BUJUMBURA, May 30th (ABP) – Infertility does not depend solely on the woman or the man, it is a shared responsibility. According to gynaecologists, a couple is said to be infertile when they live together for a year, have sexual intercourse without contraception and are unable to become pregnant.
When the woman is over 35 and the couple have been living together for 6 months, having unprotected sex, they can also be said to be infertile. It can be male or female in origin.
According to the testimonies of couples who are victims of infertility, in Burundian society, an infertile couple is stigmatised and discriminated against by their family and friends, and it is the woman who is much more affected than the man.
MT lives in the Gishubi commune of Gitega province. In a statement given to the Burundian News Agency (ABP) on Friday 17 May 2024, she said that she married at the age of 21 and had her first child after 10 years of marriage. Before the birth of that child, she suffered a great deal. She said she experienced stigma and discrimination from her husband’s family and neighbours, accusing her of “being infertile”.
My mother-in-law always encouraged my husband to abandon me and look for another fertile woman. She even dared to lie, saying that when I was a girl, I had a lot of abortions, which made me infertile, and that I’m now suffering the consequences of the voluntary abortions I had when I was a teenager. There were also cases where my husband accepted what I told him, and started to be unfaithful by having sex with the women around him. He abused me from one day to the next and I risked divorce. Many people advised my husband to look for another wife and to repudiate me from the home. I asked him every day to go and see the doctor together and he agreed after several requests. It was after the consultation that the gynaecologist noticed that I had ovulatory problems and fibroids, which were operated on and I was prescribed medication to treat the ovulatory problems. With God’s help, I became pregnant after a year”, said the infertility victim. She added that she now has three children, one a girl and two boys.
Dr Gilbert Nibitanga is an obstetrician-gynaecologist and fertility specialist. In an interview with ABP, he pointed out that 40% of infertile couples in Burundi are male and 40% female. On the other hand, 10% of couples have unexplained causes, while the other 10% have shared causes.
Turning to the causes of infertility in men, Dr Nibitanga said that most of the causes of infertility in men that have already been identified during the treatment of patients are men with poor quality spermatozoa, i.e. sperm that is not very mobile, others with small numbers of spermatozoa, and some without any spermatozoa at all. He also mentioned the cases of men who are born with genetic diseases that cannot be corrected. He gave the example of men with blocked vas deferens, men with hormonal abnormalities and others. He pointed out that if the spermatozoa do not meet the necessary criteria to fertilise the woman’s egg, the man cannot impregnate his wife.
As for the causes of female infertility, that infertility specialist explained that there is infertility due to ovulation, i.e. if the woman does not ovulate normally, the egg cannot be released. There are also causes due to the central nervous system, i.e. when there is a disturbance in the central hormones. Other causes are due to the uterus. When the uterus has fibroids, those can block the fallopian tubes or prevent sperm from reaching the fallopian tubes.
According to Dr Nibitanga, there are causes linked to endometriosis. In other words, when tissues in the uterine cavity have implanted themselves in the ovaries. He also cited genetic malformations, hormonal diseases, polycystic ovary and blocked fallopian tubes.
As for the treatment of infertility, Dr Nibitanga explained that treatment depends on the cause. There are treatable causes and untreatable causes. He pointed out that congenital and genetic causes are difficult to treat. But acquired diseases, such as fibroids in women, can be operated on, blocked fallopian tubes can be treated by in vitro fertilisation (available at the Umugiraneza polyclinic in Gitega province), and women with ovulatory problems can be given medication. In men, if the quantity of spermatozoa is insufficient, they can be given medication to see if the quantity can be increased. If the infertility is due to infection, the infection is treated.
In terms of prevention, he also stressed that there are avoidable causes. For example, by avoiding infections, they can prevent infertility, which is due to obstruction of the genital ducts. We must also avoid products that are toxic to male or female gametes. He cited alcohol, tobacco and drugs. He went on to advise couples who have been living together for more than a year without success in having a child to consult a gynaecologist together to find a solution to their problems, instead of staying at home or thinking it’s witchcraft.
As for psychologist Bonfils Uwimana, infertility has many psychological consequences for couples. Not having a child can cause high levels of stress and frustration. He also cites other problems such as depression, anxiety, insomnia, reduced sexual desire and lowered self-esteem, leading to isolation and social withdrawal.
In Burundian society, infertile couples are singled out, discriminated against and stigmatised, whether by their in-laws, their wife’s family or their neighbours. Within the couple, the woman suffers a great deal compared to the man, because many accusations are levelled at the woman. Faced with that situation, Mr Uwimana advises infertile couples to be resilient. They shouldn’t always focus on the problem of not having a child, or allow themselves to be influenced by social pressures. Instead, they should act according to their own wishes, and avoid listening to bad advice. Those couples are also invited to seek help from psychologists to help them accept themselves and prevent themselves from psychological disorders or problems linked to infertility. Mr Uwimana asked Burundian society to avoid stigmatising infertile couples, pointing out that they are people like so many others and that they are not the cause of their problems.