Speaker 1: Medical Matters.
Speaker 2: All right, it's time now for our Medical Matters feature,
Speaker 2: and today we're speaking about something that's a you know,
Speaker 2: can be a really sensitive matter for many, especially people
Speaker 2: that are struggling with infertility. We speak about how infertility
Speaker 2: affects millions globally and how more of us may be
Speaker 2: at risk of being infertile or may be suffering from
Speaker 2: infertility without even knowing it. Our guest on the show
Speaker 2: this evening is doctor Lusanda Shiman gemss, a fertility specialist
Speaker 2: and director at med fem Fertility Clinic.
Speaker 1: Doctor Lusander, Good evening, and welcome to the show.
Speaker 3: Good evening, and thanks so much for having me.
Speaker 1: Yeah, fantastic.
Speaker 2: I mean, you know, I want to start with with
Speaker 2: our conversation just on I've been reading about how quite frankly,
Speaker 2: if you or the official definition of infertility is if
Speaker 2: you do not pregnant quote unquote, and please rectify me
Speaker 2: under trying for about twelve months.
Speaker 1: That's not a lot of time of trying, is it.
Speaker 3: No, it's not. And you know, the definition is actually
Speaker 3: really interesting and I personally don't particularly like it because
Speaker 3: I think it's very prescriptive and once you tell someone
Speaker 3: it's time to fall pregnant for a year, chances are
Speaker 3: they're going to be so stressed that they might just
Speaker 3: actually struggle to poll pregnant. So there is the textbook
Speaker 3: definition of below the age of thirty five years twelve
Speaker 3: of regular sexual intercourse, and then if you don't fall
Speaker 3: pregnant within those twelve months with regular sexual intercourse, then
Speaker 3: it's defined as infertility or above the age of thirty
Speaker 3: five six months of regular sexual intercourse. So the reason
Speaker 3: why I personally don't necessarily subscribe to it is that
Speaker 3: if you tell someone that Okay, fine, go and like
Speaker 3: I said, going for pregnant, you are above the age
Speaker 3: of thirty five, you've got six months to fall pregnant.
Speaker 3: That that's quite a stress and stresses is one of
Speaker 3: the contributors to infertility. But do not incorrect in saying
Speaker 3: that if you look it up, that's exactly what they'll
Speaker 3: give you.
Speaker 2: So I mean by that definition that would basically mean
Speaker 2: a lot more of us are struggling with infertility issues
Speaker 2: than we realize.
Speaker 3: Well, this is the whole thing. If you can categorically say, Okay,
Speaker 3: on this date, right on the seventh of July, I'm
Speaker 3: going to try and fall pregnant, and and I've got
Speaker 3: I'm giving myself till next year July on the seventh
Speaker 3: to fall pregnant. Then are you really infertile or is
Speaker 3: there something physiological that's preventing you from falling pregnant? So
Speaker 3: is it really infertility or are you struggling to fell
Speaker 3: pregnant and therefore you need some assistance.
Speaker 2: Okay, So I know that you don't like the textbook definition, Sophie,
Speaker 2: give us your definition of infertility.
Speaker 3: No, you know it's not even I mean, I'm not
Speaker 3: going to go against the grain and say, oh gosh, no,
Speaker 3: this is doctor she manuments also definition or something that
Speaker 3: once you are of reproductive age and you know that
Speaker 3: you want to conceive, and you know that you are
Speaker 3: really conceived, there's nothing wrong with going to get checked
Speaker 3: out to see that everything is in order, more than anything.
Speaker 3: And if you see that it's not happening sooner rather
Speaker 3: than later. And I'm just really saying this because we're
Speaker 3: seeing a lot of couples above the age of thirty five,
Speaker 3: above the age of forty who are coming to us
Speaker 3: and they want for pregnant. And you know, there's a
Speaker 3: concept of a variant agent, which really is a non
Speaker 3: modifiable factor. So it's not to say that look, okay, fine,
Speaker 3: put yourself within the definition. But I'm just saying, once
Speaker 3: you know that you want to be a parent, it's imperative.
Speaker 3: Or I'd highly suggest that you are in touch with
Speaker 3: some sort of health practitioner who can at least guide
Speaker 3: you in the right direction. Should you not feel pregnant,
Speaker 3: and do I think it needs a year? I don't
Speaker 3: think so. I think when you're ready, you're ready, And
Speaker 3: you don't think that a lot of us are walking
Speaker 3: around and we don't know if we've got something going
Speaker 3: on or not. And I'm saying, just get assessed sooner
Speaker 3: rather than later. A case example is they say someone
Speaker 3: with polycystic ovarian syndrome, which which is a hormonal imbalance
Speaker 3: that occurs a woman of reproductive age. If you don't
Speaker 3: know that, you've already got that and now you are
Speaker 3: going to go for a whole year to try and
Speaker 3: fell pregnant and all we have to do is sort
Speaker 3: that out. Wouldn't it be great if you find that
Speaker 3: out when you decide to conceive, so that it can
Speaker 3: actually happen and not take a whole year. Do you
Speaker 3: know what I mean.
Speaker 2: So, I mean, yeah, what are some of these factors
Speaker 2: you know that affects or call they cause infertility? As
Speaker 2: you've said it till I've heard it before. You know,
Speaker 2: you're as told. Overthinking is a big problem.
Speaker 3: So when we look at infertility and what really causes it,
Speaker 3: we have to first of all, I just want to
Speaker 3: say that it can be a female factor, and it
Speaker 3: can be a male factor, but I really want us
Speaker 3: to shift to the narrative of it's a couple issue
Speaker 3: and not necessarily one or the other. That is really
Speaker 3: important that we put that out there. And then going further,
Speaker 3: we need to see is their medical problem, is the
Speaker 3: genetic problem, is a lifestyle problem? Is it a hormonal problem?
