 I in the morning thank you for staying with us remember we you can communicate with us on our social media handles at y to five four across all social media platforms using the hashtag W say W or Y in the morning if you like you can get me at Stephanie I yet across all social media platforms we have now come to the second conversation of the day and we are talking about reproductive health especially matters fertility and I am joined by experts we have reproductive health nurses from my right please introduce yourself hello good morning my name is Alice Agutu I'm a nurse by profession today we are going to talk about reproductive health nurse because as part of my expertise I'm also a reproductive health nurse I deal with fertility all right to my father's right okay my name is Lillian Avula and I'm also a reproductive health nurse so we are here today to talk about reproductive health both for men and women so let's start with you you know we can say reproductive health but maybe someone doesn't understand what it is so tell us what is reproductive health reproductive health basically is what entails among females and males this is the situation where we want to know if you can be able to to be able to be fertile if you're fertile if you're healthy enough so that we help you to go through this phase so you find reproductive health affects both male and female so we are here to expound on that because it's actually quite wide and it involves a lot of things here and there so we are here to at least make some clarification of the same because we know in our nation and also worldwide there are a lot of people who are affected by the same so we are here to give actually to give some more insight about this rating their awareness yes yes okay so what is the Alice what is the significance of reproductive health you know the knowledge what should we know about reproductive health okay I think every woman would want to be a child someday and that's why you should know about your reproductive health because as we mature from girls to puberty to being women we need to plan on how we can make these babies so we are here to talk normally about age and fertility so we are going to take you through from the time you were born as a woman when you got to puberty when you become now in the reproductive age when you're supposed now to give birth and when now you're supposed to retire maybe menopause and not take care of your children so you're going to dwell on that brackets in both women and men too all right so you can tell us you know what are some of the measures first before you get into it that you can take as a country to improve you know our reproductive health standards as a country what I can suggest is we start educating people as early as when they in their puberty age both the male and female we educated and enlightened them and tell them like once you get to that phase of now you need to start to producing what are the measures that you can take to help make the bodies prepared and what can we do to just keep ourselves in that mood keep ourselves in that space of like yeah we are ready and everything at least will go smoothly so I guess as a country is all about education telling people as early as they can and also we just try to you know pass a message tell a friend to tell a friend like yes this thing can start early and we can yeah we can do this as a country so now tell us Alice what is fertility because you know it's easy to say this this person is in fertile this one so what exactly is fertility is it not being able to give birth completely is it having difficulties in giving birth birth tell us about it okay everyone is born fertile one we are born with all our reproductive system intact but as time goes by as we mature our bodies adapt to changes environmental changes mostly and also our personal life so you might find with time we can we can have problems just like a normal human being you can have malaria today tomorrow you can have tuberculosis the same also in fertility can fit in your body so once once once it comes you'll you'll you'll realize maybe at your puberty maybe you didn't get your you didn't start your menstrual cycle as all the other girls started maybe all the other girls started when they were in standard eight you you didn't start you are in form three you are seeing nothing maybe your breasts are not growing your hips are not broadening and you're not getting the science of puberty when you're at that point you can start considering maybe there's something wrong with me so like those are just the few cases but as when we talked when we when we get into detail into fertility into into into infertility it's when maybe you're you're between the between the age of 25 to 30 you should comfortably get a baby and 25 to 30 you should comfortably get a baby when you want between 30 to 35 you can try for an ear if it doesn't come within an ear you can consider seeing a gyna or a fertility specialist when you're between age 35 to 40 and you try for six months and you're not getting results I think by then you can start and question questioning yourself can I see a doctor then when you are from the age 40 and above because that's that's where we are we are moving towards menopause when you want to get a baby I think the first thing you should do is consult a doctor first so that you start on the on the right path so my what I'm saying is infertility can get you between in between these ages and when you see any sign and sign and symptoms just try and consider seeing an infertility specialist yeah you've spoken about fertility mostly in women yes Lillian tell us about infertility or fertility in men infertility in men varies a lot you know in our African society we always think like when you talk about infertility