Female Infertility – Its Effects on Women of Child – Bearing Age
Research Work (Effects of Female Infertility on Women of Child-Bearing Age (15-45years) In Nnewi Community)
Female Infertility – It has been discovered that childlessness has led many couples into the valley of conflict, bondage of polygamy, ocean of confusion, mountain of obstacles and eventually into the cell of divorce. To order the Complete Project Material, Pay thr Sum of N3,000 to: BANK NAME: FIRST BANK PLC ACCOUNT NAME: CHIBUZOR TOCHI ONYEMENAM ACCOUNT NUMBER: 3066880122 Then send the Project Topic, Your Email Address and Full Name to 07033378184.
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The world health organization WHO, (2004) defined female infertility as an inability of a woman of reproductive age to conceive and carry a pregnancy to live birth within two years of exposure to the risk of pregnancy. Two types were identified, primary female infertility which is the inability of a woman to conceive for the first time despite cohabitation and exposure to pregnancy for a period of two years while secondary female infertility is the inability of a women to conceive following pervious pregnancy despite cohabitation and exposure to pregnancy for a period of two years.
According to Duckitt (2004), Infertility is a disease of the reproductive system that impairs one of the body’s most basic functions, conception of children. Conception is a complicated process that depends upon many factors which includes production of health sperm by the man and health eggs by the woman, unblocked fallopian tubes to allow the sperm to reach the egg, the sperm’s ability to fertilize egg when they meet, the ability of the fertilized egg (embryo) to become implanted in the woman’s uterus, and sufficient embryo quality, that continues to full term. The embryo will also be healthy if the woman’s hormonal environment is adequate for its development. But when just one of these medical factors is impaired, infertility can result. All these factors show that infertility is not always a woman’s problem. In only about two-three of cases is infertility due to the woman (female factors). The remaining one third infertility is due to the man (male factors) and a less significant fraction for unknown factor (both male and female factors).
Furthermore, several studies indicate that Africa has extremely high rates of female infertility. (Adetoro et al, 2004). Also, Inhorn, (2004) stated that female infertility produces social consequences for African women and these consequences are particularly profound for women as compared to men, regardless of the causes of infertility. Women receive more blame for reproductive set-back and also suffer personal grief and frustration, social stigma and serious economic deprivation.
In our society today, there are many broken homes and a lot of stigmatization on women owing to infertility and those women are also pushed out of their husbands’ houses without granting them access to their husbands’ properties because they cannot bear children for their husbands. Experience has shown that infertile women are marginalized in the society because they do not have anybody to defend them. Even, their interest is at stake and they are defenseless in many cultures.
Many of them are sent back to their father’s house where they are cajoled by their sisters-in-laws and given all sorts of names in order to destabilized them. Consequently they suffer from one psychological problem to another and are equally stigmatized.
Therefore, amidst these feelings and in attempt to ferge ahead in their marginalized society are always withdrawn as their ego is stake and hence, maybe prone to drug abuse and drug addition. This is concurred by Anderson(2007) when he said that most infertile women are emotionally confused, troubled, guilty, depressed, unstable, impaired and easily prone to anxiety situations. It is on the basis of healthy psychological good frame of mind and healthy parenting that motive the researcher to wards ascertaining the effects of female infertility on the reproductive women in Nnewi community.
The main purpose of the study is ascertaining the effects of infertility in women of reproductive age in Nnewi community.
The objectives of the study specifically are to:
1. Ascertain their knowledge about female infertility.
2. Identify the effects of female infertility on the reproductive women of Nnewi community.
3. Determine any maltreatment given to them for being infertile.
4. Determine whether female infertility is the leading causes of divorce in Nnewi community.
5. Identify the preventive measure for infertility.
The result of this study will be of immense benefit in providing the useful information on the effects of female infertility on the reproductive women in Nnewi community.
- It will also help the women to understand the signs of female infertility.
- This study will help to educate this group of women on the causes and the possible remedies for this problem.
- Also the study will help to create more awareness and help reduce individuals’ misconceptions of the causes of female infertility.
- The study will equally help to increase the women’s self-esteem.
- For researchers, it will serve as base for further studies.
