IN Zambia just like in most countries around the world infertility is an emotive issue.
Mostly, women unlike men shoulder the blame for infertility in many communities around Zambia and Africa in general. According to the World Health Organisation (WHO), infertility is a disease of the male or female reproductive system, defined by the failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse.
It can cause significant distress, stigma, and financial hardship, affecting people’s mental and psychosocial well-being.
Women and men who suffer from infertility are called all sorts of names in society.
For instance, in Nyanja, a dominant language in Lusaka and Eastern Province, samabala refers to a person’s inability to have children for both genders.
Additionally, a person who is infertile is called Ngomwa, which means both barren and impotent.
According to medical experts, there are various conditions which can lead to infertility in both men and women.
In women, the most common cause infertility is failure to ovulate (which accounts for about 40 per cent),uterine abnormalities, fallopian blockage, early menopause and having multiple sexual partners and bacteria, to mention but a few.
The major cause of infertility in men according to experts can be due to abnormal sperm production, genetic defects and health problems such as diabetes or infections, among
others.
Ndola-based consultant obstetrician and gynaecologist Sebastian Chinkoyo explained in an interview with the columnist that women with multiple sexual partners have a high risk of suffering from Pelvic Inflammatory Disease (PID) which can among other complications result into infertility.
Dr Chikonyo who is a consultant obstetrician and gynaecologist based at Ndola Teaching Hospital (NTH) said PID which is an infection of the
female reproductive organs has long-term effects which can result into infertility in women as the fallopian tubes become narrow and blocked.
He said PID is caused by sexually transmitted micro organisms that spread from the birth canal to the uterus, fallopian tubes and ovaries.
Dr Chikonyo says this can result into infertility in women because the micro organisms damage the reproductive organs causing the inability for a woman to become pregnant.
According to a new report published last week by the WHO, large numbers of people are affected by infertility in their lifetime.
The world health body warns that around 17.5 percent of the adult population – roughly one in six worldwide – experience infertility, showing the urgent need to increase access to affordable, high-quality fertility care for those in need.
The new estimates show limited variation in the prevalence of infertility between regions.
The rates are comparable for high-, middle- and low-income countries, indicating that this is a major health challenge globally.
Lifetime prevalence was 17.8 per cent in high-income countries and 16.5 percent in low-and middle-income countries.
WHO director general Tedros Adhanom Ghebreyesus notes that the report reveals an important truth: infertility does not discriminate.
Dr Adhanom Ghebreyesus noted that the sheer proportion of people affected shows the need to widen access to fertility care and ensure this issue is no longer side-lined in health research and policy, so that safe, effective, and affordable ways to attain parenthood are available for those who seek it.
Despite the magnitude of the issue, solutions for the prevention, diagnosis and treatment of infertility – including assisted reproductive technology such as in-vitro fertilization (IVF) – remain underfunded and inaccessible to many due to high costs, social stigma and limited availability.
At present, in most countries, fertility treatments are largely funded out of pocket – often resulting in devastating financial costs.
People in the poorest countries spend a greater proportion of their income on fertility care compared to people in wealthier countries.
High costs frequently prevent people from accessing infertility treatments or alternatively, can catapult them into poverty as a consequence of seeking care.
In Zambia, there are only two privately-owned clinics in Lusaka and Kitwe that offer IVF.
In the WHO report, Pascale Allotey, Director of Sexual and Reproductive Health and Research says millions of people face catastrophic healthcare costs after seeking treatment for infertility, making this a major equity issue and all too often, a medical poverty trap for those affected.
Dr Allotey observes that better policies and public financing can significantly improve access to treatment and protect poorer households from falling into poverty as a result.
While the new report shows convincing evidence of the high global prevalence of infertility, it highlights a persistent lack of data in many countries and some regions.
It calls for greater availability of national data on infertility disaggregated by age and by cause to help with quantifying infertility, as well as knowing who needs fertility care and how risks can be reduced.