x Abu Dhabi, UAEMonday 24 July 2017

Same rate, but causes of infertility differ in UAE

Causes of infertility in the region differ from those elsewhere, doctors say.

Although experts say infertility affects UAE couples at the same rate as those globally, about 10 per cent, they say the causes are different.

Dr David Robertson, medical director of the Bourn Hall fertility clinic in Dubai, said male infertility, metabolic conditions and polycystic ovary syndrome (PCOS) account for most cases in the UAE.

In the West the causes are more varied and include tubal disease and pelvic inflammatory disease, which are uncommon in the Emirates.

Estimates from the clinic show PCOS may affect up to 60 per cent of women in the UAE, compared with between 5 and 15 per cent of women worldwide.

The condition, an endocrine disorder marked by an imbalance in female hormones, can cause symptoms such as irregular menstrual cycles, weight gain and problems with ovulation.

Dr Robertson said the high rate was mainly reflective of the Arab and Gulf female population, adding most women who had the condition were genetically predisposed, and then it was triggered by lifestyle factors.

"It's predominantly an ethnic condition," he said. "It becomes a genetic issue over the years and it's not helped by the lifestyle here and with obesity and diabetes."

Dr Michael Fakih, founder of Fakih IVF in Dubai, said he saw more UAE men with a reduced sperm count. Dr Fakih, who also operates a clinic in Michigan, said of 100 patients in the US, 40 might have low sperm counts. In the UAE, the number rises to 60.

He attributed the figures to a lack of education among men as to what causes the condition.

"Many men use these protein shakes to buff themselves up and look good, not knowing that they're likely to cause reduced sperm count," Dr Fakih said. "What we do in this case is immediately stop them from consuming the shakes and start giving them treatment."

It can take three years for the body to recover from excessive protein-shake consumption, he said.

Experts said while most evidence linking high protein consumption to reduced sperm count was anecdotal, it was probably right.

"There's no hard and fast data, but there is some evidence that high protein increases DNA fragmentation in sperm," Dr Robertson said.

Heat and pollutants also play a role, said Dr Pankaj Shrivastav, director the Sharjah gynaecology and fertility hospital Conceive.

"Most of the toxins that get into the water table all seem to have an oestrogen effect," Dr Shrivastav said.

While loans for needy couples is a nice concept, there are challenges that must first be addressed, he said.

"It will definitely benefit those approaching their 40s who are having difficulty getting pregnant," he said. "[But] as it is, you've got this problem, then on top of that you have this loan … I'm just wondering if it will add to the psychological pressure."

And the income requirement will still stop those in the lower brackets being treated. Insurance companies could help to find a solution.

"It's really sad that they don't see it as a health condition," Dr Shrivastav said. "It causes marriages to fall apart and so much heartache for the couple and the family."

mismail@thenational.ae