By Ijeoma Ukazu
Married as a virgin in 2010 at age 31, Carol, just like any other woman was expected to get pregnant and have babies naturally but after a year, that was not to be.
One year turned into two, three and four with her hopes dashed. At this time, she became the topic of discussion among her neighbours due to her inability to bear a child.
At the fourth year and no conception, Carol’s journey to seek help began. She visited random hospitals for tests which always come out with the news that -“All is well with your reproductive organs, madam,” said the doctors.
Confused as to why the positive test results but no pregnancy, she tells The Daily Newswave, “I cannot understand why the delay in conception. I didn’t live a wayward life.”
In the fifth year, still no pregnancy. “The journey continued for me in search of help,” She said. “I moved from one hospital to another. During this period, my heart was troubled. I was having sleepless nights wondering where I could have gone wrong. It is not a place I wish for any woman.”
The sixth year, Carol sorts the help of a fertility expert introduced to her by a friend at Nordica Fertility Center Lagos. After a series of tests, In-vitro Fertilisation (IVF) was advised. Though sceptical about the idea, Carol a pastor, felt, that conceiving through, IVF, was a “sin before God”.
According to Wikipedia, In Vitro Fertilisation is a process of fertilisation where an egg is combined with sperm in vitro. The process involves monitoring and stimulating a woman’s ovulatory process, removing an ovum or ova from her ovaries and letting sperm fertilise them in a culture medium in a laboratory.
Though a good option for Carol, IVF in any part of the world is not cheap.
Continuing, she said going through the expensive treatment and fertilisation process was painful but I endured it all.
Carol and husband, Peter both pastors were elated when the IVF process was running smoothly but unfortunately failed along the way.
The failed IVF left Carol especially, devastated but she remained hopeful that someday she will live to bear her child.
She rose above the pain she felt daily, the stigma, and the gossip and hoped that God will bless her with a child soon.
At the eleventh year of her marriage, an opportunity came to be sponsored by a foundation to have a free IVF procedure and couples were allowed to choose the fertility centre they preferred.
Carol opted for Nordica Fertility Center again since she already has a history with the centre.
Alas! Carol and husband were blessed with a beautiful baby through the IVF.
The African population is estimated to be 1.2 billion; therefore 1.8 million IVF cycles should be done to meet its current population demand. Yet, according to the published data, less than 1.5 per cent of the African population has access to assisted reproduction.
For Mrs Kate Uzochukwu her plans was to have three children before her 36th birthday. She already had names for her unborn children.
But, things didn’t turn out as planned. After her first year in marriage, at 30, she immediately became worried and sorted help.
She was told all was fine with her reproductive organs but needed some rest and quality sexual moments with her husband.
Kate, who is resident in Enugu State, South-East Nigeria eventually got pregnant in the second year of marriage but unfortunately lost the pregnancy in the first trimester.
Narrating her ordeal to The Daily Newswave, she said, “Sleep was far from me. I cry myself to bed every night. People called me all sorts of unprintable names. I remember a woman calling me “Mami water” meaning priestess of the marine and that I have eaten up the child God put in my womb. She told me that, she only pitied my husband who will die without having a child of his own.”
Five years went by, Kate never got pregnant at this time, she picked up a job at a microfinance bank in her locality.
“I told myself, I will rise above infertility. Infertility will not define me,” She remained hopeful a child will come someday.
Kate grew in her career to become a bank branch manager without letting her inability to have a child weigh her down.
At exactly 10 years of her marriage, she was confirmed pregnant at the Enugu State University Teaching Hospital Parklane Enugu. Kate gave birth to her child without complications and two years after she birthed another child.
Carol and Kate are just two among the thousands of women in Africa who go through stigma, neglect and sometimes attempted self-harm due to their inability to get pregnant and give birth to children.
Experts said every one in 4 couples in Nigeria is infertile and that infertility may arise from one factor or a combination of factors.
According to the World Health Organisation (WHO) estimate that about 186 million individuals live with infertility globally. In African countries, 32 per cent of couples are dealing with infertility. The stigma associated with the inability to conceive is much, and some couples tend to experience depression and trauma while trying to conceive.
A well-known fertility expert in Nigeria, Dr Abayomi Ajayi, Managing Director, Nordica Fertility Center Lagos said infertility is a medical condition that touches all aspects of the lives of a couple trying to conceive.
