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Doctors see rise in second-birth infertility

Update: November, 17/2010 - 10:06

In-vitro fertilisation is used to treat infertility at Ha Noi Obstetrics Hospital. The method brings happiness for many couples, including those who suffer from secondary infertility caused by having an abortion or using intra-uterine devices improperly. — VNA/VNS Photo Viet Thanh

In-vitro fertilisation is used to treat infertility at Ha Noi Obstetrics Hospital. The method brings happiness for many couples, including those who suffer from secondary infertility caused by having an abortion or using intra-uterine devices improperly. — VNA/VNS Photo Viet Thanh

HA NOI — The number of women diagnosed with secondary infertility has risen by 15-20 per cent, according to the director of the National Hospital for Obstetrics and Gynecology,Nguyen Viet Tien.

Secondary infertility is the inability to conceive after already giving birth and, according to Tien, 50 per cent of couples seeking infertility treatments already have one or more children.

HCM City Reproductive Endocrinology and Infertility Association general secretary Ho Manh Tuong said about 60 per cent of female patients diagnosed with secondary infertility had had an abortion or used intra uterine contraceptive devices improperly.

"These activities often result in infections in the uterus, which can cause severe damage," he said.

Tuong said age was another important factor. By 30, the number of eggs produced declines and after 35, the number and quality of eggs decrease precipitously.

"This drop increases the difficulty of conception and the risk of delivering an unhealthy baby," he said.

Tuong explained why secondary infertility was more popular in urban rather than rural areas. "There is a growing trend that women in cities are getting married later as they have to build their career, which means that the second child is probably expected as the woman is on the verge of her mid-thirties. In contrast, most of women in rural areas are still subject to the tradition of early marriage and short birth spacing."

Tien said about 40 per cent of infertility cases were due to male factors and another 40 per cent to female factors. The remaining cases were either due to factors from both partners or from unknown causes.

About 90 per cent of male issues were sperm abnormalities, the remaining 5 per cent were to do with sexual dysfunction, including sexual desire disorders, erectile dysfunction, or dyspareunia, Tien said.

Tuong explained that sperm abnormalities occurred because male sperm are highly sensitive to their environment, particularly to temperature and chemicals, and citizens in urban areas suffer from heavy pollution and food poisoning.

Tien said: "The number of patients suffering from sexual dysfunction will likely increase because of modern lifestyles that create more pressure."

Quan Hoang Lam, director of the Centre for Embryo Technology under the Institute of Military Medicine, said infertility could be very difficult to treat since it's exacerbated by the mental pressure within families and from society.

Tien said that being able to conceive previously made newly infertile couples angry and frustrated.

"They need to overcome these feelings first before any treatment method can be applied," he said.

A patient who wished to remain anonymous said she had been trying to conceive for two years and four months but hadn't been successful. She tried artificial insemination three times but nothing worked.

"I got married when I was 30 and got pregnant just four months after that. This time it is totally different, and I am extremely worried and desperate because I am just days away from the age of 35," she said.

She said her family was considering traditional medicine as a last resort but was not certain even that would work.

Lam, whose centre treats about 10,000 infertility cases every year, said: "Many patients expect the treatment to have immediate effects while ignoring the fact that the whole process will cost them remarkable time and money and require a great deal of patience."

Lam said another difficulty for patients was that infertility treatments had not been covered by health insurance.

Tien said if the male partner was responsible for the infertility, doctors at Western-style hospitals would deploy several sperm aspiration techniques including ICSI (about a 35 per cent success rate) and PESA, TESA, and IUI (about a 80-90 per cent success rate).

Head of the Gynecology Department at the National Hospital of Traditional Medicine Do Thanh Ha said there was a steep increase in the number of patients seeking treatment, particularly female patients.

According to Ha, traditional medicine can help in some cases but not all. For example, it can rarely treat fallopian tube obstructions but can help with endocrine disorders and multiple follicles on ovaries.

Ha said that unfortunately many couples were drinking quackery remedies like plant extracts prescribed by unlicensed practitioners.

"This kind of treatment poses risks to patients," she said.

Ha said even more dangerous was the misconception that even if these herbal medicines could not induce pregnancy, they would not cause harm.

"In fact, patients who are not diagnosed and treated properly by traditional medicine practitioners still have the possibility of suffering from side-effects. In some cases, had couples come directly to a licensed hospital in the first place, they would not have completely lost all chances of getting pregnant," she said.

Deputy head of the health ministry's Mothers and Children's Health Department Luu Thi Hong said that to prevent secondary infertility, couples should maintain a safe sex life to avoid reproductive problems and unwanted pregnancies. — VNS

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