1. What are the causes of female infertility?
2. What are the effects of female infertility?
3. Have you been maltreated/seem somebody that have been maltreated for being infertility?
4. Is female infertility the leading causes of divorce in Nnewi Community?
5. What are the preventive measures for infertility?
Scope of the Study.
This study is delimited to women of child bearing age (reproductive women) in Nnewi community (15-45 years). It is only investigating the effects of female infertility on reproductive women.
Operational Definitions of Terms.
Abortion: when a pregnancy is unable to continue to term (40 weeks).
Amenorrhea: Absence of menses.
Cervical Mucus: Fluid secreted by the cervix.
Fertility: Ability to achieve pregnancy immediately after marriage and continuously for some time till menopause.
Fertilization: Meeting together of male sperm and female eggs.
Infection: Inability of the body to perform its work.
Infertility: Inability to naturally conceive a child with unprotected sexual intercourse
Menarche: the first menstrual discharge of young girl.
Menopause: Stoppage of menstrual period.
Menstruation: monthly shedding of blood from a woman’s genital tract.
Ovulation: The release of a mature egg by a woman.
Related literature from textbooks, journals, magazines are periodicals were reviewed under the following sub-headings:
• Concept of fertility
• Causes (medical, ovulatory, pelvic and tubal, uterine, reproductive, physical, age-related, behavioural, environmental and occupational, pelvic inflammatory disease, psychological etc).
• Clinical manifestations’ of female infertility.
• Effects of female infertility.
• Diagnostic procedures of female infertility.
• Risk factors of female infertility.
• Treatment (chemotherapy, surgery, diet etc).
• Challenges evident in today’s infertility remedies.
• Knowledge and misconceptions of female infertility.
• Theoretical framework.
• Summary of reviewed related literature.
The Concept of Infertility
Female infertility is a global public health concerned that often ranked as the most distressing life-crises in the life of women worldwide. (Okonofua et al 2003). The author further described it as the most important reproductive health concern of Nigerian women which accounts for between 60-70 percent of gynecological consultation in tertiary health institutions.
It is a stressful experience that affects a woman’s life; her religious faith, self-esteem and even her occupation. The common psychological symptoms reported among infertile women are depression, anxiety and suicidal ideation. (Fido, 2004).
According to Sherman (2009) in tertiary health institution, most women that come to see the doctors because of infertility problem were typically in their late 30s. Most of them tend to have some kind of ovulatory problem or a problem with egg quality because they are getting to menopause. This group observed that if you look at the population at large, the most common cause of infertility is some kind of tubal blockage, which is caused by an infection in the fallopian tube gotten either from a sexually transmitted disease or from a prior pelvic surgery. The second leading cause of infertility is lack of ovulation called polycystic ovary syndrome (PCOS), in which women do not ovulate.
International Council on Fertility Information Dissemination,(2007) state that female infertility is defined as the inability of a female to produce ovum that can be fertilized by a fertile male for at least one year. Female fertility is a contributing factor in about two third of fertility cases because female reproductive system is less accessible than that of male, because of that diagnosis and treatment in women are sometimes more difficult.
Infertility in women is conventionally defined as failure to conceive despite regular sexual intercourse for a year, without using any contraceptive. Men produce sperms throughout their reproductive years; however, women are born with a specified number of eggs, whose number reduces with age, so infertility (Arpita, 2009).
According to the Centre for Disease Control and Prevention, (2003), Infertility is becoming an increasingly common problem world-wide. It is estimated that one in seven couples face fertility challenges, approximately 10% of women in the United States have a hard time getting pregnant and this causes a lot of emotional problem to the women.
Mayo Clinic Staffs (2009) also explained that infertility in women is referred to as the biological ability of a woman to get conceived or to carry a pregnancy to full term. To fertility experts, if you are under 35 years old and unable to get pregnant after 1 year of steady and unprotected intercourse (or 6 months if you are 35 or above), it is likely there is an infertility problem to deal with. It further stated that infertility can be due to you or your partner or both.
