Phillipa Mukome Chinhoi
Outside medical circles, there is a misconception that infertility is primarily a female issue.
Women have always been blamed if couples fail to conceive and in some cases are divorced for failing to have children.
However, research by medical experts has shown that both males and females can be responsible for the problem. Each contributes about one-third of all infertility cases.
This came out during an online media training programme organised by Merck Foundation Health in partnership with The First Lady Dr Auxillia Mnangagwa, More Than a Mother Campaign and the Zimbabwe National Editors Forum (ZINEF) on Thursday.
Addressing participants, fertility specialist, Dr Mugove Gerald Madziyire said men need to go for counselling so that they do not lose their self-esteem.
He said male ego was tied to the ability to reproduce hence the need for psychotherapy for them to accept this as any other medical condition.
Dr Madziyire urged men to be investigated to establish whether their condition was treatable or not. If not treatable counselling on options such as sperm donation or adoption is offered.
“Men’s fertility is not always talked about but instead it is the woman who is talked about and blamed, this is due to stigma. Men are often not forthcoming to be assessed. Medically assessment of both partners is always encouraged, however Some causes are correctable while others are not, “said Dr Madziyire.
“In many regions in the world the proportions are almost equal about 40 percent each and the other 20 percent unexplained. In a study we did in Zimbabwe on causes of infertility, male factors contributed about 30 percent, female factors 50 percent, and about 20 percent were unexplained.
“Ignorance, patriarchy, and stigma; there is more low esteem and shame on a man who does not reproduce. Society needs to accept both men’s and women’s infertility like any other medical condition,” he said.
In a recent interview with some men in Hatfield in Harare, most of those aged 18 and above declared they were either unaware of or unconcerned with their fertility health.
One of them, Maurice Chitsa, said it was difficult to accept one’s infertility, and embarrassing if the public became aware of the condition.
“As men, we are the ones expected to provide women with a seed. As such, when you realise you are the one at fault, it becomes hard for us to accept the situation. It is extremely stressful to be labelled infertile,” said Chitsa.
“Ordinarily, infertility has historically been thought of as primarily a female issue. This is probably because women are more likely to discuss their struggles with infertility, or more willing to dig deeper into the causes of these problems.
“As for us, men, we always feel women are the ones who should go for testing, while we remain behind, waiting for the results. In most cases, when the results are out, we always expect to hear that it is the wife who is to blame,” he said.
Infertility is a global health issue affecting millions of people of reproductive age worldwide.
Available data suggests that globally, one in six people experience infertility in their lifetime.
Infertility is a disease of the male or female reproductive system that is marked by failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse.
Primary infertility is the inability to have any pregnancy. On the other hand, secondary infertility is the inability to have pregnancy after successful conception in the past.
The World Health Organisation’s International Classification of Diseases provides more information on the primary and secondary causes of infertility in both men and women.
Infertility may be explained by male or female factors, or a combination of both. At the same time, there are cases where the cause of the condition is unexplained.
Harare healthcare worker Ms Tatenda Wangonditsa said women were however, largely blamed for infertility.
“People come to such conclusions without conducting proper investigations, leading to many problems, divorce and gender-based violence.
“It is important to note that various medical conditions and other factors can contribute to fertility problems. One case can have a single cause or several causal factors. In some instances, it can have no identifiable cause,” she added.
According to the WHO, there are cases of infertility where a man produces less sperm than normal. This is mainly caused by varicocele, an enlargement of the veins in the testicle. Varicocele is found in almost 40 percent of men with infertility problems.
Complete lack of sperm occurs in 10 to 15 percent of men who are infertile.
This can arise due to hormonal imbalances or blockages in the male reproductive organs.
However, in about 50 percent of cases, the cause of male infertility cannot be determined.
In an interview, Mr Jonasi Nyakatawa and his wife Selina, from Nyatate in Nyanga, said a lot of the views on infertility boil down to gender stereotypes and this is why most people do not talk much about male fertility struggles.
This situation is attributable to the media, the family, the traditional setup, the Christian side, cultural dynamics and social pressure, among other things.
The Nyakatawas are still struggling with conception but hope one day, with God’s grace, all will be well.
They are devoted Christians, who believe God will at one point, answer their prayers.
“My in-laws tried to take us to traditional healers, but we told them not to interfere. We almost divorced as a result of the interference. However, due to counselling from the church and medical doctors, we are still together, hoping for the best,” said Mrs Nyakatawa.
According to the American Society for Reproductive Medicine, and National Institutes of Health, treatment for male infertility depends on the cause.
If a specific cause of infertility is discovered, it is sometimes possible to deal with it.
A variety of treatment options are available and they include hormonal therapy, surgery to correct blocked tubes and treatment of infections or underlying medical conditions.
A man who wishes to get a better understanding of his fertility status should consider visiting a doctor. The experts can analyse his semen, health history and other factors that may have an impact on his fertility.
In the case of a women, she can also visit a doctor if she has been trying to get pregnant for at least one year but fails to conceive.