Speaker 3: And then more so is it a structural problem? So
Speaker 3: just I'm expanding further on those different categories. So let's
Speaker 3: just say if it's a structural problem, you do get
Speaker 3: some women who are born without utresses, so they don't
Speaker 3: have a wound, and they may not know that. So
Speaker 3: that's important that we find that out sooner rather than later.
Speaker 3: And then you may ask, but how would you know that?
Speaker 3: So someone who's not going on the period has never
Speaker 3: had a period, and has never had a period, and
Speaker 3: therefore that person needs to be checked out because it's
Speaker 3: not normal for a woman of reproductive age to not
Speaker 3: have a period. And then if we go to things
Speaker 3: like medical disorders, does this person have a thyroid problem
Speaker 3: that we need to look at, and that is one
Speaker 3: of the big things that smith is their genetic issue
Speaker 3: or lifestyle. What type of lifestyle does this person need,
Speaker 3: you know, in terms of work, do they have work stresses,
Speaker 3: they don't exercise, they eat unhealthy, they are smokers, and
Speaker 3: so forth. And then hormonal problems. One of the big
Speaker 3: ones is the polycystic of wear in syndrome that I mentioned,
Speaker 3: So that is just really like the woman. And then
Speaker 3: it comes to the men, and the men we have
Speaker 3: to check. First of all, you need sperm to fell pregnant,
Speaker 3: So do they have a low sperm count? Do they
Speaker 3: have abnormal looking sperm, or do they have sperm that
Speaker 3: does not really move properly in other words, so that
Speaker 3: it can go through the wounds into the tubes and
Speaker 3: then fertilize their egg. Or is there a gland problems
Speaker 3: such as your thyroid. Is there a structural problem there
Speaker 3: is obstructions that does not allow the sperm to necessarily
Speaker 3: go into the women's reproductive tract or are they impotence
Speaker 3: Do these guys are they getting an erection, you know,
Speaker 3: or if they do get an erection and they ejaculate,
Speaker 3: are they actually producing sperm or not. So there are
Speaker 3: various factors, and that's why I come back to I
Speaker 3: think it's you know, when you've decided that you want
Speaker 3: to have a child, is go and visit your healthcare
Speaker 3: provider and just you know, you just made it, make
Speaker 3: it known that you want to have a child. There's
Speaker 3: a few simple blood tastes that need to be taken
Speaker 3: and an examination just to see if there is something
Speaker 3: that needs to be fixed or not.
Speaker 2: Lussander, I mean, at what point should a couple say,
Speaker 2: maybe we should get checked out? You know, having spoken
Speaker 2: to and family who suspects that they may be struggling
Speaker 2: with infertility issues, many of them will say, oh, just
Speaker 2: keep try and relax, don't overthink it, don't stress.
Speaker 1: It will come.
Speaker 2: But at what point should one go maybe or maybe
Speaker 2: the couple go, maybe we should get checked out.
Speaker 3: Well, look, one of the things that we need to
Speaker 3: look at is how old is the couple. So an
Speaker 3: older couple. Definitely sooner rather than later. We cannot be
Speaker 3: forty one forty two and we're just you know, trying
Speaker 3: to relax and see what happens in our lives and
Speaker 3: then if it doesn't happen, then we'll go. I want
Speaker 3: to see that couple as in yesterday, because then I
Speaker 3: can do investigations and I can have a frank conversation
Speaker 3: with them as to what's possible, what's possible, what we
Speaker 3: should look out for a younger couple. So let's just say,
Speaker 3: I don't know what age people get married these days.
Speaker 3: I've been married forever, so but let's just let's give
Speaker 3: or take people get married. I want to without touching
Speaker 3: any nerves at the age of twenty nine. Okay, So
Speaker 3: they get married at the age of twenty nine, and
Speaker 3: then they want to spend a year by themselves, and
Speaker 3: then the following year they're going to try and for pregnant.
Speaker 3: With that couple, we've got more time in order to
Speaker 3: try and for pregnant, So that definition of a year
Speaker 3: comes into play. But with that being said, when I
Speaker 3: think of when we talk about the women, this woman
Speaker 3: must be having regular mastrol cycles. You know, we can't
Speaker 3: have someone who's having irregular metroal cycles and then they
Speaker 3: are trying for a year. Once you have irregular metrol cycles,
Speaker 3: something is wrong and you need to get seen. So
Speaker 3: that couple, I would not give an extended period of time.
Speaker 3: I would want them to get seen sooner rather than later.
Speaker 3: Or if let's just say she was mestruating at some
Speaker 3: point and then stopped menstruating, that person, I'd like to
Speaker 3: see sooner rather than later. Or if they's now they're
Speaker 3: starting to go a beard which they never had, or
Speaker 3: they had been having a beard that they've been shaving off,
Speaker 3: that person, i'd want to see sooner rather than later.
Speaker 3: And then in terms of the guys, if they're having
Speaker 3: premature ejaculation, obviously they're having pre mature ejaculation. By the
Speaker 3: time there's penetration, you've already ejaculated, so you are going
Speaker 3: to find it a bit difficult to for pregnant. So
Speaker 3: I think where I would really come in is to say,
Speaker 3: if you feel something is wrong or you feel you
Speaker 3: need to consult, there's nothing wrong with having that first consultation,
Speaker 3: having investigations done, getting assessed, and then you know where
Speaker 3: your baseline is or where your standpoint is rather than no,
Speaker 3: let's just wait, let's just wait because a lot of
Speaker 3: couples actually put it off for it's longer they're necessary,
Speaker 3: and then by the time you know, by the time
Speaker 3: they come and see us, it's either now the old
Speaker 3: or the egg reserve is low, or the sperm count
Speaker 3: has been abnormal all this time and now we're only
Speaker 3: discovering it. So I think once you think about it,
Speaker 3: so if there are couples out there and they feel sure,
Speaker 3: we've been at this for I don't know, six months,
Speaker 3: they will take rather just go and see someone. Go
Speaker 3: and see your Guyanese so that you know, you can
Speaker 3: at least have the conversation, so you understand because I
Speaker 3: only say people, it's actually quite difficult. We see a
Speaker 3: lot of babies running around and so forth, but it's
Speaker 3: not it's actually hard to feel pregnant, and it's even
Speaker 3: harder when there is an issue. Sure.