Medical Causes of Female Infertility
The causes of female infertility may be classified as functional, anatomical, and psychological causes, (Monday and Adishi, 2009).
www.righthealth.com/infertility went further and broke it into several categories which are as follows:
• Ovulatory problems
• Cervical factors
• Pelvic and tubal factors
• Uterine factors
• Reproductive Conditions
• Physical Barriers
• Hormonal Imbalances
• Age-Related Infertility
• Behavioural factors/Lifestyle
• Environmental and Occupational Factors
• Pelvic Inflammatory disease
• Psychological problems
• Female infertility caused by genetic problem or an illness
All these causes are related to each other in different ways as we can see in the explanation below:
www.righthealth.com/infertility stated that ovulation is a complex event in which hormonal signals and physical events are linked in a delicate balance, it is also stated that women ovulate most effectively in their late teens and early twenties but by the age of 35-38 years, most women experience a decline in the ability to ovulate effectively.
Dyer et al (2006) stated that ovary problems also decrease the production of any one of the hormones that regulate a woman’s reproductive cycle and may result in infertility. These problems may inhibit reproduction and as such cause the ovarian follicle to remain empty. Disruption also in the part of the brain that regulates ovulation can cause low levels of the hormones that regulate this (lutienizing hormone (LH) and follicle stimulating hormones FSH).
Ovulatory problem may also be caused by poor functioning of the fallopian tubes, physical damage to the ovaries as in multiple surgeries; thereby causing the follicles not to mature properly and ovulation will not occur. (www.mayoclinic.com/health/infertiliity, 2009).
According to website,www.fertlityhelper.com,(2008) some women may develop antibodies or immune cells that attack the man’s sperm, mistaking it for a toxic invader.
Cervical infertility involves inability of the sperm to pass through the mouth of the uterus due to damage of the cervix, (www.righthealth.com/infertility, 2007). Cervical factor in infertility can also be caused by the following: Inadequate cervical mucus, which acts as a filter that allows only the best sperm to survive and fertilize an egg. Cervical narrowing or stenosis and infections of the cervix with common sexually transmitte infections like Chlamdia, gonorrhoea or trichomonas can also lead to infertility in women. (Sherman, 2009).
Pelvic and Tubal Causes
According to www.righthealth.com/infertility (2007), pelvic causes include any disruption of the normal pelvic anatomy. These include: Scar tissue or “adhesions”, endometriosis, blocked, scarred, or distorted fallopian tubes and uterus. The blockage or scarring of the fallopian tube may prevent the egg from traveling from the ovary towards the uterus to meet with sperm, this can lead to infertility, the pelvic adhesions are defined as bands of scar tissue that bind organs after pelvic infection, appendicitis or abdominal or pelvic surgery.
Frequent abortions may also produce infertility by weakening the cervic or by leaving scar tissue that obstructs the uterus. (Papreen, 2008).
Previous surgeries are important causes of disease and damage. Tubal damage may result in a pregnancy but the fertilized egg will be unable to make its way through the fallopian tube to be implanted in the uterus (ectopic pregnancy). This tubal disorder affects approximately 25% of infertile couples and varies widely, ranging from mild adhesions to complete tubal blockage. (Apirta, 2009)
Uterine causes of infertility are conditions in which there is adhesion between the anterior and posterior uterine walls due to scar tissue formation. This makes it difficult for the fertilized egg to implant. Anatomic problems like polyps, uterine fibroid and abnormal shape of the uterus can also prevent fertility. (www.righthealth.com/infertility, 2009).
Uterine muscle problems is another cause of infertility, in this condition, some women may produce weak, infrequent or abnormal contractions in the uterus that push the sperm away during ovulation. (Arpitta, 2009).
According to www.righthealth.com/infertility,(2007), there are several causes of women infertility related to the reproductive system that may be associated with disease that affect the ovaries, uterus, fallopian tubes and other associated organs and this can interfere with ovulation, fertilization or implantation in a number of ways.
http://www.cdc.gov/reproductivehealth/art.htm (2008) further divided reproductive conditions into endometriosis and polycystic ovarian syndrome.
Endometriosis is a condition that occurs when segments of the uterine lining or endometrum grow a structure outside the uterus. Endometriosis affects women during their reproductive years; a woman may be at-risk for developing it if there is a family history of the disease. Sometime it no symptoms. (Ukpong, 2006).
According to centres for disease control and prevention, (2003), Endometriosis is a condition in which sections of the uterine lining are implanted in the vagina, ovaries, and fallopian tubes or pelvic. These implants eventually form cysts that grow with each menstrual cycle and may eventually turn into blisters and scars can then block the passage of the egg within the tubes.
