Difficult to talk about, difficult to write about and most times difficult to understand.
Difficult in a sense that any idea that offers hope out of the situation is considered genius no matter how difficult the process. Notice how the word “difficult” has been used severally, well, it cannot be used too much when discussing or writing about infertility.
Show me a condition with a lot of vague areas in its description and I will mention infertility as an example. This is because many times the individuals consider why there should be a problem since they are or have been healthy.
However difficult, infertility has been a source of huge concern to individuals, couples, communities and the nation at large. Infertility, sometimes called subfertility can be devastating to both partners. Being a broad term, infertility has been defined in various ways. There has been clinical, demographic and epidemiological definitions of infertility amongst others, but one thing common to all definitions is the inability to conceive for at least one year or maintain pregnancy despite having regular unprotected intercourse, in the absence of lactation or contraception and nurturing a desire for a child in a couple.
In parts of Nigeria, couples usually fear the negative consequences of not being able to have children and societal pressure. Also, over the years, there has been some form of blame game as to which gender is responsible for infertility among couples, and for many years, in many different cultures, the woman has been asked to account for the inability to conceive amongst couples. It is almost always assumed to be the woman’s fault that there is no child in a union. Whether or not the women had or were believed to have some magical powers to produce children on their own, it is yet to be confirmed. However, thanks to media and various awareness programmes, more people are informed about the role both genders play in childbearing and that infertility issues can be from either sexes.
The exact cause of infertility is unknown and remains a subject of research. However, there are certain factors that have been associated with it. In men, factors that affect the quantity and quality of sperm (male reproductive cells) or semen (consisting of fluid and sperm) can cause infertility. Some conditions like low sperm count, low sperm mobility (motility), abnormal sperm (for example, abnormal shape), are factors that affect the semen (for example, high temperatures from wearing tight clothes, very hot environment, hot tubs or saunas, undescended testes to mention a few), mumps (especially after puberty), hypospadias, cancer, radiation therapy, thyroid disease, diabetes, age, certain drugs, sexually transmitted diseases and certain factors that may affect achieving or maintaining an erection (for example, mental stress, being overweight, obesity, excess alcohol and/or tobacco consumption amongst others) can be linked to infertility.
In women, risk factors for infertility include increasing age (fertility rate may decline from 35 years and above), smoking, excessive alcohol consumption, obesity, inadequate nutrition (especially diet that lacks zinc, folic acid, vitamin B12, iron), sexually transmitted infection (example, chlamydia may damage the fallopian tubes), maternal sepsis, unsafe abortion, mental stress and anxiety, factors that affect ovulation (that is the release of eggs) like polycystic ovarian syndrome and others, thyroid diseases, cancer and cancer treatment, previous pelvic surgeries, fibroids, endometrosis, among others. Infertility may be primary (when there has never been conception or sustained pregnancy) or secondary (when there is previous history of conception and/or sustained pregnancy, for instance, when there has been a child from one or both partners.
It is important to note that medical professionals should manage infertility. It involves thorough clinical history and clinical examination. Its management is multi-disciplinary and varies from person to person. For couples, both sexes will be thoroughly evaluated clinically to identify the possible factors responsible for infertility. In some Sub-Saharan African regions, like Nigeria, the cost of treating infertility is quite high and treatment may be affected by some socio-cultural, religious and educational factors. Some common modalities include counseling ( advice to increase the frequency of intercourse amongst couples who stay far apart, adequate nutrition, healthy weight, avoiding cigarette smoking and excess alcohol intake, surrogacy, adoption), treatment of existing diseases (including surgery for fibroids and endometrosis), assisted reproduction (for example, intrauterine insemination, in vitro fertilization, sperm or egg donation), amongst others. It is important to note that the outcome of treatment will depend on many factors such as the age, cultural or religious beliefs and the general state of health of the individual.
Infertility is considered by some affected individuals or couples to be a disability as it exerts emotional and psychological pressure on them, which may lead to serious health problems. Sometimes, because of the sensitivity of the condition, some affected persons become desperate and may fall victims of exploitation (either financially, emotionally or sexually) while seeking for solution. In all, it is high priority that the interest of those affected be maintained when decisions about infertility are made at the family, community and national level. This is because the community and nation at large can be affected when individuals or couples with infertility issues are neglected, criticised, shamed or put under any form of pressure by the society. It is absolutely (morally, socially and medically wrong to blame anyone for being unable to conceive or bear children. Also the health system and government can support by making developing schemes and creating policies that reduce the cost of treatment and accessibility to intervention by affected individuals.
The need to seek treatment from individuals licensed to do so cannot be over-emphasized in the management of infertility so as to save time and prevent untoward complications. Individuals or couples should enquire and be informed about the treatment modality to be adopted, its effects or associated or possible complications before making a decision.
Health quote of the week:
“Never bend your head. Hold it high. Look the world straight in the eye” – Helen Keller