Making miracles happen



The birth of a baby is always a miracle; but even more so for parents who have to go the extra mile to welcome their bundle of joy.

One in every six couples will need the intervention of experts to achieve pregnancy, and that remains the mission of the Barbados Fertility Centre, which has been making dreams come true for families for more than a decade.

Experts define infertility as the failure of a couple to conceive within 12 months of trying to have a baby.

Medical director of the Barbados Fertility Centre Dr Juliet Skinner
Medical director of the Barbados Fertility Centre Dr Juliet Skinner

“This is a medical condition no different than diabetes; no different than hypertension; and there are effective treatments,” says Dr Juliette Skinner, the medical director of the Christ Church-based centre.

Over the last two decades, the rate of infertility has increased, and she’s been encouraged by the fact that more Barbadian women and their partners are walking through the doors of the centre, defying their fears.

“In terms of the number of patients seeking treatment, this has been steadily increasing over the years. We are going to do 400 In Vitro fertilization (IVF) treatments this year.

“We probably do anywhere between 30 and 40 new patient consultations a week.”

Infertility patients aside, she tells Health Today that more single women are opting to undergo IVF to have a baby.

“What we are seeing is more women coming forward in their later 30s, that haven’t taken that step [pregnancy] or they haven’t found Mr Right and they are looking at treatment as a single female. That certainly is something we have seen a lot more of in the last four to five years.”

Age, she says, is the most significant factor in achieving conception and it’s the reason why women should not delay getting help if they fail to conceive.

“I always say the only limitation to the treatment being successful is the female and her age. So if somebody is not getting pregnant under 36 or 37, get on with going to seek
help, because at 41 or 42 the success rates are considerably lower.”

Skinner adds that the causes of infertility are different for every couple and it can involve one or both partners.

“Historically it was always classified into male or female or combined, and we used to say it was 40 per cent male, 40 per cent female and 20 per cent combined. It can be either male or female.”

Using the analogy of a jigsaw puzzle, she says that infertility can either be simple or very complex.

Starting from the point of ovulation, Skinner explained there could be factors which might affect the woman’s ability to release her eggs, or it could be the quality of eggs that were released.

“The quality of the egg will often come down to age. As we age as women, unfortunately, our eggs don’t get better; they decline. Conditions like polycystic ovaries will affect the ability of these eggs to be released in a timely fashion. Then the next thing is the egg pick-up mechanism, and that’s to do with the tube; and any condition that damages that tube will affect that step ––
things like chlamydia infections, which is often something that is silent.”

In addition, conditions like endometriosis and fibroids, which are common among Caribbean women, may affect the fallopian tubes and the ability of the womb to carry the pregnancy.

On the male side, most infertile men will have a low sperm count. The sperm may be abnormally shaped and show poor motility (swimming ability).

Once infertility is diagnosed, Skinner says, the best treatment option is discussed with the patient.

“There is ovulation induction, where we would assist the women in ovulation using various medical agents. Then there is intrauterine insemination, where the sperm is placed at the top of the uterus and this will get around mild male factors or potentially cervical factors; but the third and very much the cornerstone is in vitro fertilization or IVF.

“In vitro fertilization, we take the eggs out of the body fertilize the sperm in a laboratory setting, make embryos, culture embryos, select and then transfer to the uterus. So this is very high-tech in terms of medical technology.”

The first IVF baby was born in 1978; and Skinner says over the years, the success rate of the process has continually improved, giving more couples hope.

“The likely chance of pregnancy for couples is way higher in this day and age than it was 20 years ago. So with in vitro fertilization, there may be patients where this is their only realistic treatment option that would result in a pregnancy.”

IVF is a low risk process. However, it does not guarantee a pregnancy. According to Skinner, the success will depend on age and the cause of infertility –– but she notes it is worth taking a chance.

“If you don’t take action, you’re not going to get pregnant; and I think people need to understand their own condition. You need to realize that this is a medical condition. Take your head out of the sand and accept when it is not happening and come forward and get care,” Skinner advises couples.

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