Reasons why you may not be conceiving

I have gone through grief before. I have experienced heart-wrenching relationship-breakdowns, lost dear ones, felt excruciating pain which can be endured over time. And yet none of that can compare to the pain of failing to get a child,” Claire Uwase says.

I have gone through grief before. I have experienced heart-wrenching relationship-breakdowns, lost dear ones, felt excruciating pain which can be endured over time. And yet none of that can compare to the pain of failing to get a child,” Claire Uwase says.

After failing to conceive for 7 years, Uwase and her husband have lost hope of ever getting a baby. But what could the problem be?

Doctors explain

“Women may fail to conceive due to chronic pelvic infections and hormonal disorders which cause ovarian cysts- and tumors,” Dr Rachna Pande, a specialist in internal medicine at Ruhengeri Hospital, says.

Pande adds that sexually transmitted diseases can also cause infertility in both women and men when they block the tubes that carry eggs or sperms.

She warns that placing laptops on laps for long, excessive consumption of alcohol and abusive substances, physical and mental stress can also cause infertility.

Other underlying causes may include excessive exercise, eating disorders, injury or tumors, uterine or cervical abnormalities, and fibroids which may distort the uterine cavity interfering with implantation of the fertilised egg.

Dr Theobald Hategekimana, a surgeon at University Teaching Hospital (CHUK), says it is wrong in such cases to assume that the woman is the problem.

“Sometimes it could be the man who is infertile because of genetical or hormonal deficiency. Chemotherapy can also cause male infertility,” Hategekimana says.

He adds that undescended testicles, genetic defects, health problems including diabetes, prior infections such as mumps, trauma or prior surgeries on the testicles or inguinal region can also cause male infertility. Enlarged veins in the testes can increase blood flow and heat, affecting the number and shape of sperm.

Research also shows that problems with the delivery of sperm due to sexual problems, such as premature ejaculation, semen entering the bladder instead of emerging through the penis during orgasm (retrograde ejaculation), certain genetic diseases, such as cystic fibrosis, structural problems, such as blockage of the part of the testicle that contains sperm (epididymis), or damage or injury to the reproductive organs are other causes of infertility.

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Magnitude of the problem

According to a recent research, infertility and sub-fertility are prevalent within the high fertility zones of Africa.

Areas with high rates include Gabon, Central African Republic, Democratic Republic of Congo, Chad and Cameroon. Also, intermediate rates of infertility exist in parts of West and East Africa. In Nigeria, over 800,000 couples are said to have difficulty in achieving desired pregnancy.

It also says infertility accounts for more than half of the cases seen in gynaecology clinics in the developing countries.

How to deal with infertility

According to Dr Hategekimana, couples should seek medical advice after at least two years of trying to have a child in vain

He says couples should not rush to conclude that one of them is infertile simply because they have not conceived as fast as they wanted.

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Hategekimana says many couples have managed to get children after receiving proper treatment. But not all of them are always lucky.

He says as a last resort, a couple may opt for vitro fertilization (IVF). IVF is the process of fertilization by manually combining an egg and sperm in a laboratory dish, and then transferring the embryo to the uterus.

In line with that, Dr Pande says some barren women have gone for surrogates out of frustration. A surrogate is a woman who is artificially inseminated with the father’s sperm. She then carries the baby and delivers it for the parents to raise.

She adds that if the man is impotent, one of the options is to carry out artificial insemination from a donor. This method involves deliberate introduction of sperm into a female’s uterus or cervix for the purpose of achieving a pregnancy.

According to Pande, adoption is another option that can be considered by a couple that has failed to have children.

Women explain how they got children after long wait

Esperance Mujyawamariya, nurse

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Esperance Mujyawamariya, nurse

It took me 8 years to get pregnant. I became very desperate and visited several doctors in vain. But one day I went to see a visiting Chinese doctor at Masaka Hospital and he recommended surgery. Two months after the operation I conceived.

Josette Kayiranga

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Josette Kayiranga

For six months I could not conceive and this worried me so much. I started fearing that I might be barren. Although my husband stood by me during the trying times, pressure from my in-laws did not help matters. Fortunately, all medical tests showed that there was no problem. Eventually i conceived.

Esther Mukasanga

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Esther Mukasanga

A close friend of mine spent a year without conceiving. She was always sad and hated herself. I then referred her to a pastor and she obliged. After several months of praying and fasting, she conceived and later gave birth. Women should never lose hope but keep trying and the kids will come.

Shemusa Murekatete

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Shemusa Murekatete

Getting my first daughter was not a problem, but conceiving the second time was a tug-of-war. It took me 8 years to get pregnant again despite visiting a number of hospitals. What puzzled me most was the fact that all doctors told me I was okay yet I always failed to conceive.

Emmerance Mwitende

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Emmerance Mwitende

I conceived after three months. Although it appears a short time, it can actually be tormenting for a woman. People were already saying my husband married a barren woman. My husband was very supportive all the way.

Francine Uwamariya

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Francine Uwamariya

I gave birth to my first child after 7 years. That was one of the worst moments of my life. I was afraid I was getting old. I visited many doctors but they always told me to be patient.

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Foods to avoid

Food and fertility are intrinsically linked so having the right balance of vitamins and minerals in your diet is essential. But there are also a number of foods you should avoid if you really want to increase your pregnancy prospects.

l Red meat: Too much of it increases the amount of ammonia in the body, which can interfere with the implantation of the egg in the uterus. Red meat can also be detrimental for men as it increases acidity and affects sperm activity; sperm perform better in alkaline conditions.

l Refined sugar: Too much refined sugar can lead to insulin resistance, which can cause or exacerbate PCOS — a condition that affects ovulation and is one of the leading causes of female infertility.

l Alcohol: Danish research found that alcohol intake had a significant effect on infertility success among women above the age of 30 who drank more than seven drinks a week.

Agencies