we always think about the woman exactly we always forget like for you to also get pregnant you also this need this male the man yeah the man contributes yeah because you see like when when when you want to get pregnant you need an X or X chromosome or an X and Y chromosome for you to get either a boy or a girl so that means this man is very vital in the reproductive process so we have men who actually have have different problems and they really they're really cushioned down in the in the cocoon fearing to come and talk about it because we find some can be maybe genetically maybe they're born maybe without like the test is you know the test is so in so now you're saying someone can be infertile from birth yeah we have some who can be infertile from birth in the sense of maybe they have a birth defect you know if maybe like let's say the man maybe the test is did not descend at birth or maybe the man was born without remember this is something that you cannot control so if you're born without there's nothing you can do there's nothing much you can do all right yeah but you find like even through as the man grows you know men as they're born there we all are fertile from birth yeah but you find like maybe the environmental factors can come in and maybe now they can push you to towards maybe now the situation of being infertile say for example if you're growing up and maybe for men maybe you you've ever heard of something called mumps yeah if men have mumps especially during their puberty stage explain what's mom's is for those that don't know okay mumps mostly is a childhood infection it's mostly a childhood infection and it's a viral infection and once it get to your bodies there's some changes it can occur okay so mostly especially when you're a child it doesn't really have that much of an impact than when you're an adult so you find when you have this this viral infection it can cause also an infection in the body like towards the reproductive place so once it causes an infection it can maybe cause maybe some blockages or something so you see if it causes blockages in a man like maybe let's say from the where the spams are supposed to travel all through you see now the spams are not able to travel from the test is towards out when the man ejaculates so you find like that can cause a problem that's what you say maybe infections even sexually transmitted infections can also cause problems in men also you find in males we normally tell them to have nice comfortable briefs you see like when when when they put on like tight underwear it can cause like you know some heat you know they need a lot of air aeration that's why we recommend like for them to have boxes things like that and also lifestyle you know you find like in our generation right now we have so many men who are indulging in maybe alcoholism we have like maybe the chewing of mirror the cut and you see these things in the long run they normally come back and affect the system so you find for men we normally tell them like sometimes it's a lifestyle thing sometimes it may be also exposure to radiation things like that that's why it's not recommended for either female in male to expose themselves maybe to x-rays to to go maybe you see in factories maybe where there's a lot of radiation we always tell you to always protect themselves yeah so now and is age a factor in men you know as Ali said for women you get to a certain age around that 540 especially it becomes a challenge but for men is it a factor because you know we have seen men 80 yeah giving back for men age is doesn't really affect that much that's why you may find even a 60-year-old man impregnating a young girl yeah yeah but what mostly affects men would be their lifestyle or maybe a chronic disease or yeah maybe the life yeah things like that so for men age is really not a factor but still we normally encourage like if you can be able to to reproduce at an early age it will give you a more comfortable space to take care of your child by the time you also get to that to that stage all right Alice back to you so now you've mentioned you know mostly age as a factor for women the different levels at which one should give birth and when one should see a guy now or in fact infertility expert so now what are some of the causes of infertility in women apart from age okay apart from age we can talk about there's some women who have tubal blockage you know fertilization normally happen on the tubes when your tube is blocked there's no way the egg can reach the sperm or the sperm can reach the egg just that's one cause another one is hormonal imbalance hormonal imbalance when your hormones are not balanced because home hormones are the one that passes message to the our system in there in the body so like when one hormone is not active there's no way it can pass the message to the hormone maybe in the ovary to produce an egg so that's another cause and just to hold on to that a bit so hormonal imbalance I think many people experience this even at an early age is it something that one can treat and then it gets back to track actually the good thing about infertility we have modern medicine everything is treatable right now and hormonal imbalance is just one of the mere mere mere causes that you can treat through medication and you're good maybe for medication just for two months and you're good to go things like tubal blockage you can always go for a laparoscopy or you can use medication that can unblock your tubes another cause is when you have maybe ovarian cysts on your in your ovary that will prevent your eggs from maturing so that they can be fertilized so whatever so the cysts are preventing the ovaries from maturing yes for maturing so that they can be good quality eggs actually cysts reduce your quality so cysts