According to http://www.cdc.gov/reproductivehealth/ art.htm(2008), polycystic ovarian syndrome (PCOS) is another leading cause of female infertility, it is an endocrine condition that interferes with ovulation, due to excess production of androgens (male hormones), and women with PCOS often do not ovulate normally, polycystic ovary syndrome (PCOS)is also associated with insulin resistance and obesity (Lancet, 2007)
Another common cause of female infertility is a blockage or barrier in the fallopian tubes or uterus that prevents the egg from coming into contact with sperm or implanting into the uterine lining. Such a blockage may be due to a congenital abnormality, post-surgical adhesions or any condition that produces scar tissue. Poor quality cervical mucus sometimes serve as a barrier to sperm to enter the woman’s cervix and a cervical infection may also be the cause. (Healthhints, 2003)
A hormone is a chemical communication system used by the body to regulate growth and other processes. When there is over or under-production of hormone like in adrenal or thyroid deficiencies and excess production of prolactin can prevent ovulation. (Mayo Foundation for Medical Education and Research, 2009).
Aderson, (2007) stated that in a luteal phase dysfunction, a woman’s corpus luteum (the mound of yellow tissue produced from the egg follicle) may fail to produce enough progesterone to thicken the uterine lining and when this occurs, the fertilized egg may be unable to implant.
The process of ovulation depends upon a complex balance of hormones and any disruption in this process can hinder fertility. The three main sources that can cause this problem are as follows: failure to produce mature eggs which is characterized by a reduced production of FSH, and normal or increased level of LH, oestrogen and testosterone, malfunction of the hypothalamus where the hypothalamus fails to trigger and control this process, immature eggs will result and malfunction of the pituitary gland. The pituitary responsibility lies in producing and secreting FSH and LH. The ovaries will be unable to ovulate properly if either too much or too little of these substance are produced. This can occur due to physical injury, a tumour or if there is a chemical imbalance in the pituitary. www.righthealth.com/infertility, (2007).
According to Sherman (2009), age can be a very big factor and is a cause of infertility in women that cannot be avoided. Nowadays, many women are waiting until they are in their mid-30s before trying to conceive but it is harder to conceive at that age. The author further commented that fertility in women starts to decline after age 27 and drops by 50% at 35 years and reduces to 20% by 40. Women over the age of 35 often suffer from age-related infertility as their eggs resist declines and hormonal changes make conception and pregnancy more difficult. Unlike some types of female infertility, age-related problems are progressive. The longer the patient waits before seeking treatment, the less likely that assisted reproductive technology will be helpful. (Stanback, et al, 2006)
It is well-known that certain personal habits and lifestyle factors have impact on health. Many of these factors may limit a woman’s ability to conceive. However, many of these variables can be regulated to increase not only the chances of conceiving but also one’s overall health. Equally, smoking by woman of child bearing age reduces the chance of conceiving with each cycle, either naturally or by IVF by one third. (American society for reproductive medicine, 2006).
http://www.fertilityplus.org/faq/bbwfaq.html (2010) also stated that reproductive functioning requires both proper diet and appropriate levels of exercise because women who are significantly overweight or underweight may have difficulty becoming pregnant. Around 12% of all infertility cases are because a woman is either underweight or overweight. In over-weight women, their bodies produce a hormone called estrogen and too much body fat (overweight) will lead to too much estrogen and the body will react to it as if it is a birth control. too little fat (underweight) also causes insufficient estrogen and disrupts the menstrual cycle. When menstrual cycle is irregular, ovulation is inadequate or even does nor occur resulting in infertility.
Environmental and Occupational Factors
The ability to conceive may be affected by exposure to various toxins or chemicals in workplace of the surrounding environment. Substances that can cause mutations, birth defects, abortions, infertility or sterility are called reproductive toxins. Disorders of infertility, reproduction and spontaneous abortion are among the top ten work-related diseases and injuries of the present day. (www.righthealth.com/infertility, 2007).
Despite the fact that considerable controversy exists regarding the impacts of toxins on fertility, four chemicals are being regulated based on their documented infringements on conceptions. They are as follows:
- Lead – This has been proven to have negative impact on female fertility.