Speaker 2: I mean, I've been wondering whether it is infertility becoming
Speaker 2: more prevalent, or is it the awareness and the speaking
Speaker 2: about it that's making it seem like more and more
Speaker 2: people are infertile.
Speaker 3: I think there's a subset of I actually call it
Speaker 3: a silence pandemic, and I think we're not vocal enough
Speaker 3: about it. I mean, it's at takes one in six
Speaker 3: couples globe. You know that that's quite that's quite a
Speaker 3: big number. But how many people actually openly speak about,
Speaker 3: you know, they're struggling to fall pregnant. Right now, there's
Speaker 3: a whole global movement which is break the taboo, and
Speaker 3: it's really break the taboo and speak about your infertility journey,
Speaker 3: regardless of what it is. And I think it's not
Speaker 3: necessarily that it's becoming you look that you can say
Speaker 3: it's becoming more prevalent because lifestyle has changed, you know,
Speaker 3: and and the job market has changed. Women are coming
Speaker 3: up corporate ladders. You know, they're putting all falling pregnant
Speaker 3: till they're much older. And that's where I'm like, okay, guys, now,
Speaker 3: let's start social freezing. Then freeze your age when you're
Speaker 3: younger so that you've got options later on in life.
Speaker 3: So in terms of prevalency is different factors. You know,
Speaker 3: now women are working in the minds and there's there's
Speaker 3: a concept called endocrime disruptors, so environmental factors that can
Speaker 3: affect your fertility so there is different reasons why women
Speaker 3: may becoming fertile. But I also think there is a
Speaker 3: subset of women who are actually happy to speak about it.
Speaker 3: I mean, when I think about our fertility clinic, it's
Speaker 3: been around for thirty years, you know, so it's been
Speaker 3: a long time since people have been struggling to fell pregnant.
Speaker 2: You know, you speak about freezing eggs, But how accessible
Speaker 2: is that doctor? Because I'm wondering, I can't even think
Speaker 2: where I would start if something to deb that conversation.
Speaker 3: And I'm so glad you're actually mentioning that. And that's
Speaker 3: where the problem is, is that are we actually having
Speaker 3: the conversation. Are we saying to someone who is twenty five,
Speaker 3: has just gotten into the job market. Are we talking
Speaker 3: about what are your aspirations in your job market? Are
Speaker 3: you considering being a parent at some point? At what
Speaker 3: point are you considering being a parent? And then you
Speaker 3: start having the conversation about, you know, the older you get,
Speaker 3: there's a concept of ovarian aging. This is a non
Speaker 3: modifiable factor. You're are forty five, or your eggs are
Speaker 3: thirty and so forth. So where would you start? And
Speaker 3: it starts with the first point of contact with any
Speaker 3: health care provider, and that's where we are really, that's
Speaker 3: where the gap is. So even if you like, I
Speaker 3: don't know, just random, you're going to see your dentist,
Speaker 3: you know, for your six month check up, but you
Speaker 3: don't see any other doctor. The only person you see
Speaker 3: is your dentists because you're so you know, intentional about
Speaker 3: having dental health and it's for that dentist to say, listen,
Speaker 3: actually i've been doing your teeth for quite a while.
Speaker 3: What is happening with you in terms of you know,
Speaker 3: fertility and so forth. Do you want to be a
Speaker 3: parent And you're like, yes, actually I do, but not
Speaker 3: right now. Maybe and I'm a bit older, and it's
Speaker 3: that well, you know, there is maybe you should go
Speaker 3: and see a guy, and you're going to see a
Speaker 3: fertility specialist in terms of guest seeing what your options
Speaker 3: are if you're going to put or falling pregnant, And
Speaker 3: that's where the conversation begins. And we're not having those conversations.
Speaker 3: We really just have them at dinner parties. If someone
Speaker 3: just happens to mention that they say they went to
Speaker 3: and made same fertility clinic, and they froze the eggs
Speaker 3: and then everyone gets excited like, oh my gosh, so
Speaker 3: what does it entail? What did you do? You know?
Speaker 3: And I want us to start having all those conversations
Speaker 3: because then I think it will sat out a lot.
Speaker 3: It just gives you options. So it's not to say
Speaker 3: when you're older you will struggle. You know, you won't
Speaker 3: feel pregnant. It just means that in the events that
Speaker 3: you do struggle, you've got these thirty year old eggs
Speaker 3: which are sitting there waiting to be used.
Speaker 2: You know. I'm actually thinking back to the first time
Speaker 2: I became aware. Maybe I was aware, but the first
Speaker 2: time I was actually confronted with the reality of freezing
Speaker 2: eggs was through a TV show called Being Mary Jane.
Speaker 1: I don't know if you remember that show.
Speaker 2: There was a show called and Mary Jane had decided
Speaker 2: to do that because she was having so many issues,
Speaker 2: you know, in terms of relationships and she wasn't finding
Speaker 2: the one right then out of thinking in the South
Speaker 2: African context, do people go to the guyany and what
Speaker 2: does that process.
Speaker 1: Even look like? Doctor?
Speaker 3: So basically, once that thought is in your head, is
Speaker 3: two on your Guyanese visits that you have or even
Speaker 3: if you if they say you're doing your pap smears
Speaker 3: at a GP, even that conversation can really begin there
Speaker 3: to say, look at the moment, I'm a single person,
Speaker 3: right and I'm working and so forth, and I don't
Speaker 3: know if I have a prospective partner or not, and
Speaker 3: what options do I have in terms of fertility preservation.
