less than 10% of the eggs she was born with. This translates to a less than 5% chance of conceiving naturally with each menstrual cycle after age 40. The quality of eggs also declines, leading to a higher rate of miscarriage.
“Increasing age reduces fertility for both men and women, although healthy men continue to produce sperm until they die. Occupational and environmental risks, such as exposure to endocrine disrupting chemicals [pollution, radiation and pesticides], can have a direct effect on the hormones that regulate sperm production and ovulation. Infections such as sexually transmitted diseases [STDs] and mumps, smoking, alcohol use and being under- or overweight can also contribute.”
Dr. Fountain said, “Reproduction depends heavily on hormones. In women, hormones signal and prepare the egg[s] in the ovary, the timing of ovulation, and thickening of the uterus lining for implantation of fertilized egg[s] in the female. This is the basis of the menstrual cycle.”
The spokesperson said, “Anything that disrupts this cycle can cause absent or irregular periods and failure of ovulation. Polycystic ovarian syndrome is probably the most common cause, affecting up to 20% of women worldwide.”
Dr. Fountain said, “Many women take the pill to regulate their bleeds, not just for contraception. This doesn’t regulate their hormones, though. It just masks the problem so later, when they come off the pill, they may face issues with conceiving.
“In men, the same hormones stimulate production of sperm – 200–300 million per day. That’s approximately 1,500 per second and 80–300 million sperm per ejaculation. Not all sperm produced will be normal. The proportion of normal forms can decline with age, and abnormal sperm – head or tail defects, such as a large or misshapen head or a crooked or double tail – will be less likely to reach and fertilise an egg which is only going to be viable for up to 24 hours after ovulation. That’s why the timing of intercourse is important.”
The spokesperson said, “Blockages in both male and female reproductive anatomy can stop an egg from reaching the uterus, prevent the release of sperm, or thwart the implantation of a fertilized egg. These structural abnormalities include fibroids, blocked fallopian tubes, injury to the testicles, hernias [and vasectomy].
“A survey by the World Health Organisation [WHO] reported that 11% of infertility in women is due to tubal obstruction, and 12% is due to uterine fibroids.”
Dr. Robinson said, “Fibroids are benign tumours of the uterus that affect a woman’s fertility by obstructing the fallopian tubes or preventing the implantation of a fertilised egg. Heavy periods are the most typical presenting symptom. Other symptoms are pelvic pain, lower back pain, and painful sex. The cause of fibroids isn’t clear but older age, race, family history, obesity, exposure to pollutants, and low vitamin D levels have been associated with fibroids.”
The spokesperson said, “Pelvic Inflammatory Disease [PID] is the leading cause of fallopian tube obstruction. This prevents sperm from reaching an egg and fertilizing it. PID is a result of infections of the reproductive system. These are usually STDs like chlamydia, which can cause severe scarring of the fallopian tubes. Early treatment with antibiotics can prevent this.”
Dr. Robinson said, “Unprotected sex significantly increases your risk of contracting an STD, developing PID and potentially reducing your potential to have children in the future. It is often asymptomatic, particularly in women, so regular screening of partners and treatment of these infections is essential for reproductive health.
“Although the causes of infertility can sound overwhelming, increased awareness of the complexity of conception, and the many reasons why it might not happen easily is important for planning your family and, through education, we hope to improve understanding and help to reduce the stigmas associated with infertility.”
The spokesperson said, “Dr. Fountain completed her specialist training in the UK in 2010. She is certified in Endocrinology, Diabetes and Internal Medicine and provides care to people with a range of health conditions and disorders related to hormones, including infertility. Visit fountainhealth.bm for more information.
“Dr. Robinson completed her medical degree and OBGYN residency training at Johns Hopkins in Baltimore, Maryland and earned a MSc. in Pharmacology from Oxford University in the UK. She is Board Certified in Obstetrics and Gynaecology and has over 25 years of practice experience. She provides a full range of obstetrical and gynaecological services to the people of Bermuda.”
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