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Saturday, August 31, 2013

People get married for different reasons. While
some seek companionship in marriage, many go
into it for the purpose of procreation. For couples
who look forward to having children immediately
after marriage, being declared ‘infertile’ by
experts is like a death sentence.
It is generally agreed that it takes two to have a
baby and every couple is expected to be in
optimum health to have babies, medical experts
claim men are having more fertility challenge
now.
Sperm concentration in men is said to have
decreased by a third since 1990s while sperm
count is said to have decreased by half over the
past 50 years.
Studies are also showing genetic abnormalities in
sperm particularly in older men. For men
therefore, quantity, quality and motility of
spermatozoa are seen as important factors in
fertility.
Since the male factor is a prominent cause of
infertility in couples, sperm donation has become
vital in assisted conception treatment.
A study by the Society for the Study of Male
Reproduction stated that “a male factor is solely
responsible in about 20 per cent of infertile
couples and contributory in another 30 to 40 per
cent.”
According to experts, even when sperm numbers
are great, a high proportion of men may have
DNA damage that significantly impairs the
chances of natural conception. Besides, male
sperm deteriorates with age the same way it does
for women.
Studies have also shown that if a man has poor
health, smokes, drinks too much or has a bad diet,
it’s very likely his sperms are also going to be
unhealthy.
Indeed, investigation by PUNCH showed that
sperm has become a commodity in high demand
in Lagos. The Chief Consultant and Head,
Obstetrician and Fertility Department, Eko
Hospitals, Dr. Adegbite Ogunmokun, said fertility
problem, based on recent experience, had tilted
more towards the male factor.
He said, “If 10 couples come in, there will be
problem with the male in six of them, using our
parameter of 20 million sperm per millimetre. But
10 to 15 years ago, maybe about four out of 10
men would have problem.”
PUNCH correspondents, who visited some fertility
centres in Lagos, learnt that more men are having
low sperm count, thus necessitating the need for
more volunteer donors. But because donors are
scare, fertility clinics offer as much as N50,000 to
men who are interested in selling their sperm.
They also pay more when sellers have special
features that the beneficiaries are looking for.
Like blood sellers, investigations show that many
people in Lagos, especially students, now sell their
sperms anytime they need money.
A student of the University of Lagos, who
identified himself as John, said he had sold sperm
to a few fertility centres in Lagos. John said he had
been funding his education for the past two years
with what he earned from selling his sperm.
John said he was introduced to the programme by
a friend and that he had in turn brought in two
other friends to ‘business’.
“I’ve sold to a number of fertility centres. The
money has really helped me to stay in school. It
takes care of my tuition and some other personal
needs,” John said, with a measure of satisfaction.
“It’s cool money, really and I’m also doing a
service to mankind by helping out some people in
need. Even friends that I introduced to it have not
turned back since then.”
An employee in a Lagos fertility clinic, who
identified himself as Olufunsho, told PUNCH that
some women would pay any amount to get a
sperm seller with the features they want.
He said, “We pay N50,000 here but there are
times when women come in and request that, at
all cost, they must get a tall man. The person can
earn more when they make such requests,
especially if we don’t have any that fits the profile
in our bank.
“There was a time a woman came and requested
that we get a tall man for her at all cost. I showed
her the samples we had, but she did not like the
profile. She said she was not satisfied with the
heights. And we were unable to get what she
wanted from the sellers that came at the time.
“The sellers that came then were either AS, or
positive with hepatitis B or had low sperm count.
We had up to twelve sellers that came and we
were unable to get anybody. In such cases, we
could offer a lot more when we find the right
person. Sometimes, such people are also in a
position to negotiate for what they want.”
However, subsequent drops attract lesser
amounts of money for the same seller.
To sell sperm, the person, according to Olufunsho,
must stay off sex for five days. He undergoes
some tests to confirm that he is not HIV positive
and that he also has healthy sperm among others.
He said, “If the same person is still interested and
we still need him, he would repeat the screening
process again. We pay N10, 000 per ejaculation
for other subsequent ones. With my own
discretion, if the quality of the sperm is good and
we have somebody who needs something that
matches perfectly with that seller, we may reduce
the probation period, but the sperm must be very
good.
“Although that is the protocol, it could always be
amended when there is nothing wrong with the
person. Even if someone ejaculates the first time
and in twenty minutes time, he does the same, it
is still going to be good, but not as good as the
first one.”
At the various fertility centres where our
correspondents posed as potential sperm seller,
the clinic workers made keen attempts to have
them start the process immediately, by leaving
blood samples for tests.
On one occasion, a clinic worker told one of our
correspondents that he was willing to waive the
two to five days’ probation period of abstinence,
after our correspondent said he wished to “sleep
over it.”