Speaker 3: It's a very easy answer. It would be like, look,
Speaker 3: consider freezing your eggs. Okay, so what does that entail. Well,
Speaker 3: you'll need to go to a fertility specialist and basically
Speaker 3: we do explain that to to to the patient. And
Speaker 3: mind you, it's not just about freezing eggs. You can
Speaker 3: free sperm as well, So the conversation really starts there.
Speaker 3: And then in terms of what it entails, basically is
Speaker 3: injections that we give which we basically we want to
Speaker 3: get as many eggs as possible, so we grow the
Speaker 3: follicles up to a certain size, and then after that,
Speaker 3: once we track them via ultrasound, and we'll give you
Speaker 3: other medication to stop you from augulating so that you
Speaker 3: don't lose the eggs. And when we ready, then we
Speaker 3: do what we call a trigger. So to always explain
Speaker 3: it to my patients where I'm like, think of an egg,
Speaker 3: like you know, a chicken egg that we make for breakfast.
Speaker 3: So we want that egg to grow, and then at
Speaker 3: a certain size, we give you an injection so that
Speaker 3: we can go and so that we can soften the
Speaker 3: egg shell so we can go and take out the
Speaker 3: egg white and hopefully that egg white will find an
Speaker 3: egg yolk and that's what we freeze. So it's quite
Speaker 3: a simple process which takes around to give or take
Speaker 3: two weeks. So it's something and a lot of women
Speaker 3: are doing it. A lot of women are actually waking
Speaker 3: up to the fact that, look, I'm not in a relationship.
Speaker 3: I don't know what my prospects are. But what I
Speaker 3: really love about social freezing of eggs is that it
Speaker 3: gives the woman reproductive freedom. It says, I'm not waiting
Speaker 3: for mister Wright to come, because what happens if mister
Speaker 3: Wright comes at forty five?
Speaker 1: Hey?
Speaker 4: You know?
Speaker 3: So it gives that woman that reproductive freedom to decide
Speaker 3: when she wants to parent and how she wants to parent.
Speaker 2: So we're talking in fertility with doctor Lucander Shimange Masource,
Speaker 2: who is a fertility specialist. This is our Medical Matters
Speaker 2: feature that we have on a Monday. Really interesting conversation here.
Speaker 2: I'm going to open up the lines and invite any
Speaker 2: of our callers who are interested or I have questions
Speaker 2: around fertility, whether they are personal questions, we want to
Speaker 2: hear from you. There A double one double a three
Speaker 2: seven two oh to one double four six five six seven.
Speaker 2: All right, So doctor, you spoke about lifestyle changes. How
Speaker 2: important is diet when one is trying to feel pregnant?
Speaker 3: That is important, and you know, and that's the one
Speaker 3: I suppose that's the one part that's really overlooked because
Speaker 3: we live in such a different world where you just
Speaker 3: order your food online, it gets delivered to your door.
Speaker 3: You don't know how it's cooked, you don't know who
Speaker 3: cooked it, and so forth. And I think that's why,
Speaker 3: you know, long time ago, women were really just having
Speaker 3: It was not abnormal to say, you know, we hear
Speaker 3: my grandmother had nine kids, you know, because they really
Speaker 3: actually had an organic diet, they ate what they planted.
Speaker 3: And now we are in a fast culture where it's
Speaker 3: just a matter of just putting something in the microwave
Speaker 3: and you know, and eating it, or in the a
Speaker 3: fryer and eating it and we're not cooking our food anymore.
Speaker 3: We don't know what's actually going into our food, so
Speaker 3: we have to look at you know, inflammation does play
Speaker 3: a big part, and what are those inflammatory foods? You know,
Speaker 3: so when you know your process, cover hydrates your process
Speaker 3: and your processed foods and so forth. So diet does
Speaker 3: play a big part. But it's not to say you
Speaker 3: have an unhealthy diet. You can't fall pregnant, because someone
Speaker 3: can easily phone now and say, look, I've been eating
Speaker 3: McDonald's all my life, or I've been eating fast food
Speaker 3: all my life and I've got four kids. That those
Speaker 3: people are outliers. But for someone who really is struggling
Speaker 3: to for pregnant, I will always gauge the diet aspect,
Speaker 3: like what do you actually eat, you know, and how
Speaker 3: is it affecting your body. But with that being said,
Speaker 3: I think in general we all need to check ourselves
Speaker 3: in terms of our lifestyles and what we're doing, because ultimately,
Speaker 3: let's just say you do for pregnant with this unhealthy lifestyle,
Speaker 3: you bring a child into the world, you really want
Speaker 3: to die young and leave this child without a parent.
Speaker 3: And that the part that we actually don't think about
Speaker 3: you know, we've all got bragging rights about how it
Speaker 3: felt pregnant, drinking every day and I've been smoking since
Speaker 3: our sixteen and eating false food. But then what does
Speaker 3: your lifespan look like and what happens to that child?
Speaker 3: So definitely, lifestyle diet definitely does play.
Speaker 1: Impact for both men and women.
Speaker 3: It definitely for both men and women. Definitely definitely, because ultimately, yes,
Speaker 3: a man will produce sperm, but what is the quality
Speaker 3: of that sperm. Does it have a potential to fertilize
Speaker 3: an egg because we look at we have to look
Speaker 3: at how you know, well, like I said to the number,
Speaker 3: how it moves, how it looks, does it have binding capacity?
Speaker 3: So it's definitely both men and women. And that's why,
Speaker 3: you know, what I always say is that this is
Speaker 3: a couple things. It's not either all. So if one
Speaker 3: is going to be on a healthy lifestyle chain, both
Speaker 3: of you must be on that train.