and fibroids it's something you can also do surgery and do away with it so that you go back to your normal state of fertility okay just to you know dwell on cysts and fibroids because I've had so many cases of this so is it safe for one to go for surgery before before getting trying to conceive again or can one try to conceive before getting them them off actually yeah cysts and fibroids is definitely a risk factor because one it might prevent you from getting pregnant and maybe if you get pregnant something like fibroid can cause some miscarriage because now you know the fibroid and the baby they are fighting for space so whoever wins if the fibroids pushes the baby it will really it will come out and it will cause some miscarriage for cysts you might be feeling some pains during your ovulation and during your menstrual cycle so such discomforts can make you wonder what is going on in my system so you can go for an ultrasound when the doctor finds you have a cyst or he can give you medication to reduce it or if the cyst can is causing more problem he can decide to send you for surgery and when you're when it's removed you're good to go it will have solved two problems make the pains and also it will have increased your fertility chances okay talk about the fibroids because you've said they are competing and this unwanted weeds comparing them to plants you know and it's like unwanted weeds in the womb competing and how are they how are they like you know for someone who doesn't know about them okay a fibroid is an abnormal mass in the uterus it can go grow inside the uterus or outside the uterus but it's an abnormal and anointed mass in your reproductive system so normally it's a malignant normally they are always malignant because even in a farm if you don't remove the weed it will grow so in our in our edges you can just notice it maybe when you have heavy menstrual cycles that can indicate maybe you have a fibroid or you just feel some sort of pain during your menstrual cycle that can indicate you have a fibroid and also in the old age when maybe you feel your your body is a bit heavy your tummy is enlarging you might consider removing that fibroid even if you have already given birth in future actually fibroid normally don't cause you to be infertile but once they're there they can cause many problems to your yes miscarriage and also your system when you bleed too much your HB will go low and you might even become sick maybe anemia so fibroid is something that we should all consider checking our system if we have or if we are not or if we are trying to get a baby or if you're not trying to get a baby is something that should be removed once you detect it yeah so Mark to you a linear tell us about the checkups how you know how often should we go for the checkups and why are they necessary like she has said we should go to check if we have fibroid suspecting it and you know maybe not a time in a group but you don't understand a friendly food maybe it's a favorite there so what is the importance of going for the checkups first of all it is usually recommended at least every year you do a well woman check even for the males okay because in the life that we're living in we're experiencing a lot of changes maybe because of diet because you know we're having a lot of GMOs in our market and everything so it is recommended at least every year you can do a well woman check and also mostly especially like married couples and you've had like she's given us a timeline of some ages how yeah so if you're married and probably you've been trying for for getting pregnant for a while and nothing is forthcoming it is very important and advisable for you to to seek medical advice like you can go to your nearest maybe a Guiney who can do the recommended tests like to find out maybe what is the problem you as you've had we have hormonal some people have hormonal changes some have maybe infections some maybe it may be the tubal so you need to check the uterus we have some scans you need to do so best is if you've been married for a while and you're not nothing is forthcoming it's best for you to seek medical advice plus also if just you are not yet married and you'd like to just know how you're faring best is every year just do a medical checkup so now when you go for the checkup because I know of a story of someone close to me went for a checkup and was told you need to get pregnant this year so what are some you know some of the factors that would cause want to be told that and why is it necessary to follow that maybe because maybe what don't have anyone here but you just wanted to go and check I think a doctor would probably tell you that so that you can actually get in the mood to want to to to get pregnant because you know time is for us ladies time is a factor so the more you age the more everything will now start working against you so the earlier you start the better so recommended is whenever you you get into that space like yeah I've been told by the doctor I need to get pregnant right now you need to find out like why was this doctor referring me to do this right now is it because something bad will happen to my body is it my hormones will play against me things like that but normally doctors will not give you like a strict time like now now now because if it's now now now I mean you'd have already gotten pregnant yeah yeah so the thing is first of all you need to rule out worst what is actually causing you not to get pregnant at that time and what can actually be done like she said if it is hormonal we have medication to actually help us with that if it is fibroids you do away with that if it is assist you see now that one is removed and you will go back to a situation where you are able to get pregnant so basically it is just eliminating