Causes of Infertility Among Female Secondary School Students

Causes of Infertility Among Female Secondary School Students

Causes of Infertility – Over the years many countries of the world have experienced and are still experiencing the issue of infertility.  This is to say that infertility is not a new or recent phenomenon but has always been with human beings right from creation.

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According to Williams and Wilkins (1995) in most civilized and uncivilized countries of the world, infertility is one of the medicine and its most emotionally devastating effect is the increase in broken homes, unhappy marriage, and polygamous homes.

Infertility has been defined by Herin (1997) as the inability to conceive and reproduce.  He also estimated that approximately ten percent (10%) of married couples are unable to have children.  This goes to say that the subject of infertility is an important one that demands and needs the help of every one to ensure that at least its effect is reduced or minimized.

There are two types of infertility namely primary and secondary infertility.  Primary infertility occurs if despite being exposed to regular sexual intercourse for a period of twelve months (one year) or more, the woman fails to get pregnant.

While secondary infertility occurs when a woman who had been pregnant before now finds it difficult to get pregnant again for at least 12 months or more despite regular sexual intercourse.

According to Collins (1993) infertility is defined as failure to conceive when partners have sex up to twice a week for a period of one year.

Infertility in Nigeria is in the increase probably due to late marriage and adverse effects of promiscuity. Female infertility may be due to tubal disorders, and hormal defects treatment of infertility relates to the cause and in many cases the results are successful.  Currently; drugs that induce ovulation have been introduced to foster fertility.

Infertility as a health problem in both sexes can also because by a variety of conditions that adversely affect the functioning of normal reproductive system.  For example, ill health, high alcoholic consumption, cigarette smoking, the use of marijuana and other drug abuse, exposure to radiation or toxic chemicals, anxiety, malnutrition, fatigue and stress can lessen a person’s reproductive capabilities.

Moreover, child adoption increases due to infertility, some single people adopt children, many adoptions bring anticipated happiness to the childless couples.  With all these health problems, the secondary school children/pupils are now have the knowledge about infertility and how it can be preventable also not expose themselves on sexually behaviour rather make protection against sexually transmitted infections (STIS), and free of medical risk. The secondary school children or adolescents need to prevent some of the problems associated with infertility for them to set goals for their future child bearing.  Counselling about STIS, contraception and sexual behaviours will be more meaningful for them.  We can influence the children in risk of impaired fertility in a number of ways:

Stay current in the prevention, diagnosis and treatment of STIS and PID.

–       Be aware that contraceptive choice influences the risk of PID.  Encourage sexually active secondary school children/pupils or young people to avoid IUDS and to use barrier methods.

–       Begin or continue public health education efforts so the consequences of untreated sexual infection may be fully understood by your clients and particularly by all young people.

Infertility seems to be a growing problem for instance “the saddest epidemic or all”. No one knows exactly why more couples are having problems of conceiving.  Some blame the increase of inflammation disease, PID in women, the result of sexually transmitted diseases.  Fertility also decline with age in women after 35        years of age the decline becomes especially sharp after age 40 and as  more couple postpone child bearing until their mid or later thirties, they may encounter greater difficulties in starting a family.

According to Landis (1992) 20 percent of marriages proved infertile.  Women who married younger proved to be the most fertile, in that they become pregnant most often and in a higher percent age of 21 pregnancy occurred among 90 percent and they averaged 3.5 pregnancies of those who married between 21 and 25, pregnancy occurred among 86 percent of those who delayed the marriage until after age of 30, he reports that not more than half become pregnant, although the researchers admit that their sample of this age group is either small.  They do cite the confirming evidence however, that after age of 30 very few women in any of the samples become pregnant, even those who had previously demonstrated their fertility.  From age of 46 on there is only one chance in 500 of a woman becoming pregnant.

Throughout the world, the history of infertility has been considered a traged.  It has quite universally been looked upon as a defect in the wife.  But these days, however, the problem of barrieness has taken a new turn.  Absolutely sterility is thought to characterize only a small percentage of the childless marriage and where it exists.       It is now recognized that the husband is as often responsible as the wife

Meanwhile, in women the most common causes of infertility are abnormal menstrual patterns, suppression of ovulation.  Probably by far the most common causes of infertility in women is failure of ovulate.

This can result from hyposecretion of gonadotrophic hormones, in which case the intensity of the hormonal stimuli simply is not sufficient to cause ovulation, or it can result from abnormal ovaries that will not allow ovulation.  For instance, thick capsules occasionally exist on the outsides of the ovaries that makes ovulation difficult.  Lack of ovulation caused by hyposecretion of the pituitary gonadotrophic hormones can sometimes be treated by approximately timed administration of human chorionic gonadotrophic. It is a hormone extracted from the human placenta.