The worker said, “What is there to think about?
After all, you already said you’re not married. You
can leave your blood sample for testing while you
go ahead and think over it.”
Investigation showed that fertility centres want
sellers between 18 and 45 years of age and
expect them to abstain from sex, two to five days
before giving sperm sample, depending on the
centre.
Other conditions to be met by potential sperm
sellers include testing negative to HIV, syphilis,
hepatitis B and C, sickle cell and some other
sexually transmitted diseases. Tests are also
carried out to determine the count, morphology
(shape) and motility of the sperm cells.
In addition, fertility centres claim to also place a
high premium on average intelligence, education
and lifestyle. Although PUNCH learnt that such
claims are not always true as more emphases are
actually placed on height and other physical
attributes.
“It is not immediately that we pay. We prefer AA
genotype because it can be given to anybody,
unlike AS that cannot be given to just anybody,”
Olufunsho added.
However, an employee in another fertility clinic in
Lagos, Akin, said sperm sellers could get paid
within a week of starting the process. This is
possible only if they satisfy the conditions.
He said, “If the motility is good, the count is good
and you’re okay, then, you can produce for us. If
everything is okay, within a week, you can get
your money.”
A 2012 study into the reproductive health of
26,600 men in France, warned of a sperm crisis
worldwide. It said that sperm concentration has
decreased by a third since the 1990s. The study
found a continuous 32.2 per cent decrease in
sperm concentration over a period of 17 years.
During the European Society of Human
Reproduction and Embryology annual conference
in London in July 2013, some experts, critical of
the study’s validity, said it did not completely
represent the situation in certain areas,
particularly the developing world.
However, a fertility expert at Mother’s World
Care, Ikeja, Lagos, Dr. Margaret Olusegun, said
the situation is similar in Nigeria.
She said, “A man should have a good count, up to
40 to 50 million sperm per millimetre of semen
upward. But you find that these days, men have
more challenges with fertility than women.
“Although, I don’t have the statistics, men are the
ones with more challenges now, even though they
are the ones who drive out their wives if they
can’t bear children.”
Olusegun explained that good sperm should have
“at least 50 per cent motility (activeness) because
sperm cells can be active, sluggish or dead.”
“For morphology (shape) too, which could be
normal or abnormal, sperm should have upward of
50 per cent normal cells. And there should not be
bacteria growth,” she added.
Ogunmokun described low concentration of sperm
as “Oligospermia.” He, however, said a sperm
count with a minimum lower limit of 20 million
sperm per millimetre of semen would still be
considered normal. But he added that any sperm
concentration of less than 20 million per
millimetre of semen could be categorised as mild,
moderate or severe oligospermia, depending on
the count.
Ogunmokun said fertility problems could be with
the man, the woman or the two of them.
PUNCH learnt that the demand for sperm has
made the fertility business a lucrative one. Many
of the fertility centres in Lagos have facilities for
sperm preservation, where it’s freezing costs
about N50, 000 per quarter.
Ogunmokun said, “After collection, the semen is
processed and seminal fluid and all other things
are removed. The sperm is put in little bottles and
placed in special containers called dewars,
connected to a power source. It is stored at very
low temperature and there must be an indicator
for monitoring should there be a change in the
condition.”
He, however, added that there must be a standby
generator in a place like Nigeria, where power
supply is unstable, as sperm can be frozen for
decades.
“Although, there are many other reasons why
people freeze sperm, someone living far away
from his wife can decide to freeze his sperm for
the wife’s use while he’s away. Also, someone
going for cancer treatment can freeze his sperm
before starting the treatment since such
treatments affect sperm production,” he added.
Ogunmokun said fertility centres focus more on
university undergraduates to ensure that sperm
donors have a certain degree of intelligence.
He said, “The current practice is to actually recruit
sperm donors and the focus is on undergraduates.
The focus is on students because they should be
able to provide their ID cards so that background
checks can be done.”
According to Ogunmokun, the perceived increase
in the number of men with low sperm count is as
a result of infection and lifestyle habits like sitting
for too long and wearing of tight underwear.
He said, “The testes are not supposed to be too
close to the body because of the higher body
temperature. The testes are naturally colder, so
people who travel long distances or sit in traffic for
long can be prone to infertility.”
Ogunmokun advised that men should “exercise
appropriately, take good nutrition, avoid tight
underwear, premarital sex, cigarette and alcohol
to try to prevent low sperm count.”
However, Olusegun identified good hygiene as key
to the prevention of low sperm count, saying, “Our
environment is too contaminated.”
Additional report by Gbenro Adeoye
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