Infertility is shared responsibility (Part 1)
Published On July 26, 2021 » 631 Views» By Times Reporter » Features
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. Mukosai

FOR a long time in Africa, infertility has been attributed to women who have been held responsible, coupled with witchcraft related beliefs and suspicions of promiscuity.
Pregnancy is a beautiful feeling, a journey that every woman may want to experience with expectations from couples looking forward to becoming parents.
However, infertility today affects couples and tends to negatively impact marital relationships of infertile persons.
According to World Health Organisation (WHO), about 186 million people around the world experience either primary or secondary infertility.
Infertility is the inability to achieve a clinical pregnancy after one year or more of regular unprotected intercourse.
Despite WHO considering recommending infertility as a global health problem, most developing countries are lagging behind in terms of helping those facing fertility challenges due to limited resources.
To help people face the strain, trauma of psychological well-being and effects resulting from infertility, interventions through key different stakeholders must be put in place.
A Ndola Teaching Hospital (NTH) urologist said infertility problems can be addressed effectively when the responsibility is shared by both partners.
Dr Simon Mukosai, a consultant urologist, said currently, the turnout of females going through the gynecology clinic for fertility treatment is positive.
However, it required the participation from men.
“According to WHO, infertility in couples is always 50 per cent the fault of the man, 50 per cent the fault of the woman, the more reason why we should see partners seeking treatment together,” the urologist said.
He said currently, about 25 to 30 per cent of males affected by infertility seek treatment at NTH, though there were more women seeking treatment than men.
Dr Mukosai said men who experience infertility should share the responsibility with their partners as WHO has said the blame cannot be put on the woman alone.
He said both partners need to be available for investigations.
Dr Mukosai said gone are the days when men blamed their female partners in the home.
He said what should be encouraged now is for couples to seek medical help and take responsibility.
He said the most common cause of infertility in men are Sexual Transmitted Infections (STIs) with untreated gonorrhea being the major problem.
“Gonorrhea complications tend to block the tubes where sperms pass and as a result, they sperms fail to have access to the eggs. Sometimes the infection may extend to the testicles where the eggs are produced, leading to a man’s failure to produce sperms,” the urologist said.
He said in addition, some men have hormonal problems which may contribute to fertility problems.
Proper balance of hormones is key in achieving normal fertility and if one level is off, a wrench in the process is possible.
Further, research shows that among the other causes of infertility in men could be low sperm count, obesity, drug abuse, exposure to medication and harmful chemicals.
Dr Mukosai encouraged men to accompany their partners even when they are convinced that having a child entails that they are fertile and the woman is responsible.
“Fertility problems can affect both men and women equally even if one already has a child. It is very common for men to think that because they have had a child before marriage, the woman must be held responsible,” he said.
Dr Mukosai said investigations on both partners must be done because there are different factors that can cause infertility.
Similarly in women, some of the most common causes of infertility may include infections such untreated STIs that may cause blockages because of the inflammation in the fallopian tubes.
This might lead to failure of the eggs to have access to the uterus for fertilization to take place.
Another factor that might cause infertility in women is the presence of fibroids, which may lead to implantation of the fertilized egg.
Fibroids are abnormal growths that develop in or on a woman’s uterus
Other causes of infertility in women include ovulation disorders, problems with the regulation of hormones, pelvic inflammatory diseaseand infection of the uterus.
According to reserach, infertility problems can be treated in Zambia by preventing some causes.
Additionally, early diagnosis and treatment of causes can preserve fertility in some cases.
“Today, we have other options for couples who fail to achieve pregnancy,which include Assisted Reproductive Technologies (ART). These high tech operations are used for conditions such as blocked tubes and are now available, with some private clinics in Lusaka and Kitwe offering these services,” Dr Mukosai explained.
He said similarly, with cases of hormonal imbalance, medication is readily available and doctors do provide prescription to those affected.
However, the challenge is for extreme cases of some men who have had cases of mumps, exposure to radiation unknowingly and chemotherapy who cannot produce sperms any more.
This entails that the problem has reached a stage where sperms cannot be produced as the cell are dead.
In this case, no treatment can help.
Therefore, counseling for such cases would be the solution, besides encouraging them to seek other alternative options such as adoption.
Studies show that the viral infection of mumps in male children may have some complications if the infection is severe.
This inflammatory condition that affects the testicles affects boys who have been through puberty or adults.
It is important to note that not all cases of mumps can lead to fertility problems as not all infections result in testicular inflammation.
Unlike countries in the western region, adoption in Africa is a new concept that people are slowly appreciating despite the extended family still being practiced.
Although awareness on reproductive health education and prevention of infertility has been positively received in developing countries like Zambia, there is need for accessible diagnostic procedures and affordable assisted reproductive technology because the cost for establishing these centers is high and only available in private clinics.
Having realised that infertility is a global health problem, the Zambian Government has committed itself to enhance fertility services across the country.
Merck Foundation, a global humanitarian organisation, has partnered with the Zambian Government through the Ministry of Health to train fertility experts.
Merck Foundation has also partnered with the Office of The First Lady to raise awareness by educating communities that fertility affects both women and men equally, hence the need to share responsibilities.
With different alternatives now available to treat fertility problems, couples must be encouraged to share responsibilities towards fertility.

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