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Infertility: Who is to blame for the problem?

The World Health Organization has subdivided the term, as it relates to couples as follows: Primary infertility: the woman has never conceived despite living with a man, being exposed to the possibility of pregnancy and wishing to become pregnant for at least 12 months.

Secondary infertility: the woman has previously conceived but is subsequently unable to conceive despite living with a man, being exposed to the possibility of pregnancy, and wishing to become pregnant for at least 12 months. Pregnancy wastage: The woman is able to conceive but unable to produce a live birth.

Sub fertility: the difficulty experienced by some couples, both of which may have reduced fertility, in conceiving. Fertility is important to all societies. Infertility has traditionally been a source of pain, anxiety, and shame. And the more important children are to the fabric of a given society, the more it is for couples to be fertile, and the worse are the consequences if a couple is infertile.


Families of four to eight living children are common and only intensify the anguish and pain of those who are unable to bear children (primary infertility) or those unable to have as many children as they would have liked (secondary infertility). Economic and social motivation underscores the hardship imposed on a family by infertility. In most of Africa a man’s wealth is measured, in part, by the number of children he has.

Children are important as farm workers and as a source of support in old age for the parents. Male children also play an important role in certain ethnic groups where, for example, a grandchild is the only person who can replace his departed grandfather, particularly with respect to the practice of certain rituals.

Similarly, a woman’s value to her husband may be determined by her ability to bear a healthy child who will contribute to the family. A woman may be divorced summarily for her inability to bear children (even if the man is the major cause of problem). Specialists claim that infertility is a shared problem. Males and females each separately account for about 40% of infertile unions and jointly are responsible for the remaining 20%.

Most clinicians recommend that semen analysis be the first diagnostic procedure in the infertility investigation. There are a number of factors that increase the likelihood of infertility, these factors include: malnutrition - like under nutrition, may exert a general debilitating effect that may hinder a couple’s attempt to conceive.

Obesity may also lead to less frequent ovulation or to less frequent intercourse, pollution- exposure to toxic fumes, pesticides, and lead are presently being examined on the suspicion that they cause infertility. Smoking tobacco or drinking alcohol are being identified as causes of poor sperm quality in some cases, some occupations- for instance long distance truck driving, may cause oligospermia (fewer sperms) azospermia ( absence of sperms) because of the heat exposure to male organ-the scrotum, cotton seed oil may also contribute to a low sperm count.

Multiple sexual partners for either the man or the woman,  certain tight clothing (undergarments, tight pants) may have the same suppressive effect on sperm production as do hot showers because of high temperatures in the scrotal region. Athletic activities-long distance running for women may bring on amenorrhea (lack of menses). The woman who suffers from sexually transmitted diseases like gonorrhoea may end up with fallopian tubes blocked.

A man who suffers from similar disease may also suffer from infertility as complication. In both man and woman chronic diseases to vital organs especially kidneys, liver may also cause infertility. Anything that can hinder or prevent either gametogenesis (egg or sperm formation) or fertilization can potentially prevent fertilization. Into this category fall, such diverse conditions as undescended testicles, exposure to certain chemicals.

The female factor has been more widely studied in Africa than the male factor because it is commonly assumed that the woman is primarily responsible for infertility. Diseases, which can also cause infertility, like mumps; lymphatic filariasis (matende, ngiri maji) and tuberculosis have been known for quite sometime.

An unfortunate fact of life is that when time comes to father a child, some men have great difficult doing so. Though in certain cases surgery or other medical treatments may be necessary. In others safe and gentle natural therapies may be the answer. If you suspect you are infertile, your doctor can assess the problem and help uncover any underlying causes. Do not go alone, your partner may also need to be examined, because one or both of you may have fertility problems.

If you have any medical condition, talk to your doctor before taking supplements. Children are the cloth of the body. Without children you are naked – so goes a Yoruba saying in Nigeria.

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Author: Dr. Ali A. Mzige

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