Speaker 2: And just you know, I think that there's an element
Speaker 2: also around shame when it comes to fertility, where couples
Speaker 2: come to you as a last resort, but oftentimes you know,
Speaker 2: or sometimes you know, one partner may may have a
Speaker 2: bit of shame, you know, around not being able to conceive.
Speaker 2: How does one go about addressing that, particularly when you
Speaker 2: come into contact with couples that are desperate to hoole
Speaker 2: pregnant but really don't want to be there in your office.
Speaker 3: You know, I think I have the fortune of having
Speaker 3: worked to people most of my adult life just by
Speaker 3: virtue of the job that I do. So you tend
Speaker 3: to you know, you talk, you see the couple, You
Speaker 3: talk to the couple, and you can see when someone's uneasy.
Speaker 3: And this is where a reproductive psychologist comes in. So
Speaker 3: in our clinic, we've actually got a psychologist, and I'm
Speaker 3: the first person to say, look, I can see you
Speaker 3: very uncomfortable with the results that I've given you, or
Speaker 3: you're uncomfortable with being here, and I get it. I
Speaker 3: get it in that you know, the ones that you've
Speaker 3: probably succeeded in everything that you've done in your life,
Speaker 3: and the one thing that it's just supposed to happen
Speaker 3: naturally is not happening, and you may be struggling to,
Speaker 3: you know, to deal with this. So we refer, we
Speaker 3: do refer to a psychologist who will unpack everything. By
Speaker 3: the time people come into the facility, clinics. They've conceded
Speaker 3: to the fact that we are struggling and we need help.
Speaker 3: And you know, once you step into that door, then
Speaker 3: it's one of those where okay, guys, now we're going
Speaker 3: to be open with each other and we are going
Speaker 3: to work together in all this. Very rarely you will
Speaker 3: get people who will say, I really don't want to
Speaker 3: be here. My wife has forced me to be here,
Speaker 3: you know. I think way it becomes a bit of
Speaker 3: a challenge is once you get to a fertility clinic,
Speaker 3: you know, by virtue of what we do, you know,
Speaker 3: with assisting couples, and it's a lot to say they
Speaker 3: can't for pregnant spontaneously. But is when there's an insistent that, yes,
Speaker 3: we want your help, but we don't want iva for
Speaker 3: anything like that. We want for pregnant spontaneously. That's really
Speaker 3: where the challenge comes because it limits us in terms
Speaker 3: of what we can actually do as fertility specialists. But
Speaker 3: once they walk in, they've decided that okay, we need
Speaker 3: help and we are here.
Speaker 2: Zara double one, double eight, three seven two, that's the
Speaker 2: number to dial if you have questions for doctor Lussanda Shimange.
Speaker 1: Must all say.
Speaker 2: Who's talking us through infertility and fertility issues. She's helping
Speaker 2: us make sense of you know, infertility and what a
Speaker 2: difference early action or early detection can make. And yeah,
Speaker 2: I want to invite you to be part of that conversation.
Speaker 2: I want to hear from people who have struggled with
Speaker 2: fertility or are currently struggling, or if you think that
Speaker 2: you may you know, you may be having issues, or
Speaker 2: you could have issues. I really want to hear from you.
Speaker 2: We've got doctor Shermange here to help us make sense
Speaker 2: of your questions and give you the answers that you
Speaker 2: may need to please get in touch in touch with us,
Speaker 2: and our callers have the tendency of calling towards the
Speaker 2: end of the hour and they're not getting the answers
Speaker 2: that they require. You'll find people calling at fifty five,
Speaker 2: at fifty three, or you know, seven minutes to the hour.
Speaker 2: So I want to encourage you to call now if
Speaker 2: you have a question so that we can address it
Speaker 2: with doctor Shimangem. Maybe my next question that doctor Missander is,
Speaker 2: I mean, how much of a bearing does the psychological
Speaker 2: aspect have on fertility issues? You know, you often hear
Speaker 2: people saying you're overthinking it, You're overthinking the whole thing.
Speaker 1: But is it really start.
Speaker 2: I mean, I can imagine stress, as you said, and
Speaker 2: but does I have as much a bearing on fertility
Speaker 2: when people overthink conception.
Speaker 3: It's interesting that you say that, and I was hoping
Speaker 3: we're really going to address this. So when I think
Speaker 3: about my journey, so I didn't have any fertility treatment
Speaker 3: to anything like that, I just want to say that,
Speaker 3: you know, I had all my kids spontaneously, but I'm
Speaker 3: thinking back to when we're trying for our first child,
Speaker 3: and you know, based on your question, I think there
Speaker 3: was an element of overthinking and it just was not happening,
Speaker 3: you know, first man, second month, and I'm like, what
Speaker 3: is wrong? So I was so I was ready to
Speaker 3: go and see a fertility spacialist by man five. You know,
Speaker 3: not because of anything, but I'm like, but because it
Speaker 3: was just that expectation that is going to happen. And
Speaker 3: then when I stopped, you know, because this is exact
Speaker 3: and so forth, and you know, sat down with my
Speaker 3: husband and I was like, oh my gosh, you know,
Speaker 3: we get pregnant. Now you know what's going to happen
Speaker 3: with exams and all that, so maybe we should just
Speaker 3: like shelve it for now and we'll start it going.
Speaker 3: So we literally just like stopped overthinking, and then we
Speaker 3: felt pregnant, you know. So there isn't because it does
Speaker 3: get technical. It really does be technical, because now you'll
Speaker 3: have a woman's like, no, no, no, we can't have sex
Speaker 3: now because I'm not ovulating, you know, I'll there, you know.
