Children are a delightful cheer, no doubt. And in most cases when a woman and man make the decision to be together, these are foremost in their minds. For some it comes naturally, perhaps even unexpectedly. For others it takes a little wait, while for the unfortunate few, this wait turns indefinite and frustrating. After how long should one worry?

Doctors caution that pregnancy is really a game of chance; different couples conceive at different rates. On average 90% conceive after a year of sex when not using any form of contraception. 95% conceive after two years, and only five per cent could take longer.

With the exception of women above 35 years who must seek medical advice after six months of trying, one should actually start worrying if after two years of regular sex without use of contraceptives there is still no sign of pregnancy. They should then visit a gynaecologist for check ups which will include an investigation into past medical history, and any existing gynaecological and medical problems that could be affecting one’s ability to have children.

Before the expiry of this period, no fertility treatment should be undertaken.  Contrary to the common societal views that blame infertility on solely women, research has shown that women and men contribute 50% each to the problem. Therefore it is important for medical examinations to be carried out on both parties.

What causes infertility?

The website www.christianet.com lists some of the causes of infertility in men as medical illness, medical history like operations on testes or to repair inguinal hernia as well as use of drugs and chemotherapy and erectile and/or ejaculatory dysfunctions. Men in occupations that expose them to large amounts of toxins and excessive heat, those who consume excessive alcohol and recreation drugs, are over weight and who are above 40 are also likely sufferers.
For women, age increases your chances of infertility, with the most fertile days being when one is in their 20s. After 35, a woman’s chances of conceiving reduce significantly. Gynaecological conditions such as failure to ovulate, amenorrhea, tubal damage, cervical mucus defects, fibroids, infrequent sexual intercourse and poor timing, pelvic infections and medical conditions such as Tuberculosis can all stand in the way of pregnancy.

What options are available?

After two years of trying, it is time to visit an expert. Depending on the underlying cause, different options are available. Sometimes couples cannot conceive even in the absence of any apparent condition that would lead to infertility. Such couples are advised to try natural methods and food supplements. Eating fresh vegetables and ground nuts is said to increase sperm count in men. There is need for the couple to practice proper timing by monitoring the woman’s fertile days. If the man experiences some erectile and ejaculatory dysfunction, the couple should take some time without having sex so that sperm can accumulate both in quantity and velocity.

If these simple natural methods do not seem to work, Dr. Tamale Ssali of Kampala Women’s Hospital and Fertility Centre advises several options depending on one’s particular situation. The first is the use of fertility drugs. These usually enhance ovaries to produce a larger number of eggs, explaining the conception of twins, triplets and quadruplets among couples who had initially failed to conceive.

In vitro fertilization may be advised. In vitro literally means “In glass”. The result of this method is what is usually referred to as test tube babies. Here the egg is removed and fertilised outside the mother’s body then inserted into the uterus so it can attach to the wall and begin the 9 months process of growth.

Intra uterine Insemination is an option for women who cannot conceive for other reasons, but have perfectly healthy fallopian tubes. Here the sperm is inserted directly into the cervix via the vagina. After being given this slight helping hand, the fertilised egg is left to plant itself naturally in on the walls of the uterus.
When a man is experiencing poor or low sperm motily, an intracytoplasmic injection could be the solution. A single sperm is injected directly into the egg using a very fine needle.

After a few tries, at least one of these methods is guaranteed to work. The very last option is usually surgery. This will usually be recommended by a doctor when there is something blocking the fallopian tube. Such obstruction could range from fibroids, scar tissue or an infection. Sperm donors and surrogate mothers could also be used.

Dealing with the psychological and financial strain

African traditional society places so much importance on child bearing. To many, one’s manhood or womanhood is measured by how many children one has. In extreme cases, couples are even encouraged to be unfaithful if their partners do not conceive.  This plus the internal disillusionment of someone who cannot have kids is denting not only on one’s psychological wellbeing but also on the finances as couples move the world to find a cure. Some go to witch doctors, quacks, herbalists and different medical practitioners, all in a bid to find the magical panacea to this heavy pressing ill.

To make matters worse even the most highly recommended procedures may not work for a particular couple, or may work after several tries and a lot of money spent. A counsellor is therefore recommended to help couples deal with all this strain while maintaining their relationship. The first priority in marriage is the companionship and love. Everything is secondary. With this mindset, couples can be able to counter whatever turns out to be their fate. Important to note is that in many cases it is this stress about failure to have kids that actually stands in the way.


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