Over 1,500 couples visit fertility clinics every month, with 15 cases recorded in Mulago Hospital everyday
I nfertility primarily refers to the biological inability of a person to contribute to conception despite regular sexual intercourse minus contraception for a year.
According to Dr Othman Kakaire, a consultant at the Department of Obstetrics and Gynaecology at Mulago Hospital, little was known about infertility in the past. Because of the multiple partners one had, it was quite hard for one to know who was infertile. But mostly it was seen as a woman problem. Men had many wives who would at times have extramarital affairs and conceive from other partners without the knowledge of their spouses.
However, today with increasing monogamy and faithfulness, the vulnerability is becoming clearer. It is a problem that affects both men and women in the productive age group.
Among the causes that lead to infertility is impotence, low sperm count (of less than 15 sperms per ml, sometimes caused by infections like STDS), viral mumps, blocked sperm ducts that transmit the sperms or blocked fallopian tubes which transmit ova from the ovaries to the uterus to meet the sperms, big blood vessels around the testes, and hormonal disorders.
Many medical practitioners say abortion is one of the major causes of infertility among women, while among men it is STDs. In Uganda infertility is 40% a man’s problem, 40% a woman’s problem and 20% due to both of them and other factors.
Between 6-8 percent of Uganda’s population are infertile. In Africa especially the Central African Republic and many West African countries, over 30% of the population are infertile.
Dr Vincent Karuhanga of Friend’s Polyclinic and Ambulance Services in Kampala says the country is witnessing increasing infertility rates because of obesity and the changing lifestyles especially among career oriented women. Such women, Karuhanga says, want to first complete their studies and advance in their careers before settling down to have children. He says people who are likely to experience this are those who are 45 years and above in men and 35 years and above in women.
He advices that for sperms to increase, men need to bathe hot water and need to wear boxer shorts instead of wearing trousers that hold their testicles upwards. Men and women should eat foods rich in vitamins to reduce on the risk of infertility.
However at policy level, there seems little government response to the problem, with many public hospitals lacking facilities to carry out such specialised treatments at affordable costs. Mulago Hospital alone, according to Dr Kakaire, receives about 15 new patients with infertility related problems per week yet the hospital is unable to adequately treat many of the cases.
Some private organisations have set up infertility treatment centres. But these also need to be complimented or reinforced by government efforts. Joyce Fertility Support Centre in Kololo, and the Women’s Hospital International and Fertility Centre in Bukoto have brought hope to infertile couples.
It costs between US $500-600 dollars on average to treat a case of infertility in the private hospitals. Most Ugandans cannot afford this.
Dr Ssali Tamale, of Women’s Hospital International and Fertility Centre says they receive at least 20 new patients per day. This makes it 100 per week on average and 1,500 in a month. Dr Ssali says it is a widespread problem that affects people of all walks of life. He told this writer that treatment varies from person to person because some couples have complicated cases where they are required to hire “wombs” [paying a person to carry the foetus until the baby is due]. They are known as surrogate mothers. Dr Ssali’s first miracle baby celebrated her 5th birthday on October 2. He said the hospital has treated over 15,000 people since 2006.
Infertility is a disturbing phenomenon at family and peer level, as well as in the wider society. In many of our societies, a marriage is never complete until the birth of the first child. A person who cannot produce children is held in low esteem by society and his/her peers.
It is also a major cause of promiscuity as spouses seek to have children outside marriage, hence leading to promiscuity and polygamy and increase in HIV/AIDS prevalence.
The desperation that comes with infertility often drives many couples to visit witchdoctors thinking they were bewitched or cursed. They are often exploited and or fleeced by the unscrupulous witchdoctors or traditional healers under false assurance that they will cure their problems.
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written by Kakaire Othman, February 02, 2010
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Please tell me about relation between blood group and male infertility. My blood group is A negative and I am 33 year men and facing infertility problem.
Thank You for your cooperation.
Kishor