the cause of the infertility and then finding a solution like what would be the best treatment for me to help me get pregnant yeah so box you Alice we can share to ask some of the measures for people will struggling with infertility what are some of the options given to them because I know of I've forgotten the name really but somehow you you you store your you can store your eggs or your spams something like that so tell us some of the options yeah actually we can start with the one you've mentioned it's a modern technique where you're able to freeze your eggs maybe right now if you're 30 and you're not ready to get pregnant you can go to a specialist they take out your eggs they freeze them because as we have said in this topic age and infertility as you grow older your infertility goes down a bit so as well you're still young you can be able to remove these eggs and freeze them and it will the eggs will help you even when you're at 40 and you try to get pregnant then you're not able to get pregnant we can do a procedure called IVF and implant the eggs you had freeze into your uterus and successfully you become pregnant just just one of the methods you can use another method you can use you can always boost your system by using supplements as a woman we all need to be on supplements well women supplements supplements such as folic acid vitamin C which is an anti-detoxant there's also omega omega will give your eggs strength even when you're 38 or 39 and you want to get pregnant you will get pregnant we also have an hormonal imbalance drug called DHA it will maintain your hormones and also another drug called CQ10 it will also engage your chromosomes in your eggs so that they become active even at the age of 40 you're able to conceive with your normal eggs we should also look at their lifestyle we should take healthy foods such as vegetables healthy fats such as avocado we avoid processed foods meat products because meat meat will just make you be obese because here we're also looking at your BMI once your eggs are too fatty definitely when you're too fat your eggs are a bit slow even if in your normal malformation if you're a bit fat or obese you can be a bit slower on things so that's why that's how our our also our bodies work so if you want to maintain a if you can maintain a good BMI you can be active you can release some stress through yoga acupuncture you'll be able to maintain your fertility through these years okay so we've talked about medication preservation and lifestyle change you should also avoid alcohol smoking and drugs those are things that will have will affect your fertility also a woman and also a man so maybe you can take us through you know you've mentioned the processes but someone maybe one jico you know common money she might not be able to afford IVF because I know it's a very expensive process so are there other options for for people like this that they can afford because they want to get a baby but they're having difficulties yeah yeah if you if you are if you are you on the timeline that I've said and you're seeing you're not getting a baby what you should consider is just the baseline checks that I've said healthy eating lifestyle change elimination of drugs and also using supplements eventually with time you'll get pregnant that's why we are seeing a lot of women getting pregnant it's just adapting to a normal life life change you avoid the things that can make you become infertile such as drugs things things like those so what I'm saying those are that's one of the cheapest way just avoid things that can get you infertile but when we go when you go to a gyna you can consider doing a surgery if your tubes are blocked or if you have cyst or fibres you can consider doing a surgery then you go back to your marriage you will get pregnant and if it doesn't happen after trying the lifestyle change the medication or maybe surgeries where it's applicable you can always visit a fertility specialist fertility specialists are all over Nairobi right now we we are blessed to have a lot of fertility clinics in Nairobi you can walk in there and you can you can consult with a doctor and he can he can he can bring an intervention before we go to IVF which is a bit expensive you can be an intervention such as monitoring maybe can give you injection then it tell you on a certain day make sure you will be ovulating do an ovulation test then go and be active and be and be sexually active with your husband on maybe maybe from day 10 to day 14 you can get pregnant also on maybe day 10 to 14 he can he can do an I you are I you are it means inserting spams directly to the uterus that is affordable around 30 to 40 thousand so he can tell you on a certain date you'll be ovulating I've done test then come to the clinic I'll insert spams into uterus and we'll be able to track the egg that will be ovulating at that time you can also get pregnant through that and if the other options are not working it is when your doctor will tell you maybe we need to do an IVF because as we are trying all this time is also moving maybe you started trying when you are 33 and now when the doctor is telling you know we need to do an IVF it's maybe when you're 37 and he's seeing you're going to read the mark of 40 and at 40 maybe he might not behave be able to help you effectively so the doctor might want to introduce IVF to you IVF is in vitro fertilization is a procedure now and we'll do everything in the lab you've had people say test your babies but it's not normally test your babies explain that because it's being misunderstood it's being misunderstood because when they think the baby is developing in us in attested but this this embryo is only out of your body for maximum of five days so the doctor will remove the egg from your