Conception – Source Getty Images
Angela Onwuzoo
Lots of misconceptions about infertility abound, and particularly damaging is the cultural belief that only women can have reproductive challenges, thus, absolving men of any responsibility. This has created gaps in how infertility issues are handled in homes, reports ANGELA ONWUZOO.
14 years ago, when she was still single, Mrs Jumoke Albert, loved attending birthday parties and christenings.
As a party lover, the businesswoman, who owns a thriving boutique in Lagos, planned to celebrate her own children when she got married.
The 42-year-old housewife, never envisaged facing a challenge in terms of conceiving her own child because her siblings were all married with kids, and had no form of delay.
Sitting on the edge of a black sofa in their three-bedroom apartment in Yaba, Jumoke recalled with a sombre voice, how months of waiting after her colourful wedding in 2010, had turned into long years of waiting with so much pressure and being blamed for her childlessness.
Wiping her tears at intervals, while narrating her experience to our correspondent, the businesswoman said her 14 years of marriage had been very horrific.
The humiliation and ridicule she endures daily from her husband’s family members, who constantly accuse her of being responsible for their childlessness, are troubling.
The business administration graduate said she had been constrained to stay away from any merrymaking both in the family and the neighbourhood to avoid being mocked and reminded that she was yet to have a child for her husband.
More heartbreaking for Jumoke is the fact that her husband, who was diagnosed with a low sperm count by a fertility doctor, is silent about his condition and refuses to go for treatment, while his family keeps blaming her for their childless situation.
Women as culprits
“Imagine being blamed by in-laws every day for not giving their son children, when their son – my husband – can’t get me pregnant because he has a low sperm count and pretend that all is well.
“Imagine being so scared of my husband’s family members each time they visit, especially my mother-in-law, for fear of being called a barren woman, while my husband, who has the problem will keep quiet and not even defend me”, Jumoke muttered, fighting back tears.
The businesswoman told our correspondent that she is more troubled by her husband’s refusal to support her in finding a solution to their childlessness.
She recounted, “We both went for medical evaluation after years of waiting. When the results came out, the doctor said I was medically okay. But he told my husband that he had a low sperm count and would require treatment.
“You won’t believe that after that particular visit, my husband refused to talk about it again. He ignored the treatment, insisting that he was a man and there was nothing wrong with his sperm.”
In an emotive voice, Jumoke recalled that from name-calling to insults, and constant abuse, the past 14 years had been the worst of her life, simply because she was unable to get pregnant and her husband refused to seek help even when his medical report showed he has issues.
One in six people at risk of infertility
It is an open secret that in Nigeria when a union is unable to produce a child, it’s often regarded as the woman’s fault.
However, according to experts, that is far from being the truth, explaining that sperm count among men is declining and is partly responsible for the increased infertility being recorded among couples.
Infertility is a disease of the male or female reproductive system and is defined by the failure to achieve a pregnancy after 12 months or more of having regular unprotected sexual intercourse, according to experts.
Pregnant woman
Image Source: Rolling Stone
They note that infertility is a global health issue affecting millions of people of reproductive age worldwide.
The World Health Organisation in a new report stated that a large number of people are affected by infertility in their lifetime, while experts say that the ratio of male to female infertility is about 50:50.
The report said around 17.5 per cent of the adult population, about one in six worldwide, experience infertility, showing the urgent need to increase access to affordable, high-quality fertility care for those in need.
In her interaction with PUNCH Healthwise, Jumoke said, “My husband’s family members frustrate my life every day because I have not been able to get pregnant, yet the fault is from my husband.
“My husband refused to open up and I can’t even discuss the problem with his family members because they have a mindset that childbirth is the responsibility of the woman and it is always the woman’s fault when there is an issue of infertility or childlessness in the home.
“Imagine going through this trauma year in, year out, for 14 years, yet my husband has refused to seek help or talk about it. Some of my family members have advised me to separate from him, but I don’t want infertility to be the reason our marriage didn’t work out.”
While speaking with our correspondent about her travails, Jumoke recalled that their love affair, which used to be envied by many, slid into torment and pain when she was unable to conceive five years into the marriage.