According to Guyton and Hall (1996), this hormone, although secreted by the placenta is a powerful stimulator of ovulation.

It is also important to recognize the psychological stress to which an infertile couples may be subjected.  Their marriage may also be strained because the female role is defined largely by the ability to bear children and be a mother and the woman may feel inadequate in her role as a woman.  Historically in most cultures, fertility has been encouraged and indeed demanded, hence pressure on infertile couples were high, leading to more psychological stress.

Statement of the Problem

The specific problems associated with infertility that prompted the study are enormous and confronting both to the society in general and the individual concerned in particular.

Infertility has caused many problems ranging from physical such as childlessness and cultural attachment to child bearing.

Childlessness in the part of the world is seen as a taboo and an open scandal and moreso when such couples are duly married in the church.  They are quite often confronted with one choice which from the eyes of tradition is nothing shoot of “in official break-up” of the marriage.  Time is the only determining factor.

Cultural attachment to child bearing implies those women in community or village, who are unable to bear children and people regard most of them as witches and wizard society that feed with human blood, using their own children to replace their life span.  Based on those facts, people in the community especially women who bear children don’t allow them near to their family especially their children because they believed that those witches craft women will kill their children to replace their life so that they will remain like them.  With these reason there are being isolate from other women in the village, community because there are regarded as wicked people.

Social problems are emanating from infertility examples broken homes, marital conflicts. There are many factors which lead to broken homes (the ending of a marriage).  These include infertility, adultery and incompatibility of husband and wife.  Broken homes can also be the result of poverty and a hard life.

Martial conflicts (a serious disagreement) which implies when they grow up and realize that infertility has been their health problem, they are not compatible with their partner.  Such couples are unwavering in the face of social pressures but not for all time to come.  Three to four years after a fruitless marriage is consummated statutory bodies like sponsors of the marriage should come to the aid of such couples to assist them with counselling and encouragement and find out how they could like to help each other and move forward.

Psychological problem which is ability to bear children and both sexes may feel inadequate to their roles, having mental illness, and emotional inbalance.  So their need to been encourage as the time is the only determining factor.

Most of the causes are preventable.  If the adolescent are knowledgeable on its causes.

Every individual community organizations have one role or the other to play in preventing the scourge of infertility.  Do these levels of organization, secondary school, communities and individuals see infertility as tormenting and worthy of preventing? These are what this paper seeks to find out.

Objective of the Study

All research works have objectives for which they are carried out.  The objectives of this research work includes the followings:

1.     To determine the meaning and knowledge of concept of infertility.

2.     To assess the knowledge of cause of infertility.

3.     To determine their knowledge of the consequences of infertility.

4.     To determine their knowledge of the preventive measures against infertility.


Significance of the Study

Every research work seeks to improve knowledge about an existing problem and solution.  The significance of this research therefore, is to add to the already existing literature on infertility.  It is also hoped that this research ill acquaint the entire society and particularly the female secondary schools students in Idemili North Local Government Area of Anambra State with what infertility is, its causes, consequence, or effect and the prevention.

It is also expected to this research work to express the implication of infertility both on the individual, his family and society at large therefore, aiming women to always take precautionary and preventive measures to curb the menace of it.  It is also expected to encourage women to cope assuming they find themselves in such predicament.

 Delimitation of the Study

This study is strictly delimited to the knowledge of causes, consequences, and preventive measures against infertility.  It covered all secondary school in Idemili which is eighteen (18) in number.  But the study is only based in the three (3) secondary schools of Oraukwu Community Idemili North Local Government Area.

Limitation of the Study

This study is limited to find out the knowledge of causes of infertility among female students. The researcher has also chosen to discuss such issues on infertility as what infertility is all about, the causes, consequences and preventive measures of infertility.  This is to make for a clear understanding and proper solution so that infertile couples can at least live in peace.

Research Question

1.     How knowledgeable are the students on the concept of infertility?

2.     How knowledgeable are they on the causes of infertility?

3.     Are they knowledgeable on the consequences of infertility?

4.     Do they know the preventive measures against infertility?

Research Hypothesis

1.     There is no significant difference on the knowledge of concept of infertility by level of study of students.

2.     There is no significant differences on the knowledge of causes of infertility by level of study of students.

3.     There is no significant difference on the knowledge of the consequences of infertility by level of study of students.

4.     There is no significant difference on the knowledge of the preventive measures against infertility by level of study of students.   

Review Of Related Literature

The review of related literature will be done under the following headings.

1.     Concept of infertility

2.     Causes of infertility

3.     Effects of infertility

4.     Implication for sex education

5.     Control measure of infertility

Concept of Infertility

The concept measure of infertility Ashiru (1988) defined infertility as a couple’s failure to conceive after a period of regular intercourse.  For further enumerated that this is normally one year but may extend to 18 months.