- Medical Treatment and Materials – Repeated exposure to radiation, ranging from simple x-rays to chemotherapy, has been shown to contribute to a wide array of ovarian problem.
- Ethylene Oxide – This is the chemical used both in the sterilization of surgical instruments and in the manufacturing of certain pesticides which has the potential to provoke early miscarriage and cause infertility.
- Dibromochloropropane (DBCP) – is a chemical found in pesticides, which can cause ovarian problems, leading to a variety of healthy conditions like early menopause that may directly have impact on fertility. (American Journal, 2003).
Pelvic Inflammatory Disease (PID)
PID is the most common cause of infertility world-wide it is an infection of the pelvis or one or more of the reproductive organs, including the ovaries, the fallopian tubes, the cervix or the uterus. Sometimes, PID spreads to the appendix or to the entire pelvic area. It is usually caused by the same bacteria that cause sexually transmitted infections, such as gonorrhea or Chlamydia. (Smeltzer and Bare, 2004).
PID may also develop from bacteria that reach the reproductive organs through non-sterile abortion, hysterectomy, childbirth, sexual intercourse, use of an intrauterine contraceptive device (IUCD) or a ruptures appendix. (Anne and Allison, 2006).
These include the condition in which there is failure of ovulation as a result of stress or other forms of emotional instability usually this causes failure of luteinizing hormone (L.H) to be released. (Dexeus institute, 2006).
Problem like marital conflict or family disagreement may prevent frequency of intercourse, predisposing the couple to infertility. Such problems probably account for relatively few cases of infertility. (Monday and Adishi, 2009).
Female Infertility Caused by Genetic Problems or an Illness.
Turners Syndrome, a chromosomal abnormality, occurs in about 1 out of 2,500 live female births. The female is missing one of the x chromosomes in most of her cell and has a fragmented x in few other. According to the Turner’s syndrome society (2010), most (90%) Turners syndrome individuals will experience early ovarian failure. Although, most women with Turner syndrome are infertile because of abnormal ovary development, the Cincinnati Children’s Heart Centre (2009) reported that there have been case reports of women with Turner syndrome becoming pregnant on their own.
Clinical Manifestations of Female Infertility
Some or all of the following symptoms may be present, though, it is possible not to experience any symptoms:
• Inability to achieve pregnancy after one year of regular unprotected sexual intercourse.
• Irregular painless menses which may suggest anovulation.
• Fullness, heaviness, pressure, swelling or bloating in the abdomen.
• An irregular menstrual cycle is a sign because it shows damage, blockage or injury to some parts of the female reproductive system.
• Absence of menses can also indicate infertility in the sense that there may be no eggs being produces by the woman.
• Dysmenorrhoea, dyspareunia and waist pain suggest that there is retroversion of the uterus.
• Fluctuations in weight, irregular hair growth and acne over the age of puberty are also signs of female infertility because these are sometimes caused by hormonal imbalances which can affect the female reproductive system.
• Painful menstrual cramps can signal endometriosis which can cause blockage or damage to some part of a woman’s reproductive system.
• Pain during intercourse is a sign of endometriosis as well as fibroid/tumours, which can block passages in and around the reproductive system.
• Irregular basal body temperature
• There are other signs of female infertility which can be seen after the attending physician has done some in depth tests to seek answers. (www.medicinehealth.com (2008), mayo.com (2009) www.fertility/helper.com (2008))
Effects of Female Infertility
Women with infertility suffer from one form of abuse to the other as a result of their infertility. The commonest sources of the abuse were from neighbours, spouse or spouse’s relatives. (Matsubayasshi et al, 2004).
In Nigeria not having spousal support was observed to independently predict psychological distress among infertile women. Lack of such support leaves the women with infertility vulnerable to range of stressful events which may range from domestic conflict to political violence. They also suffer personal grief, frustration, social stigma and economic deprivation. The stress placed on the infertile woman can be intense and impinge on her psychological and social well being. (Ukpong, 2006).
The Diagnostic Procedures for Female Infertility
After 12 months of trying to conceive, a woman should consult her gynaecologist for a referral to a fertility specialist. There she will undergo a series of tests. The test results will give clues to the type of infertility and ultimately a treatment plan to overcome the problem. Firstly, the specialist will look at the woman’s medical history, which includes information on any previous pregnancies, the regularity of her periods and whether she has had painful periods, pelvic pain, infections or surgery. Next there will be a physical examination, which may include:
Blood Tests – these give information about the hormonal imbalance of the woman. Other tests will also be checked for blood group, sperm antibodies and sexually transmitted infections such as HIV, Hepatitis B and C.
