In Nigeria, one in every four couples has experienced infertility. Martins Ifijeh chronicles the lives of couples who have gone through the pain associated with the health and social challenge, as well as how this can be addressed
Ever woken up in the middle of the night to think about your life’s journeys through infertility and how science has been unfair to your reproductive life? How about being in the midst of friends and colleagues who, without much effort, get pregnant and have babies?
Wonder no further. This is the life one in four Nigerian couples go through every day because they are unable to have children of their own. They unfortunately fall into the unfavourable science’s game of numbers – not every couple will have children at ease or at all.
Endometriosis and My Journey through infertility
One of such women is Gloria (not real name), a 37 year old woman who has nursed the pain of infertility for 12 years; a period of time she thought she would be done with child bearing.
Gloria married her longtime boyfriend, Reuben on May 12, 2008 few months after her National Youth Service Corp. She was only 25 and had hoped in six years she would have her two sons and a daughter run round her home. But she was wrong. Life didn’t serve her the menu she ordered.
At first it was not much of a concern to her and her husband, as they had thought their anxiety and work induced stress were playing a role in the pregnancy delay.
“By the second year, I started to worry. I got all manners of advices from family and friends; and then I started moving from one deliverance home to the other. In one breathe, they will tell me I had a spiritual husband preventing the pregnancy. In another; they will say it was my in-laws that were spiritually causing my infertility. I moved from pastors to imams and then to herbal homes with no solution in sight. To me, it was motherhood or nothing,” said Gloria.
But when all religious and herbal interventions failed four years after, Gloria approached a gynaecologist, who upon examination told her the painful sexual intercourse she experiences; the painful menstruation and the discomfort she gets during urination were responsible for her infertility. Medically put, Gloria had severe endometriosis. She was told her odd of having a child of her own was slim.
Unfortunately for her and Reuben, they took the doctor’s message hook, line and sinker. She is on the verge of losing her family love if she does not become a mother. To the family, endometriosis has foreclosed the possibility of the union producing children. It is either she becomes a mother or the love fades.
This is one plight of many Nigerian women suffering infertility. The society believes it is their exclusive preserve to bring forth children to the house, and that infertility is not caused by men.
According to the Managing Director of Nordica Fertility Centre, Dr. Abayomi Ajayi, women suffering from endometriosis may have children of their own if the condition is well managed.
“With proper and conservative treatment, women with endometriosis can have normal conception and delivery, but if such women are still having trouble conceiving, they may need to see fertility specialists to explore their options for becoming pregnant. With invitro fertilization (IVF), there is a possibility of becoming pregnant,” he added.
Endometriosis, according to health experts is a condition in which the tissue which normally lines the uterus grows outside of it. They believed these tissues may grow in the ovaries, fallopian tubes or even intestines.
Holding on to Hope
Mrs. Adefemi is a bank manager who lives in Ikeja area of Lagos. Her love for children endeared her to the children department in her church. She has always dreamt to have little ones flock around her. But she had wanted her own children to be among such children too.
During her young days, she had a picture of the successful life she wanted which includes having a good job, marrying a responsible man, and then having beautiful children that would call her ‘mummy’. She was 21 years at the time and was going to stop making babies by her 30th birthday.
She worked hard for this dream to come through. The universe aligned with her on all her dreams, but one; her home is empty, no children to run round her expanded building. This was her only low point in life.
At the early days of the marriage, she had agreed with her husband their first child would be called Lifted Adefemi no matter the gender. As time weaned, they were no longer taking about what name their babies would have. She would even prefer the worst of names so long she had her child.
“For the first time in three years we did not celebrate our wedding anniversary. Not even a Facebook. It appeared as an unspoken agreement between me and my husband. None of us spoke a word about the anniversary. Science was dealing a blow on us.
“We would sometimes wake up in the middle of the night to wonder what we were not doing right. We knew something was wrong but we couldn’t place it.
“By June last year which was our 7th wedding anniversary, we decided to go for IVF; a process by which a woman’s egg is fertilised by a man’s sperm outside the body, usually done through a laboratory procedure involving high monitoring and stimulation of the reproductive elements. It is an assisted reproduction technology (ART) that has given new hope to couples who cannot conceive naturally.
“We have located a good IVF centre now in Lagos here where I underwent a couple of tests, along with my husband. We paid for three cycles. Fortunately for us, the 2nd one eventually implanted, and in few months’ time, I hope to be a mother,” she happily said.