ovary and he will request your husband to give out a semen sample then he will fertilize the egg and the sperm in a laboratory and watch over it as it matures the same way that this this this egg and sperm will fertilize in your body and mature and attach to the uterus so the doctor will watch it for maybe one day today day three normally they do transfers on day three when the embryo is on the third day but if he might want to continue watching it I've told you can only watch it for a maximum of five days so you can ever either be done transfer on either day three or day five so on day five the eggs that you had removed and the sample that your husband had given the sperm they are joined together they become an embryo on day five they become blastocyst we return the babies back to a uterus and the babies are normal the babies are normal because when we say watching them the doctor is watching them through a microscope and embryologists does this work very well so he will be able to tell you this one is growing this one is not growing this one might come out twins this one is strong this is grade one grade two because definitely when he removes it he doesn't remove one egg we remove like 10 10 to 15 eggs so he will take the best and implant in your uterus once he implants in your uterus if the procedure is successful after two weeks you'll test for a pregnancy test and you'll turn out to be pregnant it's very effective it's the most effective method yes it's the last option and the most effective one to treat infertility okay leave them back to you so how do you solve the problem of men with low sperm count because this is also common for low sperm counting men first we need to find out what is causing this low sperm counting men because if it is environmental that is lifestyle you know you need to eliminate if it's taking alcohol then you need to actually stop if it's drugs you actually need to stop because you see if that if that is what now is affecting and you really want to try out then you eliminate that another thing would be if if the low sperm count is being caused maybe by a tumor or blockage remember the prostate gland is the most important gland in men so if there's a problem with that also we need to to to find out if it's a tumor then it needs to be eradicated removed you know to so that this man can go back to optimal sperm production if if it's genetic then you need to know like something genetic really we do not have like a solution at the moment you know the good thing with medicine it's ever-changing every day so someone someone even me we can start maybe researching on that yeah so that we can see what would actually be the effective method to actually help if it's genetic but yeah basically it would be so for now if a man maybe has you know low sperm count as a genetic problem that can't really be solved for genetic really that can be solved but if maybe it's environmental factors and everything you eliminate that then remember we also have medication to help boost this so if if if that you've seen the doctor the doctor has done something called a semen analysis because you see for a sperm we look at three factors we look at the count then we look at the morphology which is the structure of the sperm you know the sperm needs to have a nice oval head and a tail and also we look at motility the tail now is now what actually propels the the sperm towards the egg to fertilize okay so when you consider all these factors even when the doctor wants to to to give you maybe an advice we look at he'll consider the the semen analysis then recommend maybe a drug that would actually help that so men should not beat themselves up in the sense of like oh I have slow sperm count let's find out what is the cause of the low sperm count and as much as the count is low remember if you want to try out naturally then you probably need to boost with diet exercise if you're obese you need to lose weight if it's alcohol you need to do away with that smoking you know as much as it is hard but if you really want children there are some things you can actually sacrifice for yeah okay still on matters men I know there's a lot of you know guys saying you I want to be a sperm donor so is it a thing that it's going on that I can go and do needs my sperm and I'm given a certain amount and then I sign something that I will be incognito for life you know is it a thing yeah right now it is a thing because let's say I am married and my husband is the one who maybe genetically does not have any sperm in the semen remember semen is just a fluid to help carry the sperm from the test is to out okay so you might find you might have semen but there's nothing in it so without spam there's nothing you can do about that so you find we really want to have this baby but my husband is not able to so you can get a sperm donor whether known known meaning let's say a friend a brother decides to donate so you see that is an agreement between us but now if now we've gone you see now for a case like that definitely you need to do IVF because I cannot go maybe I'm okay and my husband is not okay I cannot go to to sleep with someone else so that I get pregnant so I would get someone maybe in anonymous from the fertility clinic so with the fertility clinic they will tell me like maybe we have different sperm donors we have this I can say I can describe the characteristics that I want oh yeah so you can you can get like a tall duck and handsome because we have people who actually donate and yes the hospital would actually give them something for for that but to me I would not know who the sperm donor because I wanted to remain anonymous for the sake of my peace you know I've gone to seek help but now I wanted to remain anonymous this is someone who's just helped me