For centuries in the Ghanaian society, if a couple is unable to have a baby; it is considered an abomination and a woman’s problem.
For Abi and Dede, a fertile couple in their 20s, they have been having regular unprotected sex but they have no chance of conceiving each month. Somebody will then ask what went amiss?
The answer largely depends on the ages of the couple. While the man‘s (Abi) age is thought to play a role, the medical definition of infertility focuses on Dede.
A woman under 35 years old is considered infertile if she fails to become pregnant after 12 months of regular unprotected sex. But for those over 35, the threshold is six months instead of 12.
After two months of trying to conceive, the couple upon advice by a neighbour consulted their gynaecologist for a referral to a fertility specialist. They underwent a series of tests – blood test, ultrasound examination, and semen analysis.
For the blood test, a series of tests are conducted to establish if there is a hormonal basis for the couple’s infertility. This may be connected by the hormonal supplements. Other tests will check for rubella, blood group, sperm antibodies and sexually transmitted diseases such as HIV, Hepatitis B and C.
For Ultrasound Examination, it gives information on what the ovaries and uterus look like. A specialist will look at the growth of the eggs, the thickness of the lining of the uterus (if thin, it can indicate hormonal problems), the presence of the fibroids or polyps or the uterus as well as possible signs of endometriosis or ovarian cysts.
With Semen Analysis, men need to provide a semen sample and this allows specialists to assess the number of sperms, how well they swim (known as motility) and the presence of sperm antibodies.
Finding out, Abi was infertile or sub-fertile; and this according to Dede said brought a sigh of relief to her, though she was going through serious predicaments and marital problems in attempts to save her marriage from collapse.
According to her, she was left in a traumatic experience in the past 10 years of her marriage, as she experienced feelings of blame, denial, guilt, torture and anger, which placed stress on her relationship.
Though Dede was not responsible for not conceiving a baby, she said society had placed the responsibility on her, and labelled her with names.
“As a Christian, I strongly believe that God gives children. That has been my motivation because my in-laws and friends have on several occasion, lured me to see a native doctor but I failed to do so, knowing obviously that God’s time is the best”, she explained.
But, Dede said she could no more stand the disgrace, stigma, insults and beatings from her in-laws and with advice from her spiritual father, she decided to open up and reveal results of the infertility test they conducted seven years ago.
“In fact, the revelation saved my marriage and brought me hopes to bear children because whilst I go through the unforgettable nightmares, my husband careless and failed to be put on treatment”, she said.
After knowing the outcome of the infertility results, Dede said her in-laws carried some doubts, however, it took the intervention of the family specialist who conducted the tests to confirm it.
So in the long run, my husband could not resist the pressure from my in-laws and accepted to be put on treatment.
Types of infertility
Both men and women suffer infertility problems and these are no more common in one sex than the other. Sometimes multiple factors are involved in one or both partners.
Among couples who are infertile, medicine proves that about 40 per cent of cases are exclusive due to female infertility, 40 per cent exclusively to male infertility, and 10 per cent involve problems with both partners.
In the remaining 10 per cent, the cause is unknown.
Women can suffer from disorders such as hormone imbalances, blocked fallopian tubes, endometriosis or abnormalities of the reproductive organ.
On the other hand, men can also be infertile if they have problems with the number and shape of their sperm, produce antibodies against their own sperm or have blocked spermatic cords, but in some cases, the exact cause of infertility cannot be explained.
Proper diagnosis of infertility will help in selecting an appropriate treatment plan that maximizes the chances of becoming pregnant, but going through the treatment, is an emotional rollercoaster for patients who failed to become pregnant after a number of cycles.
According to Dr Edem K. Hiadzi, a Fertility Specialist with the Lister Hospital and Fertility Centre in Accra, it might take a while before a couple undergoing infertility treatments becomes pregnant.
This is because, there are many factors to take into consideration, but, he encouraged early treatment for couples with infertility problems.
The beginning of a cycle is full of hopes, anticipation and the anxiety of wondering, “Am I pregnant?” and this can be quickly followed by dealing with the disappointment and despair of failed cycles.
Ultimately, Dr Hiadzi who is also the President of the Fertility Society in Ghana added that the prospect of never having children might have to be faced.
Speaking at a training session on the “Role of the Media to break the Stigma around Infertility and Infertile Women in Africa”, recently held in Accra, Dr Hiadzi noted that illnesses such as tuberculosis and mumps could easily lead to infertility among men and women.
Negative and outmoded cultural practices such as Female Genital Mutilation and prolonged obstructed labour due to delays by unskilled birth attendants sometimes leads to fistula with the women leaking faeces or urine or both.
The Ghana Journalists Association in collaboration with the Merck Foundation, a subsidiary of Merck KGaA, Germany, organized the health media training to equip reporters to report accurately on infertility issues in the country and help control stigma.
Dr Hiadzi said alcoholism, smoking, chronic Sexually Transmitted Infections (STIs) as well as unsafe abortion were other contributory factors to infertility and advised Ghanaians to shun unhealthy lifestyles.