INFERTILITY is a global health problem characterised by the failure to achieve a pregnancy.
It affects both women and men – regardless of race, religion, culture, class, or socio-economic status. Although both women and men can experience infertility, women are often perceived to suffer from infertility, despite men contributing to about 40% of cases.
Infertility has significant negative social impacts on the lives of infertile couples and particularly women, who frequently experience intimate partner violence, divorce, social stigma, emotional stress, depression, anxiety, and low self-esteem due to the issue.
In 2009 Africa had the highest burden of infertility. In many African countries, the success of a marriage depends on the ability of a woman to bear children. This causes serious psychological trauma and social isolation. The causes of infertility can be classified into male factors, female factors, or both.
These causes can be congenital or acquired, such as past reproductive system infections. If a couple is struggling to conceive, they are advised to see a gynaecologist early so that the possible cause can be determined. Once a cause is identified, this will guide appropriate patient management.
However, in up to 30% of couples, no cause is found, leading to what is known as unexplained infertility. This too can be treated. Contraception use and vaccination do not cause infertility. Lately, there have been rumours linking Covid-19 vaccines to future infertility.
Based on how the vaccines are developed and from past experiences with vaccines, this is unlikely.
The World Health Organisation (WHO) has recognised infertility as “a disease of the reproductive system”, defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.
Available data suggests that an inability to have a child or to become pregnant can result in stigma, may be used as grounds for divorce, and will often justify the denial of access to family traditions.
While the cause of infertility can easily be found, the biggest challenge globally has been accessing treatment.
Availability, accessibility, and quality of interventions to address infertility remain challenges in most countries, and Namibia is no exception.
Most countries do not prioritize the diagnosis and treatment of infertility, especially in Africa, with other health challenges such as HIV-AIDS. In addition to this, most medical aid schemes do not cover infertility treatment. Assisted reproductive technology provides infertile couples with hope, even though few can afford it.
To address infertility effectively, governments and medical insurance schemes need to recognise infertility as a disease, thereby reducing the need for costly and poorly accessible treatment.