Ultrasound Examination – This gives information on what the ovaries and uterus look like. The doctor will look at the growth of eggs, the thickness of the lining of the uterus (if thin, it can indicate hormonal problems), the presence of fibroids or polyps on the uterus as well as signs of endometriosis or ovarian cysts. Surgical laparoscopy may also be used to identify endometriosis or blocked fallopian tubes. (Monday and Adishi, 2009).
Risk Factors of Female Infertility.
According to Mayo Foundation, (2009), there are some risk factors if avoided can help to reduce female infertility. There include:
- Age – After about 32, a woman’s fertility potential gradually declines. Infertility in older women may be a higher rate of chromosomal abnormalities that occur in the eggs as they aged. Older women are also more likely to have health problems tha may interfere with fertility.
- Tobacco Smoking – women who smoke tobacco may reduce their chances of achieving a pregnancy and reduce the possible benefits of fertility treatment.
- Alcohol use – For women, there is no safe level of alcohol use during conception.
- Being Overweight – Among American women, infertility often is due to a sedentary lifestyle and being overweight.
- Being underweight – Women at risk include those with eating disorder, such as anorexia nervosa and women following a very low calorie or restrictive diet. Strict vegetarians also may experience infertility problems due to lack of important nutrients such as vitamin B12, Zinc, iron and folic acid.
- Too much exercise – In some studies, exercising more than seven hours a week has been associated with ovulation problems. On the other hand, too little exercise can contribute to obesity which also increases infertility.
- Caffeine Intake – Studies are mixed on whether consuming too much caffeine may be associated with decreased fertility. Some studies have shown a decrease in fertility with increases caffeine use while others have not shown adverse effects. If there are effects, it is likely that caffeine has a great impact on a woman’s fertility than on a man.
Types and Forms of Female Infertility
There are two types and forms of female infertility: primary and secondary. Primary female infertility is the inability of a woman to conceive for the first time despite cohabitation and exposure to pregnancy for a period of two years while secondary female infertility is the inability of a woman to conceive following previous pregnancy despite cohabitation and exposure to pregnancy for a period of two years.
Types and Forms of Infertility Remedies Available
Infertility is a problem that has solution but people find it very difficult to seek this solution. In this part of the study, we are going to see the remedies for any cause of infertility in the female. The remedies are as follows;
The use of medication is very important in some treatment of female infertility. Drugs like Antibiotics can help in the treatment of an infection. In hyperactivity or hypoactivity of the adrenal or thyroid gland, hormone therapy is necessary. Progesterone deficiency requires progesterone replacement. For ovulatory problem, drugs like clomiphene and gonadotrophins can be used. Endometriosis also requires drug therapy like danazol or medroxyprogesterone. (Papreen et al, 2007)
It is the use of surgical operation in treating infertility. For example, in removing blockage or scar tissues from the fallopian tubes, uterus or pelvic areas, minor surgery is the remedy depending on the location of the blockage or scar tissues. Surgery may also be necessary to remove tumours located within or near the hypothalamus or pituitary gland. (Monday and Adishi,, 2009).
Assisted Reproductive Technologies
An assisted reproductive technology (ART) has been developed over the years to assist women to achieve pregnancy. ART procedures are those fertility treatments in which both the egg and the sperm are handled in the laboratory for the purpose of establishing a pregnancy. (Monday and Adishi, 2009). There are many types but the most practiced ones are vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). It is mostly done when other steps to achieve pregnancy failed.
The indications for ART according to Papreen (2008) are as follows:
• Bilateral damage or blockage to the fallopian tubes
• Ovulatory dysfunctions.
• Diminished ovarian reserve. That is, reduced ability of the ovaries to produce eggs, which may be congenital, surgical or due to the ageing.
• Structural or functional abnormalities of the uterus.
• Immunological or chromosomal abnormalities.
The international council on infertility, (2007), stated that, in female infertility that is caused by over or under weight, the best remedies id dietary change, which involved an adequate and nutritious diet with plenty of fresh fruits and vegetables. Also, maintaining a normal body weight can also increase fertility.
