High Prevalence Of infertility In sub-Saharan Africa

SUB-SAHARAN Africa has a high infertility prevalence compared to developed countries such as the UK and USA, an expert says.

By Kudakwashe Pembere

This was revealed by a Ghanaian fertility specialist Dr Ekem Hiadzi during a media training workshop which was part of the Merck Foundation Community Awareness Program.

According to a WHO report from 1987 infertility is the failure of a couple to achieve a pregnancy after 1 year of unprotected intercourse. Primary infertility is if pregnancy has never occurred while secondary is if there has been a preceding pregnancy irrespective of the outcome,” said Dr Hiadzi.

“In the United Kingdom, infertility prevalence is 6 percent, in the US its 10 percent whereas in sub-Saharan Africa the prevalence is 20 to 30 percent.”

Dr Hiadzi said in developing countries the high level of infertility is due largely to consequences of reproductive tract infections.

“These are commonly from sexually transmitted infections post abortal infections and puerperal infection which lead to tubal occlusion and peritubal adhesions. All the above lead to blocked tubes and/or peritubal adhesions. Several studies have shown higher levels of infectious organism in infertile women compared to fertile controls,” the fertility specialist said.

Added Dr Hiadzi, “In addition prolonged obstructed labour is a frequent complication of pregnancy in many African countries. This is often complicated by pelvic infection which can result in maternal death or severe tubal damage or obstetric fistula (urinary or fecal) and its sequelae.”
He also bemoaned how there are only few women in developing countries obtaining care from trained personnel at delivery.

“The majority still rely on traditional birth attendants or churches where non-sterile delivery procedures are practiced. The result is a high rate of pelvic infection after delivery,” Dr Hiadzi said.
Due to stigma associated with infertility particularly in Africa, Dr Hiadzi said, “Infertility is a major cause of marital disharmony in Africa and it exposes women especially to ostracisation, social discrimination and physical violence.”

While infertility affects both females and males, for the sterner sex, in sub-Saharan Africa, sexually transmitted disease especially by Gonorrhea and Chlamydia account for a significant proportion of cases. “These infections cause chronic epididymitis and occlusion of the vas deferens leading to oligospermia (low sperm count) and azoospermia (No sperms in semen),” Dr Hiadzi noted.

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