We need a lot more baby talk
Fertility expert says there is too much secrecy around treatment:
Itis one of the marvels of modern medicine, an astonishing fertility treatment that has created and transformed lives for generations.
So why, one leading expert will ask this week, is IVF treated like a guilty secret?
Sarah Martins da Silva, a consultant obstetrician and gynaecologist at Ninewells Hospital’s assisted conception unit in Dundee, will chair a conference to boost awareness and discussion around fertility treatment – first pioneered in the UK 40 years ago.
Dr Martins da Silva, named by the BBC as one of the 100 women of 2019, said: “It’s not largely talked about. Perhaps because its embarrassing, perhaps because people are ashamed they can’t conceive, perhaps because it can be a long process with heartbreaking results.
“Even within the medical profession, information about treatment is not routinely included in a patient’s medical records.
“So if a patient was being seen by gynaecology next door, they wouldn’t have access to someone’s IVF history as it’s locked away in a cabinet with us in assisted conception.
“The secrecy isn’t doing the topic any favours. Talking about infertility is key to bringing it into modern-day society – and to fixing it.”
Dr Martins da Silva and her research team focus on male infertility, an area she has become fascinated with since joining the unit eight years ago, after studying development of the ovary.
Now the mother of three is on a mission to make male infertility a thing of the past.
Sperm count levels have fallen by 50-60% in the last four decades.
And Dr Martins da Silva, who splits her time between seeing patients, working in the lab and delivering babies, believes failing to address the issue could potentially spell an end to the human race.
“The statistics are terrifying,” she said. “One in 15 men have a problem with their sperm.
“And one in 110 men have no sperm at all. We really don’t know why sperm counts are falling – and how much of a crisis point do we need to get to before we really address what’s going on? If we don’t look at the problem soon, we’re going to end up with a zero sperm count. If that happens, nobody can get pregnant.”
When an issue of male fertility arises, the option is to treat the female with IVF or similar.
But Dr Martins da Silva, 48, is hoping to change that by researching a treatment option for men.
“The onus seems to fall on the woman to sort contraception and fertility out,” she said. “It’s crazy because I can’t think of any other scenarios in medicine where we say, ‘we can’t treat you sir, but we can treat your partner instead’.
“Sperm are very tricky cells. We don’t understand how they operate. Sperm count and swimming is a huge part of what we see in the clinic – in fact it’s the issue in around half the cases we see – and we don’t know how to treat it.
“There are so many couples who can’t conceive because the male has a low sperm count and there is nothing we can offer him.
“That galvanised my focus on how do we go from a group of scientists looking at biology to making a difference for these patients.”
Dr Martins da Silva’s research focuses on how sperm works, with a particular emphasis on the function of the sperm-specific calcium CatSper channel which can help them swim.
“If there’s a problem with the way calcium is internalised there can be fundamental issues with a man’s fertility,” she explained.
“We have found various pesticides that can affect the way that channel works. We are now trying to identify drugs to make that channel work better.”
From 3,400 drugs, the Dundee researchers have identified two promising ones that appear to help sperm swim better. They’re also working on a male contraceptive, after securing funding from the Bill and Melinda Gates Foundation.
“We’re not close to a breakthrough yet, but we’re working on it,” said Dr Martins da Silva.
Education, however, could spell a breakthrough for fertility rates.
“At the moment, we teach teens about reproduction, contraception, STDs and unwanted pregnancy and I’m a huge advocate of that.
“But what we don’t tell them is when they get to a certain age, they are less likely to be able to conceive.
“So many couples think they don’t want a baby because they are busy with their careers, and think they’ll ‘get to it one day’.
“What they don’t realise is that their fertility will dwindle. There’s a misconception that fertility problems are rare, but they’re actually common.
“One in six couples of reproductive age can’t conceive.”
‘ Soon we’re going to end up with a zero sperm count and nobody will get pregnant