Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected sexual contact. Worldwide more than 70 million couples suffer from infertility, affecting up to 15% of all the couples in their reproductive age.

In West Africa up to 30% of the women suffer from secondary infertility, the failure to conceive after an initial pregnancy

In Africa, the situation is worse. WHO demographic studies from 2004 have shown that in sub-Saharan Africa, up to 30% of women aged 25–49 suffer from secondary infertility, the failure to conceive after an initial first pregnancy.

A Wedding in the Gambia

In African societies becoming a mother and bearing children is often the central aspect of the adult female role. Motherhood allows women to demonstrate their commitment to their husbands and families and secure her welfare and status. In addition to the personal grief and suffering it causes, infertility can create broader problems, particular for women, in terms of stigma, economic hardship and social isolation.

Infertility can be caused by many factors; Male, female, or a combination of the two. In approximately 30% of the cases no reason will be found. The main cause of infertility in Africa is genital infection. This may have been sexually transmitted or caused by traditional practices such as FMG, illegal abortions and home deliveries in unhygienic circumstances. If left untreated these infections often result in scar tissue and blockage or dysfunction of the fallopian tubes causing infertility.

Prevention of these infections should be included in any program addressing the issue of infertility. Teaching young people how to avoid getting STD’s and encourage them to seek adequate diagnosis and treatment if any suspicion arises.

Infertility is often surrounded by taboo and mystification. The barren woman must be ‘cursed’ of surrounded by ‘Djins’ bad spirits. In general it is the woman who carries the blame, and the shame.

Women in Africa are not encouraged to seek medical help. Fertility care, if available is very basic. Medical staff are often already overstretched and infertility is not a priority. Infertile women may be wrongly or over prescribed with fertility drugs or even treated with unnecessary or harmful procedures such as D & C.

Modern assisted reproductive techniques such as IUI and IVF are either very costly or simply unavailable. Combined with the widespread lack of insurance coverage, seeking fertility care often means a lonely path for women wishing to conceive.      

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