Ajayi says “Infertility may affect your relationships with others, your perspective on life, and how you feel about yourself but how you deal with these feelings will depend on your personality and life experiences.”
He advised couples who are dealing with infertility issues to always engage in physical activities or exercise and avoid any form of a sedentary lifestyle.
On nutrition, he said adequate diet is very important in combating infertility, daily intake of folic acids regularly would go a long way for the couples.
The Nordica Fertility Boss adds that ultimately, the lifestyle of the patient matters as well as activeness through constant exercise would help infertility treatment.
President of the African Reproductive Care Society (ARCS), Prof. Oladapo Ashiru is a question and answer session during the 2022 World Infertility Awareness Month organised by Merck Foundation harps on increased awareness of infertility as well as fertility education would assist in stemming the tide.
Ashiru who is also the Secretary-General, of the International Federation of Fertility Societies, (IFFS) revealed that some causes of infertility span from the environment and diets, however, it is important that there should be increased access to care.
He states that access to care in Africa is minimally low while the infertility burden is high, stressing that there is an urgent need to bridge the gap.
The Professor points out that the African Reproductive Care Society, International Federation of Fertility Societies and Merck Foundation are teaming up with other countries to demand more emphasis be put on infertility as well as the need to increase access to care.
He said according to the United Nations having a baby is now a human right, therefore all hands must be on deck to ensure that every family is happy by having a baby.
Creating more awareness surrounding infertility stigma, Dr Senator Rasha Kelej, the Chief Executive Officer (CEO) of the renowned Merck Foundation in her YouTube TV program titled: ‘Our Africa TV Program’ by Merck Foundation, episode three; Breaking Infertility Stigma, said, infertility can be prevented as 75 to 85 per cent of infertility is caused by untreated infectious diseases that can be treated, prevented and managed.
Reeling out some causes of infertility, Dr Kelej said to include; Child Marriage, Female Genital Mutilation, Sexually Transmitted Infections, unsafe abortion and unsafe delivery as well as early pregnancy amongst others.
She further states that “All the aforementioned can cause infectious diseases if not treated early enough.”
The Merck Foundation CEO points out that raising awareness on prevention is key to ending infertility stigma, adding that infertility cause is shared between the woman and the man (50/50), noting that, it is a shared responsibility between the man and the woman to have a child.
According to her Merck Foundation has been building health capacity of doctors and also breaking infertility stigma and supporting girls education in Africa.
“We are making history and legacy in Africa by training the first Fertility specialists, Embryology, Oncologists, Diabetes, Endocrinology, Respiratory experts and more in many countries. Merck Foundation programs have greatly contributed to building professional healthcare capacity through providing more than 1300 scholarships to doctors from 50 countries.
“Scholarships of one year, two-year and three-year Diploma and Master degree in more than 32 critical and underserved specialties are provided to these doctors. This is part of our strategy to build health capacity by providing specialized training in various specialities and define interventions to break infertility stigma.”
Dr Kelej revealed that social and cultural issues are part of the reason the #MoreThanAMother campaign started gearing towards driving the course to end infertility stigma in Africa and the global community.
She encouraged men to “Share responsibility and go get tested, treatment and stop blaming the woman for her inability to get pregnant.”
Source: Indore Infertility Clinic
A systematic review and meta-analysis by Yuanyuan Wang et al. published in the June 2022 edition of The Lancet Global Health show that at least one in three infertile women in Low and Middle-Income Countries (LMICs) suffered from intimate partner violence over 12 months and approximately one in two suffered over their lifetime – with psychological violence being the most common form of IPV, followed by physical violence, sexual violence, and economic coercion.
The study also found that infertile women in LMICs were more likely to suffer physical violence and sexual violence over their lifetime than fertile women.
The Lancet Scientific Journal review adds that in this era of leaving no one behind, it is time to bring infertility out of the shadows of reproductive health research and policy. There is a pressing need to shine a light on the lived experiences and psychosocial realities of infertility for individuals and couples in resource-poor settings who are particularly vulnerable to abuse and exploitation.
“As a first step, culturally sensitive awareness campaigns could help reduce the stigma and open dialogues on safe, effective, and affordable ways to attain parenthood for those who seek to,” the report states.