She recounted, “We got married in 2010 and had a beautiful wedding. Our honeymoon was splendid because we were truly in love with each other. We planned to have children immediately so we could move on.
“But, one year after, there was nothing, the second year passed, and I didn’t conceive. Then I became apprehensive when we got to the fifth year. However, I noticed that my husband was not too keen for us to go to the hospital to find out the cause.”
Despite the humiliation that Jumoke goes through in the marriage, her husband remains adamant about seeing a doctor.
She added, “One day, I told him that we should go and see a gynaecologist, but he refused and asked me to go alone. Initially, I thought he was joking. When I realised that he was not ready to go with me, I went alone. I did several tests and when the results were out, the doctor told me to be patient and that I was medically okay.
“He requested that my husband come for a medical evaluation. The doctor told me that the issue of infertility is not a woman’s problem. When I got home and gave him my medical report and told him the doctor would like to see him, he hissed and walked away.
“After much persuasion, he agreed that we should see the doctor.”
Jumoke who heaved a sigh of relief when her husband eventually agreed to see a doctor was thrown into agony again when her husband refused to accept the result of his test.
My husband refused treatment
The Ogun State indigene said further, “We did several tests and when the results were out, the doctor said I should be calm that I was okay but that my husband had very low sperm count that would require some treatment apart from lifestyle modifications.
“I assured him of my love and that he should commence the treatment. He told the doctor that he would come back for his treatment. But when we went home, he told me that he would not go for any treatment and he never did, maintaining that there was nothing wrong with him.”
Despite her husband’s condition, the businesswoman said she has decided not to leave the marriage, despite the hostility from her mother-in-law.
She said, “Last year, my elder sister suggested that since it was obvious that he has a problem and has refused to address it, I should go for in vitro fertilisation treatment or leave him and marry someone else so I can have children.
“I don’t want to break up with him because of infertility and he has agreed that I should go for IVF and not adoption. We are currently saving for it because it is expensive. Once the money is complete, I will go for it.”
Men’s refusal for tests fuelled by ego, culture
Gynaecologists, who spoke on the issue identified culture, ego and ignorance as major reasons why some men feel the issue of infertility in a marriage is the problem of the woman and have refused to seek help.
A Consultant Gynaecologist and Obstetrician, Dr Adeleke Kaka, told PUNCH Healthwise that blaming a woman for childlessness is a societal and cultural issue that should be discouraged.
Dr Adeleke Kaka
He said it was unfortunate that there are still many traditional men who, despite their educational background, believed that nothing could be wrong with their reproductive system, and ended up blaming the women for infertility.
Besides culture, the maternal health expert also identified ego as another major reason why men refuse to seek help when they have issues with getting their wives pregnant after many years of marriage.
Oppression of women over infertility
There have been misconceptions about infertility, which have led to the oppression of the female gender in many cultures in Nigeria.
These misconceptions have created gaps in the ways infertility issues are handled in many homes in Nigeria and other African countries.
Some women who are still waiting for the ‘fruit of the womb’, as it is so called, who shared their experiences with PUNCH Healthwise, said it was depressing enduring their husbands’ family members’ accusations of being infertile when the problem is actually from their husbands.
Some studies have also shown that cultural assumptions about women’s reproductive responsibilities have shaped medical science.
The studies note that although male infertility is as common as female infertility, we live in a world where there are more practitioners and technologies focused on treating women than assessing and treating men.
Yet many others
Mrs Esther Ibeh lives every day of her life with a broken heart, also for not having a child, even though it was no fault of hers.
In her narration that could move anyone to tears, the depressed civil servant recalled how her husband of nine years refused to disclose his medical report to her when he was diagnosed with an infection and low sperm count.
She said, “My husband knew that he had a problem even before we got married, but he hid it from me. He was my first love. We met while in the university and our courtship was a beautiful experience. We got married and things were going smoothly between us. Three years into the marriage, I became worried when I didn’t conceive.
“He asked me not to worry about it, and that God’s time is the best. When I suggested that we see a doctor, he told me that he prefers we go spiritual and pray about it. When it was obvious he was not ready to go to the hospital, I went alone, and after a medical evaluation, the doctor said I was okay.”