so with that definitely this man needs to give a consent in the hospital of the fertility clinic needs to write down a consent to release any parental rights because that is very important so that this person even if we meet in the streets and they like this baby looks like me does not have a right over my child because their donor signed a consent to remain anonymous and just giving the sample there and the hospital is the one maybe to to to agree with maybe to get something or not okay yeah Alice is this the same with women can women donate eggs yeah actually women can donate eggs very well because we have these girls between 25 to 30 they have good quality of eggs and we have a woman from 45 is unable to get pregnant because the quality of egg is low so we we are really creating awareness there's a way we can help this other woman that's really that really wants a baby but she can't get a baby because of her age or maybe she did surgery and the ovaries were removed you know that's not her fault yeah so we have these young girls who are willing to donate their eggs so that they can help someone else become a mother so that's that's when you go to a fertility clinic if the fertility specialist tells you your ovarian reservice law we might not be able to get good quality eggs for you he might recommend a donor so when we choose a donor we choose a young donor so that it can increase also your chances so you can say maybe maybe i'm low i can say i want a lower girl i will definitely get a lower girl because it's all about passion this girl is helping someone who cannot get pregnant because this young girl you are 25 you're born with a lot of eggs millions and hundreds of thousands of eggs you can help someone get be a parent because that's the end goal we all all we all as women we want to be parents so once you carry the baby and the sperm is from your husband so the child is still yours it's from your family this your husband's child is the child is also yours because and you carry this child you carry this child the blood flow is from you the care the feelings the emotions this baby turns out to be yours and nobody can really know that you use a donor egg actually whatever you signed in the hospital it's confidential it's anonymous and you go on with your life and lastly maybe you can mention briefly about surrogacy you know this is also another option do we do it in Kenya okay surrogacy surrogacy the laws are not passed in Kenya but we do it through a method called adoption so you can have someone carry carry the pregnancy for you and once it's delivered once the baby is delivered through the adoption laws you can be able to have this child as your and the moment one can can decide to opt for for a surrogacy maybe you had surgery and your uterus was removed or maybe from your childhood you've never had a uterus there people were born without a uterus and maybe when you see things like fibroids when fibroids are too much in your uterus your doctor might decide just to do away with the uterus because removing the fibroids might cost more harm to your uterus and we also have diseases like tuberculosis of the uterus when you have that you might also be not be able to carry your own child so that's when you you get into an agreement with another person to carry the pregnancy for you up to term now these people are lending their uterus and definitely a surrogate is compensated after that but after delivery now through the laws in Kenya you can be able to have your child through the process of adoption yeah okay so thank you very much ladies for sharing you know such amazing insights on fertility and reproductive health so tell us how someone can reach you in case they want some consultation or anything and remind them and remind them what you do okay like I began telling you my name is Lilian and I'm a fertility health care expert so don't be shy don't beat yourself up and also reduce stigmatization because as we've seen as much as you have a problem there is a solution and it all starts by you going for a consultation and get an advice from a health care expert on how well you can actually go about the problem so you can reach us out on um we have a facebook page lotters fertility agencies we can also reach us on a number 0 7 9 1 8 2 6 8 8 6 5 yeah and also we have an instagram page lotters fertility get to us reach us out let us help you and let us reduce this stigma because as we've seen we can create smiles to different homes different families and yes we can do this together I cannot do it and do this together okay tell us Alice what is your final word tell us where we can get you okay we are actually creating awareness don't sit at home if you want to be a child come out reach out to us we'll be able to take you to various specialists in Nairobi we have fertility point we have MediHill we have Dr Sarita they're all fertility specialists and if you want to reach us you can reach us through 0 7 9 1 8 2 6 8 6 5 or you can go to our facebook page lotters fertility agency you can get our contact there we can chat through whatsapp and be sure you will bear a child because our slogan is from life to life from life to life from life to life wonderful wonderful thank you ladies again for coming on board we'd love to have you again and again okay thank you so much thank you that has been Lillian and Alice from again lotters fertility agency from lotters fertility agency talking to us about reproductive health specifically matter fertility they say from life to life I hope you've enjoyed today's show thank you for staying with us all the way till 10 a.m join us again tomorrow same time 7 a.m to 10 a.m from the team we thank you so much and we wish you a great day ahead my name is Stephanie Ayata the hashtag is why in the morning at y254