Not Delaying Parenthood
According to The San Francisca Chronicle, (2007), infertility that is caused by delay parenthood can be avoided by conceiving as early ass possible because it is the most common female infertility that be easily treated by the women themselves.
Having identified all these remedies above, the best remedy for female infertility is abstinence till marriage. This will help to reduce the likelihood of sexually transmitted infections that can impair fertility.
Challenges Evident in Today’s Infertility Remedies.
• Lack of awareness programme on female infertility and various mitigation process by the health personnel.
• Religious problem, where people believe in going from one church to other forgetting that age has a great role to play in female fertility.
• Traditional belief, women think that infertility is caused by evil manipulation.
• Almost all the female infertility remedies are not affordable to many women.
Knowledge and Misconceptions about Infertility.
In many cultures, infertility is considered a shameful condition, something that is not freely discussed. So, not surprisingly, many men and women either do not know or still have misconceptions about the true causes of infertility.
Dr. Silke Dyer is the director of infertility serviced at Groote Schuur Hospital, a large public tertiary care hospital in Cape Town, South Africa has begun asking almost all his patients “Now why do you think you are infertile?” many of them shrug (their shoulders), she says. So think they truly do not know.
Dr. Arowojolu, the gynecologist from the University of Ibadan, Nigeria, agreed that many patients do not understand what is causing their infertility problems. There are also a lot of misconceptions surrounding infertility, he answered because childbearing is viewed as a natural part of adult female life and some have explained infertility as supernatural. It has been labeled as an act of God, a punishment from unhappy ancestors or the result of witchcraft. In an urban slum are of Banladesh, nearly half of 120 men and women surveyed said evil spirit caused female infertility.
Another common misconception that some forms of contraception cause infertility may be powerful disincentive to contraceptive use. Group interviews with men and women in Cameroon’s North West province revealed that contraception was thought to spoil the womb and that young less educated women were particularly unlikely to use contraception as long as they felt susceptible to infertility (Richard, 2002). In south- west Nigeria, study participants in a study alsi suggested that contraceptives can damage the uterus, leading to infertility (Okonofua et al, 2003).
Even family planning providers sometimes misunderstand the effects of contraceptives on fertility. In an FHI study in Ghana, many of 97 providers interviewed said that used age or parity requirements to ensure that only women of proven fertility obtained contraceptives, mainly because they believed that hormonal methods delay fertility or cause infertility. (Stanback, et al, 2006)
Contraceptives prevent pregnancy, they may mask underlying fertility problems, but they do not cause infertility. The risk of long-term impaired fertility after using any contraceptive method is low and fertility usually returns immediately or shortly after contraceptive discontinuation (Okonofua et al, 2002). In fact, by preventing unplanned pregnancy and thus the potential for either postpartum or postabortion infections, all contraceptives can help prevent infertility and improve the chances that women will become pregnant when they choose to do so.
While many couples do not know the true causes of infertility, the consequences are often apparent especially for women in the developing world. Grief, frustration, guilt, stigmatization and ridicule, abuse, marital instability, economic deprivation and social ostracism are just some of the consequences that have been reported in various parts of Asia and Africa, (Papreen et al, 2008). Many of these consequences are personal but others are societal. Throughout the world, women are expected to bear children but these social pressures can be particularly intense in parts of the developing world where voluntary childlessness is rare and opportunities for women, asidr from motherhood are few. In hopes of becoming pregnant, some women who consider themselves infertile may even engage in extra-marital relations, a behavior that places them at risk of STDs including HIV. (Dyer et al, 2009).
Theoretical framework for the study.
A Bio-psycho-social and life crisis theories are the theories propounded by Deborah A. Gerrity from the university ot Buffalo about infertility.
This article briefly reviewed the literature on infertility and its emotional, physical, existential and relational effects on individuals, couples and families. Life crisis and bio-psychosocial theories are discussed as they applied to persons having infertility issues. In addition, stage models derived from a bio-psychosocial perspective are presented. Most of the literature applied to White, middleclass persons. A short review of the literature for diverse individuals (race, ethnicity, sexual orientation, marital status) is included. Treatment suggestions are posited for the mental health practitioner working with individuals and/or couples.
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