Notes to broadcasters
In medical terms, “infertility” is defined as not being able to get pregnant after one year or more of regular, unprotected sexual intercourse. Men and women are affected equally by infertility, with 30% due to male factors and 30% to female factors. Forty per cent of infertility is caused by both male and female or unexplained factors. In many sub-Saharan African societies, there is a negative perception of infertility, and this stigma can cause those affected not to seek early medical attention. Women with infertility problems are particularly stigmatized, which adds psychological suffering to physical suffering.
Data from the World Health Organization shows that more than 180 million couples in developing countries suffer from primary* or secondary infertility*. In sub-Saharan Africa, infertility is caused by infections in more than 85% of women. This compares to only 33% worldwide, and underscores the importance of prevention programs in Africa.
Infertility can be addressed with surgery or assisted reproductive technologies such as artificial insemination.
This script defines infertility condition and its symptoms. It explains the causes of infertility in both men and women and ways in which one can reduce the risk of infertility. It underlines the importance of seeking medical assistance as soon as a couple realizes they are not able to conceive and describes the treatments and recommended reproductive technologies available to help a couple achieve a healthy pregnancy.
This script is based on actual interviews. You might choose to present it as part of your regular health program, using voice actors to represent the speakers. If so, please make sure to tell your audience at the beginning of the program that the voices are those of actors, not the original people involved in the interviews.
You could also use this script as research material or as inspiration for creating your own programming on infertility in your country.
If you want to broadcast a program on infertility, here are several topics that the program could cover:
- How to prevent infertility
- Causes of infertility in men and women
- Treatments available for infertility
Estimated running time for the script: 15-20 minutes, with intro and outro music
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A note to the audience: Alice is not her real name. For this program, she requested that we do not use her real name for privacy purposes.
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SIG TUNE UP THEN UNDER
First things first: what is infertility? I asked Pauline Kibui, who is a clinical embryologist in Nairobi.
I sought help on my own first because my husband was not really ready to seek medical help. They could not find anything wrong and so I was put on vitamin and mineral supplements and asked to relax and continue trying. Six months later, I was tired and almost depressed and asked my husband to go with me to a fertility doctor. We went through so many tests and eventually, I was told that an infection had caused my Fallopian tubes to become blocked. That was so devastating for me. I went into depression.
So the trick is to be safe. Protect yourself from infections by having safe sex, which may also mean abstaining. That way, you increase your chances of remaining fertile. Prevention also means maintaining a healthy diet, and not too much alcohol or smoking. For men, activities like driving hot cars or motorbikes, or taking very hot baths create a very hot atmosphere in the scrotum area which may affect sperm production. Of course, age reduces functionality for both men and women: a woman does not produce as many eggs to aid in fertilization and a man’s sperm quality reduces with age.
In Kenya, a mother is referred to as mother to their child’s name. It felt bad not to be known as a mother to someone. It is also common for the woman to be blamed for not being able to conceive, even though there are men who are infertile. In my case, I did not realize that I had recurring bacterial infections which led to pelvic inflammatory disease and hence the infertility.
Once we establish that these factors are not causing infertility in the couple, then we have tests to determine whether the eggs are being produced as they should be and whether the man’s sperm count and quality is okay. And if the eggs and sperms are not enough for conception, what is the cause.
For women, if the Fallopian tubes and uterus are fine, intra-uterine insemination or artificial insemination is the first line of intervention. Unfortunately, if the uterus has growth or large amounts of scar tissue, surgery is required to remove any growth. followed by in vitro fertilization. Also, if the Fallopian tubes are blocked, then even surgery may not help. This may call for in vitro fertilization, which is a lengthy and expensive process that may require several tries.
Professor Koigi also has some encouragement for men who are afraid of seeking medical assistance.
On today’s program, we have been learning about infertility. We have heard from Professor Koigi, an obstetrician and gynaecologist, and from Ms. Pauline Kibui, a clinical embryologist. We learnt some of the main causes of infertility in men and women, including: blockage of reproductive tubes; hormonal imbalances; abnormal production and dispensing of sperm or eggs; an unhealthy diet; being overweight or underweight, especially for a woman; high consumption of alcohol and smoking; prolonged exposure of the genital area to heat for men; and genetic abnormalities.
We have also learnt about reproductive technologies like intra-uterine insemination, where the man’s sperm is injected into the woman’s uterus during ovulation, or intracytoplasmic sperm injection, a laboratory procedure where a single sperm is injected directly into each egg using a fine glass needle and then implanted in the woman’s uterus.
We also heard from Alice, who. together with her husband, has tried to conceive for 11 years without success. The couple eventually decided to adopt and are happy with their five-year-old daughter.
Contributed by: Winnie Onyimbo, Trans World Radio, Nairobi, Kenya
Reviewed by: Pauline Kibui, clinical embryologist at the Institute of Primate Research, Nairobi, Kenya.
Professor Koigi Kamau, Obstetrician and gynaecologist, Nairobi hospital, November 6, 2018
Pauline Kibui, clinical embryologist at the Institute of Primate Research, September 6, 2018
Alice (not her real name), October 11, 2018
Endometriosis: A medical condition that occurs when parts of the endometrium (see definition of non-receptive endometrium below) grows in other places, such as the Fallopian tubes, ovaries, or along the pelvis.
Gynecologist: A medical doctor who specializes in the functioning and diseases specific to women and girls, especially those affecting the reproductive system.
In vitro fertilization (IVF): An assisted reproductive technology whereby an egg is fertilized by sperm in the laboratory or elsewhere outside the body. Commonly known as test tube technology.
Non-receptive endometrium: The endometrium is the mucous membrane that lines the uterus, and which thickens during the menstrual cycle in preparation for possible implantation of an embryo. A non-receptive endometrium means that the endometrium is not prepared or receptive to implantation of an embryo.
Primary infertility: This term refers to a condition or state whereby couples/individuals have not become pregnant after at least one year of having regular sex without using birth control methods.
Secondary infertility: This refers to a condition or state whereby couples/individuals have been able to get pregnant at least once, but are unable afterwards.
Surrogacy: In vitro fertilization makes it possible to gather eggs from a woman (or egg donor), fertilize them with sperm from the husband/boyfriend/sperm donor, and place the embryo into the uterus of another woman (surrogate) or substitute woman who then carries the baby until birth.