Speaker 3: And then the poor guy's straight now he's supposed to perform,
Speaker 3: and then he has performance anxiety. So there is an
Speaker 3: element of that. But what I really want to stress
Speaker 3: upon is the mental part or the psychological part, which
Speaker 3: is really the silent cost to infertility, were either a
Speaker 3: couple can't talk about the challenges that they have so
Speaker 3: they're basically suffering in silence, or the couple can't go
Speaker 3: and talk to someone and they don't know what to do.
Speaker 3: And and almost like there's a shame in that we
Speaker 3: are struggling to feel pregnant, you know, and and and
Speaker 3: and that is the part which I really wish we
Speaker 3: could just get over that. It's okay, it's okay if
Speaker 3: you're struggling to fell pregnant, because you can actually get help.
Speaker 3: So there is there is that one part where a
Speaker 3: couple start overthinking it and then you've got all the
Speaker 3: apps and you've got all the ovulations and you're just
Speaker 3: you're doing a lot, and you know, then you're not
Speaker 3: even lovers anymore.
Speaker 1: Yeah, it takes your fun out of sexy.
Speaker 3: Time exactly missions to get pregnant, you know. And we
Speaker 3: see that often. We see that often, and I do
Speaker 3: say to my couples, I'm like, listen, while we're working
Speaker 3: on you guys falling pregnant, don't forget why you felt
Speaker 3: you got together in the first place. Don't forget that
Speaker 3: you are still lovers. You're still a couple. So it's
Speaker 3: you're still a couple, So it's okay to just actually
Speaker 3: enjoy being with each other, you know. And I think
Speaker 3: that is so important because it's I think it's just
Speaker 3: kind of like as an element of it doesn't have
Speaker 3: to be a job, you know, it does not have
Speaker 3: to be a job. And I think it and it
Speaker 3: happens without you even realizing that. It's just that you know,
Speaker 3: we can I mean, jeez, you can. You can definitely
Speaker 3: depict it, you know, from the consultation. So there is
Speaker 3: definitely a psychological aspect to it. But there's also the
Speaker 3: other side, because couples do break up trying to feel
Speaker 3: pregnant and it doesn't happen, you know, couples do get
Speaker 3: depressed and do get anxious. So that is the one
Speaker 3: part that we really always need to address. And I
Speaker 3: always ask, like, you know, so how are you doing?
Speaker 3: You know, how are actually how are you dealing with this?
Speaker 3: And especially when you know the guys sometimes struggle to
Speaker 3: open up. Eventually they do because they realize, look, there
Speaker 3: is no judgment here. We just want to help you.
Speaker 2: Sure, let's take some calls. Gaylee, you're in Pretoria and
Speaker 2: you've got a question on freezing eggs.
Speaker 1: Welcome to the show.
Speaker 3: I a listening commodore and the.
Speaker 5: Doctor Hi, go ahead.
Speaker 6: Yes, thank you so much for insight for and yeah,
Speaker 6: very important topic. So I just I've got actually one
Speaker 6: question for the doctor. So I'm forty three this year, okay,
Speaker 6: and what I wanted to know One can I still
Speaker 6: freeze my eggs at forty three or are they too old?
Speaker 6: And number two, what would be the cost for for
Speaker 6: for yeah, for for for freezing eggs, like just a
Speaker 6: rough estimate of how much I would be looking at?
Speaker 6: Thank you and listen online doctor the signer.
Speaker 3: Thank you Gailen for that very important question and the
Speaker 3: one thing I mean, I'll discuss the custo and so forth,
Speaker 3: but the one thing that you mentioned is I'm forty three.
Speaker 3: Should I still freeze my eggs? Or am I too old?
Speaker 3: And you know, I think gone are the times where
Speaker 3: doctors make decisions for patients. It's a conversation that you
Speaker 3: need to have. So how would it would go with me?
Speaker 3: Let's just say I'm like, okay, listen you forty three.
Speaker 3: And obviously our gauge the ovarian aging, which is a
Speaker 3: big thing. Age is a non modifiable factor, and I
Speaker 3: would have done all the investigations. But I'll also ask
Speaker 3: why are we freezing? Why aren't we having a baby?
Speaker 3: So I would want to know the reasons for that,
Speaker 3: and would also talk about the quality of the eggs,
Speaker 3: you know, to say, do you want to freeze eggs?
Speaker 3: Obviously there will be investigations that will be laid with,
Speaker 3: but ultimately the quality of the eggs would be a
Speaker 3: big thing in this situation as to let's just say
Speaker 3: we go and we freeze your eggs. We are not
Speaker 3: going to freeze twenty eggs. We may be lucky if
Speaker 3: we freeze one or two eggs, and then once we
Speaker 3: freeze those eggs, they still need to be fertilized by
Speaker 3: sperm at some point, and when they get fertilized, they
Speaker 3: need to get to what we call a blastocyst stage,
Speaker 3: so a day five. So we need to actually create
Speaker 3: a baby with these eggs, you know, And this right
Speaker 3: now the success rate is actually quite low. So it's
Speaker 3: a matter of you've got this information, what do you need?
Speaker 3: What do you want to do? A lot of our
Speaker 3: patients over the age of forty so forty three forty
Speaker 3: two actually end up using donut eggs, which are younger eggs,
Speaker 3: which has a better chance of success. So to answer
Speaker 3: her question, should she freeze eggs at forty three, I'm
Speaker 3: saying at forty three, please have a baby? Can we
Speaker 3: help you have a baby at forty three, not help
Speaker 3: you freeze eggs?
Speaker 4: You know?
Speaker 3: And that's what I say because remember also the older
Speaker 3: you get, you've also got increased risks of congenital abnormality,
Speaker 3: So having abnormalities worth the babies. So I think that
Speaker 3: is really just a frank conversation to have. Is it
Speaker 3: worth freezing eggs at the age of forty three. I
Speaker 3: wouldn't entirely recommend it, but there are some patients who
Speaker 3: insist on it. But as long as they have their
Speaker 3: information and they make an informed decision, then you know.