She continued, “When I gave him my medical report and asked him to also go for a test, he told me he was fine and that we should wait on God. One day, one of his close friends came to the house and I complained to him about my husband’s nonchalant attitude towards our childlessness and the troubles that his family had given me over the issue. His friend pitied me and advised me to go to a particular hospital to do a test. He also mentioned the name of the doctor that I should see.”
Husbands hide medical reports from wives
According to her, her husband knew he had a serious fertility challenge but hid it from her despite the ridicule she endured daily.
She tearfully narrated, “When I went to that hospital and met with the doctor when he saw the name on my folder, he asked if I was the wife of his patient (he mentioned my husband’s name) and I said yes. He told me to stop going up and down to look for a solution that the problem had to do with my husband.
“The doctor told me that my husband may not be able to get me pregnant because he has an infection and azoospermia. I almost fainted in the hospital that day. It was a shocking revelation.”
An emotional Esther did not hesitate to confront her husband when she got home for keeping such a sensitive issue away from her that had stolen her joy all these years.
“When I got home and confronted my husband for keeping such information from me, he pleaded with me to forgive him. He said he was afraid to tell me so that I would not leave him”, she recalled.
Seven years after marriage, childlessness has also caused a lot of tension in the home of another woman, who only gave her name as Abigail.
It has also created a serious crack in the marriage of the banker as the husband makes life difficult for her by not yet giving him a child.
Abigail did not mince words when she told PUNCH Healthwise that her husband’s family had also made her home hellish without asking about the cause of their childlessness.
The banker said, “I am 39 years old and my husband is 45 years old now. We have been married for seven years now. Two years into the marriage, both of us became worried when I couldn’t conceive. So, he said we should wait for another year. Before our marriage was three years old, his family members started harassing me to give him a child.
I was asked to resign from my banking job
“They even confronted me to resign from my job and find a solution to what they called ‘my barrenness’. When I could not bear the silent torture anymore, I told my husband that we must get to the root of the cause of our infertility.
“But my husband has refused treatment. I am the only one going from one hospital to the other to find a solution to our childlessness. I have tried every means to persuade my husband to see a doctor but he refused and said he was okay.”
Abigail told our correspondent that her husband and his family kept accusing her of being responsible for their childlessness and didn’t care if the problem was from her or not.
Juliet and Rosemary, who also spoke with PUNCH Healthwise shared similar disturbing experiences that have become rampant in society today.
Fertility and female gender
According to the British National Health Service, having a low sperm count can make it more difficult to conceive naturally.
The BNHS, however, noted that even though it is difficult, successful pregnancies can still occur after treatment.
In a 2024 article published in the International Journal of Humanity Studies, the authors said matters concerning infertility mostly hinge on societal narratives.
According to them, this has led to a lot of misconceptions which have had great influence in the lives of people and society at large.
The authors said, “There have been many misconceptions about infertility which have led to the oppression of the female gender in African societies. The earth is addressed with the pronoun, “she/her” because it is believed that ‘she’ mothers mankind and all living things. From this, a conclusion can be drawn that society, since time immemorial, has made childbirth and fertility a women’s issue without paying attention to other factors.
“For instance, when a piece of land does not produce vegetation, it is assumed to be barren. Environmental factors and, in some cases, conditions of the seeds planted on them are ignored. The same applies to women after they have been married for a year or more and are unable to give birth.
“Their partners rarely suffer any blame because it has become women’s duty to carry all of it since childbirth is considered the primary responsibility of women. Thus, all issues of fertility—especially, the negative ones—are traced back to them.”
‘Stop blaming women’
Meanwhile, fertility experts who spoke with PUNCH Healthwise on the issue said men should stop blaming women for being responsible for infertility in marriage, stating that infertility could be caused by male and female factors or a combination of both factors.
While speaking with our correspondent, the consultant gynaecologist and obstetrician, Kaka, attributed the infertility blame game in marriages to culture and ego on the part of the men.
The maternal health expert, who is a former Medical Director of Gbagada General Hospital, Lagos, explained, “You know, culturally, people believe that you can’t question the man in a way. Some men still have that mentality and carry it along that they are the head of the family and why will a woman come and tell them that they have a problem?
