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Early intervention improves fertility odds

Update: June, 18/2013 - 09:47
Children play in Phu My Hung New Urban Area in HCM City. Infertile couples are given stronger hope of having children with the development of modern intervention science and technology. — VNA/VNS Photo The Anh

by Nguyen Thu Hien

HA NOI (VNS)— The cries of a child break the quietness of the infertility hospital waiting room in Ha Noi. Couples turn their heads towards the parents consoling their daughter, nurturing the hope that one day they will have a child.

Thanh (not her real name), 29, the child's mother, says that just two years ago she was still struggling to get pregnant after six years of tears and disappointment.

"It was my mother who first began worrying about my possible infertility. She wondered whether there were any arguments between me and my husband because I hadn't conceived after two years of marriage.

"At that time, I laughed. I thought there was nothing to worry about because I was only 22."

Dr Le Vuong Van Ve, director of the Andrology and Infertility Hospital of Ha Noi, says Thanh did not know that couples of child-bearing age who had been attempting to conceive for at least one year without success were diagnosed as infertile.

Nearly eight out of every 100 couples in Viet Nam are infertile.

Unfortunately, Thanh is not alone in her lack of understanding over infertility. A "Starting Families Asia" study, released in December by the Asia Pacific Initiative on Reproduction, shows 54 per cent of the surveyed Vietnamese women did not know much about infertility.

Life became uneasy for Thanh as rumours about her infertility started spreading.

Her sisters-in-law insulted her and asked her husband to divorce her.

"I felt the pressure," she said.

"I also blamed myself for having no child, thinking it was my responsibility to get pregnant. I must be the reason."

Dr Nguyen Thu Thuy, an expert in obstetrics and gynecology, says it is the women who usually get the blame, not the men, even from the women themselves who think infertility is their fault.

According to the Starting Families Asia study, 80 per cent of the 1,000 surveyed women across 10 countries in the Asia Pacific, including Viet Nam, did not suspect their husband of having a fertility issue.

However, Thuy says 40 per cent of infertility cases are due to female factors (female infertility), 40 per cent male factors (male infertility), 10 per cent both partners and the rest unexplainable.

Ve explains the most common causes of male infertility are azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). In some cases, sperm cells are malformed and die before they reach the egg.

Meanwhile, female infertility can be caused by ovulation disorders, blocked fallopian tubes, birth defects involving the structure of the uterus, and uterine fibroids.

The experts agree the sooner childless couples seek medical help, the higher their chances of successful treatment.

But in many cases their ignorance of fertility issues leads them to delay the process.

The study showed 46 per cent of the surveyed women believed that God decided their fertility. So, many got help from quacks or from the supernatural, instead of science.

Thanh's mother took her to quacks who gave her medicinal herbs. And her mother-in-law took some magic crank to her house "to drive away the female ghost that possessed my husband and prevented us from having a child".

"If impossible, I would cut my husband free so he could get married with another woman and have his babies.

"He never criticised me but once he said that God might not want us to have a child."

Two more years passed without good news for Thanh. She heard about a quack in northern mountainous Bac Kan Province whose herbs could make a woman get pregnant, so she caught a bus to his house, hundreds of kilometers away. He gave her a potion which she took regularly, but after six months "no change, no news".

She ordered another consignment but after another six months she thought: "It is time to become resigned to my fate."

However, a relative in Ha Noi advised her to go to a hospital where modern techniques could help couples have babies.

Her only worry was whether she could afford to pay for the treatment.

Doctor Ve says Viet Nam has successfully applied most advanced assisted reproductive technologies: intrauterine insemination (IUI), which costs VND10 million (US$476) per session, or in vitro fertilisation (IVF), which costs VND50 million ($2,380) .

Doctors asked for her husband to be present because they needed to conduct a physical examination on both to determine their general state of health and search for physical disorders, potentially contributing to infertility. Both would also be interviewed about their sexual habits and family genetic issues.

Then more specific tests could be carried out. For women, these are an analysis of ovulation, x-rays of the fallopian tubes and uterus, and a laparoscopy. For men, initial tests focus on semen analysis.

Thanh persuaded her husband to go to the hospital but "he became angry when he thought I was blaming him".

Thuy says many Vietnamese men consider their fertility to be their strength and a source of self-respect. So, they find difficulty in accepting they should be checked.

Eventually Thanh's husband agreed to go with her.

After tests, Thanh's husband was diagnosed with variocele, resulting in oligospermia. There was nothing wrong with Thanh's reproductive system.

Ve says about 35 per cent of male infertility cases are caused by variocele.

His alchohol addiction was another risk factor.

Thanh's husband went through a period of treatment but she was still unable to get pregnant. So an IUI was performed.

Ve says IUI places washed sperm directly into the uterus to increase the number of sperm reaching the fallopian tubes and subsequently increasing the chance of fertilisation.

After trying IUI three times Thanh failed to get pregnant.

Ve says if IUI method is unsuccessful, IVF will be recommended.

"Although there are dark parts which current science has yet to shine on, scientific findings have raised the chances for childless couples."

Professor Nguyen Dinh Tao of the Embryo Technology Centre says the centre has improved the process of growing and isolating sperm stem cells which help men with azoospermia have babies without asking for donor sperm.

But as luck would have it, Thanh finally conceived on their fourth attempt with IUI and a girl was born.

Now, after one year, Thanh and her husband have returned to the hospital waiting room to see if they can have a second baby.

"One baby is not enough to offset the six years of worry. I want one more," she says. — VNS


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