Infertility and the futility of blame game

Written by ONYINYE ECHENDU
Echendu is a fertility physician with The Bridge Clinic, Lagos.
~The SUN, Nigeria. Monday, June 20, 2016

PRECIOUS and her husband, Michael, have been married for eight years but have no children. Their marital journey, which started on a fairy note while they were in the university culminated in a grandi­ose wedding ceremony that was well attended by members of both families as well as friends and well-wishers from far and wide. The highpoint of the ceremony was the arrival of Michael's mother from the United States, where she was nursing one of her daughters' newly born baby, to attend the wedding in Lagos.

A few years into the marriage, Michael's sisters started murmuring their concerns over the inabil­ity of Precious to have a child. Initially, Precious kept these concerns to herself but after a while, she complained to her husband who reassured her and took it up with his sisters and mother. At the time, Precious mother in-law warned her daughters to let the poor woman be as she was confident Precious would bear many grandchildren for her.

On the eve of their sixth wedding anniversary, Precious was invited by her mother in-law. Unsure of the reasons for the invitation, Precious told her husband of the invitation and they both wondered what the invitation was all about. To her greatest surprise, Michael's mother told Precious that her in­ability to bear children for her son has got to a stage that the family wants an explanation. She further informed her that their involvement was necessi­tated by the sheer cowardice of their son, Michael, who could not ask her some critical questions. The woman told her pointedly that they are very fruitful in their family and asked her if barrenness was in their home. Michael's mother asked her how many abortions she carried out before she met her son etc. She was very surprised her husband did not utter a word and cried throughout the meeting.

When they got home that evening, she called her husband to ask why he would let his family humiliate her in that manner, and what made them think their inability to bear children was her fault. Michael got angry and, for the first time in their re­lationship, slapped her for linking him to her inabil­ity to conceive. Ignited by this incident, Precious gathered herself and went to the doctor to ascertain who is to blame for their infertility.



In another area of Lagos, Ifeanyi and his wife, Chinwe were married for five years but have no child, except the one Chinwe had for her boyfriend when she was in her teenage years. People around the couple started murmuring till it got to the stage of pity by many and then to scorn by a few oth­ers. Instinctively, Ifeanyi started seeing all fingers pointing towards his direction, after all, his wife has 'redeemed' herself. So he secretly went for semen analysis test where he was told that the test result shows he had low sperm count. For him, that sealed his fate on child bearing.

Fear set in on him so he started avoiding discuss­ing the issue of child bearing. That soon gave way to violent disposition whenever the issue got to the stage of going to see a doctor. He will only retort: 'no one should bother me; God is the giver of chil­dren; He will give us a child only when it pleases him'.

The two real life stories, different as they seem, have a lot in common. They are both journeys in infertility and has the same destination - childless­ness. The stories talk about the same thing, finger pointing or blame trading or blame game. While in the first story, the couple was pointing at each other, in the second story, the husband was finger pointing at himself and wallowing in self-blame.

Many couples who remain childless for a long time are most likely those who have stayed too long on this blame game. Infertility is defined by the World Health Organisation (WHO) as "the in­ability to conceive a child." For WHO, a couple may be considered infertile if, after two years of regular sexual intercourse, without contraception, the woman has not become pregnant and there is no other reason, such as breastfeeding or postpartum amenorrhoea (inability to menstruate as a result of breastfeeding).

Granted, conception happens in women, no woman, on her own, makes conception to happen. It must happen when the man's sperm meets the woman's egg. So infertility is a couple's issue, not just the man's or the woman's. On marriage, a man and woman pledge to be together in all situation, through thick and thin until death does them part. Since infertility is one of such things that could come out of marriage, just like pregnancy, child birth and so on, it should be borne by both spouses in line with their pledge on their wedding day.

The question is: how far can blame game take a couple dealing with infertility? Indulging in blame games can actually take infertile couples far but in the wrong directions. It will obviously lead them to de­layed resolution of the fertility challenges, erosion of their marital bliss and serious disagreements and bad blood, which might lead to violence and separation or divorce. Blame game could also elongate treatment time and increase the cost of treatment as early inter­vention brings about quicker resolution of the chal­lenge and reduced cost of treatment.

Infertility, being a medical issue, has many treat­ment options. These treatment options could be drugs, surgery or in-vitro fertilisation (IVF); some may just require nothing but lifestyle changes. An obese or alcohol-abusive couple may just be required to lose weight or quit some unhealthy lifestyles to boost their chances at conception. One couple's challenge may not be another couple's challenge and until a couple seeks medical attention, they may not know what challenges they have and the treatment options avail­able to them.

To further underscore the futility of blame games in the treatment of infertility, medicine has acknowl­edged male and female factors that cause infertility. Statistics, had also shown that male and female fac­tors each account for 40 percent of the cases of infer­tility, and 20 percent of the cases are jointly caused by both spouses. So whenever a couple fails to conceive after regular unprotected sexual intercourse for a pe­riod of one year, or in cases where the woman is in her thirties, after six months, should seek prompt medi­cal attention to properly diagnose the causes of their infertility and have these causes treated early. Blame game does not cure infertility, but concerted efforts at treatment do.