Nine attempts at pregnancy without success
Kemi had married her husband who previously had a two year old son out of the share belief that soon she will have her own children who will call her step son ‘brother’. She unfortunately had bouts of miscarriages and eventually had an ectopic pregnancy that almost took her life.
“I took in nine times for my ex-husband. But for every time this happened, it would end up in a miscarriage. It got to a point that even when I told him I was pregnant, I will see sadness written over her face, because he was almost certain it would end in disappointment. This was unfortunately what happened on every occasion.
“But the 7th and 8th time were promising. We had passed the usual two to three months where I often experience the miscarriage. I was hopeful, but on the two occasions, I lost the pregnancies at 6th month. I was told I had cervix incontinence, and that my body was unable to hold the baby beyond that point.”
In the heat of the disappointment, she took in again. This time, she almost lost her life for it. From minor pain at the 3rd month, she started to have unbearable pain until she was rushed to the hospital where they diagnosed that the baby was growing outside of her womb, a situation doctors call ectopic pregnancy.
“I was told if I allow the baby to grow in such state, it may destroy some vital organs and put my life at great risk.”
This 9th pregnancy complication was what broke the camel’s back until she left the house and vowed never to remarry.
The depressing picture
Gloria, Adefemi and Kemi are just three among millions of Nigerian couples who have gone through or still going through the challenges of fertility.
Records from hospitals show that 40 to 45 per cent of all consultations in gynaecological clinics are infertility-related in Nigeria, a statistics that brings to bare the burden of infertility in the country.
Dr. Ovie Latimore of Medical Director, Grailvine Medical Centre, Asaba, believed the percentage of couples with infertility would have been reduced if many come forward for treatment, adding that the medical condition can be addressed both in males and females.
“A lot of Nigerian couples, especially the males are still living in denial. Some men would tell you as long as they can last long in bed, they are fertile. There are still too many dark areas on the knowledge of infertility treatment by Nigerians. This has in no way helped in addressing the burden in the country,” he said.
Infertility leads to unhappy relationships
Studies have shown that infertility is not only a medical condition, but a major social concern that has silently destroyed many homes.
A marriage counselor and social health worker, Mrs. Blessing Nwaneri-Obi said: “Apart from the impact infertility has on the psychology of couples; it has caused the breakup of several marriages. Over 30 per cent of marriage breakups have been linked to fertility related issues. This is why we must give treatment a priority.
“Often times these marriages break up because partners do not see other solutions to the problem, as they may have gone for help in odd places without results, thereby fueling frustration,” she added.
Reasons for Infertility
The World Health Organisation (WHO) has listed infection, genetics, environmental, and health challenges like adrenal and thyroid diseases as major causes of infertility globally.
For Africa, including Nigeria, the health body believed 85 percent of infertility was caused by infection as compared to 33 per cent worldwide.
Dr. Ajayi, who is an obstetrician and a gynaecologist, says apart from infection, which is a leading cause of the health challenge, excessive intake of alcohol, coffee, smoking, appendicitis, low sperm count, use of steroids, among others could cause infertility.
Endometriosis and associated risks
Dr. Ajayi who has championed fights against endometriosis in Nigeria said there exist category of women whose fertility problems has no medical explanation.
Adding that some of such women may be suffering from endometriosis; a disorder in which tissues forming the lining of the uterus grows outside the uterine cavity.
Dr. Ajayi, who has assisted infertile couples to birth several thousands of babies through IVF, said this was because endometriosis happens to be the cause of half of all unexplained infertility, affecting one in 10 women of reproductive age.
He however added that the condition can be properly managed and that women living with it have the possibility of carrying their own babies.
Men are Also Prone to Infertility
Dr. Ajayi said infertility burden is shared equally among men and women, adding that one of the drawbacks on the treatment of the health challenge was that often times women were the ones who access treatment, while most men continue to live in denial.
He said: “Worldwide, sperm count has reduced by more than 30 per cent. When comparing the sperm count of men who used Nordica’s service 10 years ago and now, the decline in counts have reduced by more than 30 per cent, and they are increasingly contributing to infertility.
“Men should not shy away from coming out as there are now technologies to assist men with very low sperm to be able to fertilise an egg. Intra-cytoplasmic Morphologically-selected Sperm (IMSI) is helpful in this regards,” he added.