Understanding infertility: The myths and misconceptions

Screengrab of Dr Kireki Omanwa. [Spice FM]

As the world marks Infertility Awareness Month, a persistent myth that childlessness in a family, is primarily a woman’s fault, was countered by Dr. Kireki Omanwa, President of the Kenya Obstetrical and Gynaecological Society.

Speaking on spice FM on Friday, June 20, Dr. Omanwa revealed that statistics indicate men as slightly more affected by infertility than women.

“About 40% of the issues of infertility are actually caused by men or male factors, about 35% are women or female factors, about 10, 15 are both, then we have a small percentage, where it is ‘unknown’, it means that, we have done the basic tests and we still can’t find the reason why this couple can’t have a baby,” he said.

Dr. Omanwa further explained that infertility falls into two main categories: primary and secondary, saying primary infertility is when a couple in a relationship have intercourse two to three times a week. And a year has passed and there is no conception.

While secondary infertility is when a heterosexual couple in a relationship have intercourse two to three times a week. But they have had a conception in the past or they have a baby or babies and now trying to have another.

He emphasized that sexually transmitted infections, particularly chlamydia, are a silent cause of infertility in both men and women.

“They are young patients who are able to do everything, but their tubes are blocked. Why? Because of sexually transmitted infections, especially chlamydia. Chlamydia is an infection which has no symptoms at all,” he said.

In women, Dr. Omanwa pointed to several contributing factors of infertility including, age and declining egg quality, fibroid, and hormonal imbalance.

Age and declining egg quality

“So if it's a patient who is 36, for example, and she's in a relationship and six months, nothing has happened and everything is deemed to be okay, then we can actually consider age that to be a reason. And then because that even if we were to do IVF, you find the embryos that we create are poor quality, and then chances of implantation and having a baby become a challenge” said Omanwa.

Fibroid

Omanwa also stated that ,“About 30 to 60% of women of reproductive age, especially of African origin, whether they're in Kenya, will have problems with fibroid. We don't exactly know why,”he questioned.

He also mentioned other factors such as hormonal imbalances, Polycystic Ovary Syndrome (PCOS), endometriosis, lack of intercourse, lifestyle habits, and psychological stress.

In men, Dr Omanwa stated various factors, highlighting sperm quality has the leading cause.

Sperms

“When it comes to men, men we have challenges. The biggest problem is the quality of the sperm, “he said.

Age

On the issue of age as a contributing factor to infertility the doctor said “I don't want to call them older men, but slightly mature men, usually in their 50s plus. And there are other issues which may accompany this. For example, other diseases like diabetes, like hypertension and so on. But it has been noted that younger men are also having this challenge.’’

He also warned against dangerous practices, such as penis enlargement procedures and injections.

“There are men who actually go and have different things injected into the penis, remember this is something which is intrusive and this can lead to infections, in the process of trying to enlarge your manhood you may actually bring on a secondary problem which can affect your fertility,” said Omanwa.

Dr Omanwa observed that men compared to women are uncomfortable to address the issue of infertility saying, “No man wants to be perceived as being weak, so we don’t want to open up, especially in very intimate and very sensitive issue,” adding that women are more comfortable to visit clinics compared to men.

Another major barrier is the cost of infertility treatment. While assisted reproductive technologies like In Vitro Fertilization (IVF) and Intrauterine Insemination (IUI) are available, they are far from affordable for many.

“Cost is a factor, we are trying to work with the different areas, I hope the national and county government can also come in to support that, I hope SHA can also come in and also do that, because the cost can prohibitive,” said Omanwa

Omanwa noted that in cases where natural conception is not possible, sperm-assisted reproductive technologies such as (IVF) and Intrauterine Insemination (IUI) are considered viable alternatives.