Speaker 3: There's a point of departure in terms of cost with
Speaker 3: freezing eggs. And let me just say we are freezing
Speaker 3: and not necessarily going to fertilize, just really keeping them there.
Speaker 3: There is a cost permans. It differs from clinic to clinic,
Speaker 3: and I'll be lying if I give you absolute values,
Speaker 3: but rough estimate it's about two thousand rand per month
Speaker 3: to keep them frozen. But for the actual process we're
Speaker 3: looking at about plus minners. I want to say about
Speaker 3: sixty to seventy k but I'm speaking under corrections. But
Speaker 3: you're welcome to phone our clinic and they will definitely
Speaker 3: give you the correct values, the correct amounts, all.
Speaker 2: Right, So I hope that helps you kill it and
Speaker 2: you'll be able to make a decision asap. Going forward,
Speaker 2: let's take a call from anonymous you're in Davidton, Grievening,
Speaker 2: and go.
Speaker 5: Ahead, high doctor. I'm telling fully four this year and
Speaker 5: I did try a I v in one of the
Speaker 5: government hospital, and I think I tried twice and the
Speaker 5: first one it was failed, and then the second one
Speaker 5: it went to a chemical pregnity that it didn't last
Speaker 5: for a month. So now that i'm telling for the
Speaker 5: two years, for the four three, what must I do
Speaker 5: to boot both my eggs is to try for the
Speaker 5: last time because in the pri in the government hospital,
Speaker 5: they told me that I must look for it now,
Speaker 5: so of course is my age anymore?
Speaker 3: Thank you for that question. So just to let you know, well,
Speaker 3: the questions I would have to ask is that when
Speaker 3: you did the first IV, it's how old were you?
Speaker 3: That is.
Speaker 5: Around thirty eight or thirty seven?
Speaker 3: Okay, foes, but now can you see what we're talking
Speaker 3: about is that that's thirty seven and thirty eight there's
Speaker 3: still a chance and you went for it, and well
Speaker 3: done for going for it, and I'm sorry that it
Speaker 3: did not work out into a live birth. But now
Speaker 3: you're forty four, so that is definitely I mean that
Speaker 3: that age group. That is the age group that yes,
Speaker 3: and I know you're coaching in the government hospital. They
Speaker 3: say you must use a donut, but in the private
Speaker 3: space as well, and it goes back to the first caller,
Speaker 3: should she freeze the eggs at forty three? Can I
Speaker 3: use your eggs at fourty four. I'm not saying that
Speaker 3: you can't, but knowing what you know, the prognosis is
Speaker 3: not that great, you know, because we know that there
Speaker 3: is a decline in terms of your life births the
Speaker 3: older you get, and it starts going down at the
Speaker 3: age of thirty five, whereas with the donor eggs, and
Speaker 3: which is not a bad option, your chances actually remain high.
Speaker 3: So to answer your question is what should you do?
Speaker 3: I think you need to get hold of, you know,
Speaker 3: get in touch with a faculty specialist and just really
Speaker 3: see what your options are because there's also be blood
Speaker 3: work involved. But from a cost effective point of view,
Speaker 3: I would recommend donor eggs. But like I said, we
Speaker 3: do get patients, so like, look, I just want to
Speaker 3: try my eggs and if that doesn't work, then I'll
Speaker 3: go to donor. You know, but at the age of
Speaker 3: forty four most definitely me and you are the same
Speaker 3: age mates.
Speaker 7: By the way, Yeah, yeah, And the reason why I'm
Speaker 7: saying that because I've got a period that's playing hide
Speaker 7: and seek, and it just goes to say actually it
Speaker 7: goes to show what actually happens to your eggs.
Speaker 3: The older you.
Speaker 7: Get, yes, yes, and they low reserve.
Speaker 3: Now exactly so you understand that language of your age.
Speaker 3: And I'm sure it's like zero point four or something,
Speaker 3: and you know what that means. So I think, I think,
Speaker 3: secretly you know the answer.
Speaker 4: No.
Speaker 5: I thought maybe going at the root of because they're saying, okay,
Speaker 5: it's on the internet. They say, okay, if you can
Speaker 5: both the egg maybe like three to six months and
Speaker 5: then maybe you can able to to to get more eggs.
Speaker 5: But then with in eight I think the don't one,
Speaker 5: as you said, it will be the best option.
Speaker 3: And you know, and you think a very important thing.
Speaker 3: I love the fact that you went back to the
Speaker 3: internet because we know they're listening and the algorithm just
Speaker 3: follows you. Yes, so the one thing about boosting your eggs. Yes,
Speaker 3: we may go and get five eggs, but what is
Speaker 3: the quality of those eggs? There are still forty four
Speaker 3: years old?
Speaker 4: They are not.
Speaker 3: And that's where everyone misses it is that you know, yes,
Speaker 3: number is a big thing, but also age of the eggs,
Speaker 3: quality of the eggs is a massive thing.
Speaker 2: Yes, all right, Anonymous at home. That was helpful and
Speaker 2: I wish you all the best on your journey.
Speaker 5: Thank you so much.
Speaker 1: All right then, anonymous.
Speaker 2: In Davidton, I think let's take a voice note now
Speaker 2: and hear what more you have to say.
Speaker 4: Is calieah, I just want to find out you're saying
Speaker 4: you can also freeze sperms. How much does it cost
Speaker 4: roughly to freeze sperms? Thank you?
Speaker 1: Listen on the lady Lisander the freezing of sperms? Did
Speaker 1: you hear that?
Speaker 3: I heard that question and thank you for it. And
Speaker 3: I'll be honest, I do not know how much it
Speaker 3: actually costs to free sperm, but definitely a lot less
Speaker 3: than freezing eggs, only because of what it entails. So
Speaker 3: with freezing eggs there is medication involved to stimulate the eggs,
Speaker 3: for us to remove the eggs for them to be frozen.
