Infertility: Reducing stigma, but more still to be done

Reducing stigma, but more still to be done (Photo: iStock) "I was mourning, mourning the loss of a baby that I will never hold, mourning the mother I could've been and crying for my womb. I had, had another miscarriage after struggling to get pregnant for 5 years," says 38-year-old *Stacy Wairimu. Stacy struggled to conceive, and the pressure from womb watchers became even worse. Womb watchers are people who keep asking women when they are getting pregnant. "2 months after our wedding people would ask, so when are we having the baby the shower? At first, it didn't bother me because I knew I would conceive once ready. But that never happened as planned," she says After one year of trying to conceive, Stacy knew something was not right. That is when she started seeking medical intervention. "I tried everything, even IVF didn't work. My body went through so many changes. After the 3rd miscarriage, I told my husband, I couldn't do it anymore. I can't prepare myself psychologically and physically for a baby and then I do not get to hold the baby, I couldn't do it anymore," she says Apart from psychological distress Stacy had to deal with insensitive comments from womb watchers. "People would say I had several abortions when I was younger, others said I started using contraceptives when I was younger so my womb can't conceive. The funny one was that I didn't want to lose my figure. Figure?" she adds laughing After her 4th miscarriage, Stacy conceived. She had her rainbow baby. "I was so scared, during the whole pregnancy, even at 9 months I was still scared, thinking I might lose the baby. But I finally went home with my baby girl," she says Roseline Mueni a 32-year-old, struggling to conceive says that she has PCOS that has contributed to her infertility. PCOS is a polycystic ovarian syndrome. It is a hormonal disorder which may cause ovarian enlargement and small cysts to line the ovaries "I was so stressed, I had PCOS, my tubes were blocked, there was pressure from in-laws to conceive," she says Roselines says that she stopped enjoying sex and it was all about conceiving. "Sex now becomes like work, every time I had sex with my husband, in my head I was just thinking is this the time I will conceive? It reached a point where I resented sex, it was like a task. I hated it," she says Roseline hasn't conceived yet, but she's still hopeful. She says if push comes to shove, she will try surrogacy or even adoption. Dr Saudah Farooqui Consultant Obstetrician and Gynecologist at Nairobi West Hospital says infertility Is not being able to get pregnant (conceive) after one year or longer of unprotected sex, or inability to conceive after 6 months of trying for women over 35 yrs of age. Dr. Farooqui says that there are many causes, some may be hormonal, structural, environmental, or infections. "The symptoms include: Irregular periods, lack of periods, long menstrual cycles, abnormal discharge and/or foul smell from vagina and pain during sex, she says On treatment, Dr. Farooqui says that treatment varies Depending on the reason for the infertility. For hormonal issues evaluation and necessary medications for structural issues surgery may be necessary. Dr, Farooqui adds that there's an increase in awareness and taboo and stigma are lifting a little so people are talking about it more but we still have a long way to go "Secondly it may be on an increase due to environment, diet, radiation etc things that were very different before eg pollution, excessive fast food intake in this day and age," she says POLYCYSTIC OVARIAN SYNDROME Dr.Farooqui says polycystic ovarian syndrome may cause infertility. Most women with PCOS do not ovulate. "Assisted reproductive technology helps. Many patients have success with oral medication," She says The symptoms include acne, obesity, excessive hair growth which is a more male pattern, and prolonged menstrual cycles (long periods without menses). "Treatment includes some weight loss especially if the patient is obese, as low as 5% loss of body weight can help markedly, investigate for other hormonal and endocrine abnormalities and treat accordingly. Treatment is tailored per patient," she adds Dr. Farooqui says there is no known prevention for PCOS but having a healthy lifestyle helps. She advises seeing a gynaecologist early on to manage symptoms and prevent the progression of other associated metabolic abnormalities. Male infertility is a disease of the reproductive system that makes a person unable to have children. Male infertility means that a man has a problem with his reproductive system. Health System Specialist Junior F. Mukudi says many biological and environmental factors can impact male fertility. Possibilities include Azoospermia where Your infertility can be related to your inability to produce sperm cells. Another possibility is Oligospermia which is The production of low or poor-quality sperm. It could also be a Varicocele: A varicocele is a swelling of the veins that drain the testicle. It's the most common reversible cause of male infertility. Infections such as epididymitis and orchitis can also cause testicular damage and affect fertility. The man could also suffer from Ejaculation issues. in Retrograde ejaculation occurs when semen enters the bladder during orgasm instead of emerging out through the penis. "Symptoms of male infertility include Problems with sexual function for example, difficulty with ejaculation or small volumes of fluid ejaculated, reduced sexual desire or difficulty maintaining an erection (erectile dysfunction)," says Mukudi Other symptoms include Pain, swelling or a lump in the testicle area, recurrent respiratory infections, and inability to smell. Abnormal breast growth (gynecomastia). Mukudi says treatment for male infertility depends on the cause. If a specific reason for infertility is discovered, it sometimes is possible to treat. A variety of treatment options are available and include hormonal therapy, surgery to correct blocked tubes, and treatment of infections or underlying medical conditions. "Low sperm count refers to the number of sperm in semen while erectile dysfunction refers to the inability to get or maintain an erection firm enough for sex. Low sperm count can be treated, through, surgery, medication, hormonal replacement and assisted reproductive technology" he says.

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