“Some of these men are enlightened but they hold on to the belief that nothing can be wrong with their reproductive system. So for that reason, they feel that nothing can ever go wrong with their system. If they now have issues having children when they get married, they believe that the problem is from the woman.”
‘Men with infertility afraid of test’
The gynaecologist disclosed that some men with fertility issues don’t like being subjected to a test so that their wives will not know that they have a problem and leave the marriage.
The maternal health expert added, “They will keep telling the woman to go and do the test. The woman will do all kinds of tests but they will refuse to do it. There are still some traditional men who are still living in the past. But I think it is all about ego. Ego is also part of the reason men blame women because they don’t want it to be seen that they have an issue.
Male reproductive part – Source Ivitra
“The fear of the unknown that if they go and do this test and it is found they have a problem with their system, they feel that the woman may opt out of the marriage.”
Kaka noted that in cases of infertility among couples, both men and women contribute 30 per cent respectively while the remaining 40 per cent could be a combination of male and female factors.
Although Nigeria has no accurate data on infertility, the physician noted that 40 per cent of gynaecological consultations in the country were due to infertility.
He further said, “I want to also let you know that some of the men might have known their status – that there is an issue with their fertility capability even before getting married and they will hide it from the woman.
“The man will keep cajoling her that nothing is wrong with him to keep her in the marriage. And sometimes, the man may be the one who has a problem and the family of the man will harass the woman that she is the one who has a problem.
“They keep putting pressure on the woman and some men won’t come out to tell their family members that they have an issue. Some of them will refuse to see the same gynaecologist that their wives are seeing so that they won’t know that they have a problem.”
Low sperm count on the rise
The gynaecologist pointed out that low sperm count had been on the increase worldwide, a development he linked to stress and lifestyle.
Kaka noted that fertility tests for men are simpler than for women, and called for more education about the causes of infertility among couples.
Preventing infertility in men and women. Image credit: GetMe Giddy
Another Consultant Obstetrician and Gynaecologist, Dr Abayomi Ajayi, said it is wrong to assume that only women are to blame for infertility because they are the ones who get pregnant.
He stressed that men contribute to infertility equally, if not more than women.
The gynaecologist described the idea of holding women responsible as a product of ignorance and lack of information.
Ajayi, who is the Managing Director of Nordica Fertility Centre, Lagos, said, “People think the problem is always with the woman because she carries the pregnancy, and so if she is not pregnant she is to blame. But, if you ask me, there are more cases of infertility caused by men than women, and now, sperm count appears to be decreasing across the world.”
Dr Abayomi Ajayi
Risks of male infertility
Also, a fertility and reproductive health expert, Dr Ibrahim Wada, advised men to be more careful with some social habits they indulge in, noting that such can increase their risk of low sperm count.
He warned that social habits, such as smoking, alcoholism, drug abuse, and working in hot environments are possible factors leading to low sperm counts in men.
According to him, even though the impact of these social habits is difficult to quantify, studies have shown that they negatively affect sperm production in men.
Dr Ibrahim Wada
“We are talking about smoking, alcoholism, addiction or abuse of drugs, and working in hot environments. These are the things that need to be talked about but the contributions and roles they play are uncertain and very difficult to quantify,” Wada said.
The reproductive expert also stated that infection was a major risk factor for low sperm count in men.
Men with low sperm counts require treatment
An Obstetrician and Gynaecologist at the Aminu Kano Teaching Hospital, Kano State, Dr Labaran Aliyu, told our correspondent that for a man with a low sperm count to be able to impregnate a woman, he must get a proper medical examination and treatment from a specialist.
According to him, there are different causes of low sperm count in men that require different medical interventions.
Aliyu, an Associate Professor of Obstetrician and Gynaecology at Bayero University Kano, explained, “Low sperm count has a lot of causes. It may be that the man is not producing the sperm cells from the testicles. That is a problem.
Low sperm count
“Sometimes, the man produces enough sperm cells but then, there is no outlet for the sperm cells to come out and enter into the vagina of the woman because the seminal vesicles through which the sperm cells in the seminal fluid will pass are blocked. So, the man is producing sperm but he cannot pass it out.
“These are issues that require different treatments. If the man is producing sperm cells and there is a blockage, the treatment is for the man to undergo an operation, because he is producing, only that there is a blockage.”
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