Speaker 3: But in terms of freezing sperm, it just really needs
Speaker 3: a man to ejaculate by a masturbation and then that
Speaker 3: sperm is processed and then it's frozen. So you can see,
Speaker 3: it does not require any form of medication unless there
Speaker 3: is something clinically wrong with the male who is freezing sperm,
Speaker 3: who may need medication but definitely.
Speaker 1: Sure.
Speaker 2: Okay, all right, well at least okay, we've got a sense,
Speaker 2: and I'm sure the listener will then be able to
Speaker 2: go and do a bit more research and consult. That's
Speaker 2: what I'm hoping this interview does. It gets people to
Speaker 2: want to consult. Let me read somewapped messages, someone asking,
Speaker 2: good evening, I just want to know if excessive alcohol
Speaker 2: intake can affect female fertility. We've heard it. I've heard
Speaker 2: my mom speak about it before. Is that true, doctor Lusander?
Speaker 3: It's I always laugh at this question because you know,
Speaker 3: we alway speak up outsiuthe Africa and the issues with drinking. Yes,
Speaker 3: you know, but yes everyone is falling pregnant. Yes, Look,
Speaker 3: I think the one thing we need to really realize
Speaker 3: is that this is not a blanket statement, and it's
Speaker 3: more of an individual statement. You know, It's not uncommon
Speaker 3: to get someone to say I don't drink, I don't smoke,
Speaker 3: I go to gym five times the week, I eat
Speaker 3: healthy and so forth. But I'm I'm struggling for pregnant.
Speaker 3: And you just get those people who are just they're
Speaker 3: for pregnant easy. You know, they're made to full pregnant
Speaker 3: So to answer the question about alcohol, definitely it does
Speaker 3: play a part. It is a toxin at the end
Speaker 3: of the day, and you don't know how your body
Speaker 3: is going to react to it. You know, you don't
Speaker 3: know if it's going to have an adverse effect or not.
Speaker 3: So for me, for anyone trying to fall pregnant, I'll
Speaker 3: definitely lean towards a more healthy lifestyle. And when I
Speaker 3: say that, I mean if you have a glass of
Speaker 3: wine every now and then, then you know it is
Speaker 3: what it is. But also, don't stop living because you're
Speaker 3: just trying to fell pregnant. There's life at the end
Speaker 3: of the day, you know. And I think that it's
Speaker 3: very important that I say that, because you can't spend
Speaker 3: your whole life living a certain way because you are
Speaker 3: trying to fall pregnant and then it doesn't and then
Speaker 3: it comes it has other ripple effects. So alcohol, yes,
Speaker 3: does play It does play a certain role, especially because
Speaker 3: of equality. You know, everything goes back to equality, s
Speaker 3: film quality at the end of the day, you know,
Speaker 3: So it does. But I also say, don't stop living.
Speaker 3: Don't stop living. Just rather, I'd rather had someone to
Speaker 3: come and see me then to stop alcohol and try
Speaker 3: and fall pregnant for five years.
Speaker 1: Okay.
Speaker 2: Another listener here saying, I'm forty one year I'm a
Speaker 2: forty forty one year old female. I'm on chronic medication.
Speaker 2: Is there any risk of getting pregnant? I've never been
Speaker 2: pregnant before, but now I'm ready.
Speaker 1: Thanks.
Speaker 3: It would be first of all we'd want. So she asked,
Speaker 3: if there's any risk of falling prety?
Speaker 2: Yeah, I think maybe that might be framed. I think
Speaker 2: what she means is she wants to fall pregnant. She's
Speaker 2: she's never been and she thinks she's ready now.
Speaker 3: Okay, So you know that's also one of those where
Speaker 3: it will take a full consultation because you'd want to
Speaker 3: know what chronic medication is she on, first of all,
Speaker 3: because there is medication which can prevent women from having
Speaker 3: regular menstrum cycles and therefore struggling for pregnant. And then
Speaker 3: so that would be the first thing, and then the
Speaker 3: second thing. At forty one, she has ever tried falling
Speaker 3: pregnant before, so obviously you'd want to know is she
Speaker 3: in a relationship? Is she doing this by herself? And
Speaker 3: if she's in a relationship, is to assess the guy
Speaker 3: as well, and then for her to just basically assess
Speaker 3: the medications that she's got and to have a physical
Speaker 3: examination with an ultrasound scanned and then from there then
Speaker 3: we can have the conversation about okay, call, you can
Speaker 3: go and you know you can try and for pregnant,
Speaker 3: but we and we need to take agent. I know,
Speaker 3: I'll always keep going back into age. How does she
Speaker 3: want for pregnant, that you want to be assisted, that
Speaker 3: you want to susue the own and so there's a
Speaker 3: lot of evaluations that really and I think a lot
Speaker 3: of people are going to call to say what should
Speaker 3: they do? And ultimately is you actually need to see
Speaker 3: someone so that you can you can have a full
Speaker 3: comprehensive examination, consultation, worth investigations to really know where you
Speaker 3: are sitting because it's easy for me. So of course
Speaker 3: you can feel pregnant at the age of forty one
Speaker 3: and next thing you've got block tubes. Yeah, then it
Speaker 3: completely nullifies everything.
Speaker 2: Yeah, definitely sad that we are going to have to
Speaker 2: let you go and leave this conversation. There's sort a
Speaker 2: fruitful one really quickly. Where do people where can they
Speaker 2: find you if they want to get in touch?
Speaker 3: So I'm based at made Same Fertility Clinic. It's in Brianston.
Speaker 3: It's corner Peter Place and a nursery lane. Or you
Speaker 3: can just really go to our website made Fame, Madfam,
Speaker 3: dotzo dot zta and you can see all the information
Speaker 3: that's say and you can book an appointment through the website.