According to Heroin (1997) defined infertility as inability to conceive and reproduce.  He also estimated that approximately ten percent (10%) of married couples are unable to have children.  Also, according to Schroedes (1989) infertility as when pregnancy does not occur after one year of normal sexual activity without contraceptive.  Moreover, infertility is one of the disorders connected with reproductive organs.  Other disorders include sterility, Abortion, Breech babies, impotence, miscarriage, Extra uterine pregnancy, Dysmenorrhoea and a host of others.

According to Rowley (1985) infertility is a situation or condition whereby the male is unable to produce active and productive sperm that could make a woman pregnant, or whereby a woman has immature ova which cannot receive active sperm and therefore cannot become pregnant.

Most normal couples achieve a pregnancy within a few month of trying.  Failure to do so after one year may be arbitrarily defined as infertility provided that normal intercourse is taking place not less than twice a week.

Clayton, Lewis and Prinker, (1980) defined infertility as a women’s inability to conceive and bear a living child, or a man’s inability to produce a pregnancy.  Couples are therefore described as infertile if they are unable to achieve pregnancy after one year of steady martial relationship without contraceptives.  The World Health Organization (WHO) subdivides infertility into three types viz:

1.     Primary infertility,

2.     Secondary infertility and

3.     Pregnancy wastage.

Primary infertility is a situation in which a woman has never conceived despite living with a man, being exposed to the possibility of pregnancy; and wishing to become pregnant for at least one year.

Secondary infertility is a condition where a woman has previously conceived, but is subsequently unable to conceive.  It can also be described as a term used for a couple who have previously succeeded in achieving at least one pregnancy, even if it ended in miscarriage.

Pregnancy wastage is a situation whereby the woman is able to conceive but unable to produce birth, while sterility is the absolute inability to bear children.  Nwangoro, (1978).

Okafor (1988) defined infertility as when couples cannot achieve pregnancy after a year of normal coitus.  According to Chambers Universal Learners Dictionary (1994) infertility is defined as when couples are unable to have children.  Some people think that infertility is limited to women.

In Nigeria and indeed the world over man can also prove infertile.  For instance Williams (1995) said that among 15.30% of couples, infertility is a problem.  Male infertility he continued may be due to insufficient numbers of sperm or their motility.  This is to prove that men can also be infertile.  However, our focus in this study is on women.

Causes of Infertility

There are so many causes of infertility.  According to Ajayi (1986) “there are a number of causes in which both partners suffer from reproductive deficiencies”.  According to Osagie (1992) if a woman has a mind health problem it constitutes a major problem because it can affect her fertility.  Female infertility may be broken into several categories.

–       Ovulatory problems

–       Cervical factors

–       Contraceptive pills

–       Endometriosis or blocked fallopian tubes

–       Uterine factors.

Ovulation is a complex event in which hormonal signals and physical events are linked in a delicate balance.  Women ovulate most effectively in their late teens and early twenties.  By age 35-38, most women may experience a decline in the ability to ovulate effectively.

Probably by far, the most common cause of female infertility is failure to ovulate as result from hyposecretion of gonadotrophic hormones in which case the intensity of the hormonal stimuli simply sufficient cause ovulation, Guyton and Hall (1996).   Ovulation can be seriously affected by:

–       Abnormalities of the thyroid gland.

–       Over production of prolactin (a hormone leading to breast milk production)

–       Excessive male hormone (androgens)

–       Physical stress, psychological stress and extreme lifestyle changes.

Cervical infertility involves inability of the sperm to pass through the mouth of the uterus due to damage of the cervix.

Causes include the following:

1.     Inadequate or hospitable cervical mucous

2.     Cervical narrowing or “stenosis”

3.     Infections of the cervix with common sexually transmitted diseases (chalmydia, gonorrhea, or trichomonas, as well as mycoplasma hominis and ureaplasma urealyticum).

4.     Immune attack of sperm or “sperm allergy”.



Larson (1997) observed that contraceptive pill is one of the causes of infertility in quote “There are contraceptives which prevent the fertilization of the ovum by sperm”.  Pill suppress ovulation or they may act as mucus in the neck of the womb.  Thus contraceptives can causes infertility.


Guyton and Hall (1996) continued to say that one of the common causes of female infertility is endometriosis.  It is a common condition in which eudiometrical tissue almost identical to that of the uterine eudometrium grows and even menstruate in the pelvic.  Cavity surrounding the uterus, fallopian tubes, and ovaries.  Moreover, salpingitis is another common causes of female infertility, that is inflammation of the fallopian tubes, this causes fibrosis in the tubes.  In past years, such inflammation was extremely common as a result of gonorrhea infection, but with modern therapy, this becoming a less prevalent causes of female infertility.

They went on to say that another cause of infertility is secretion of abnormal mucous by the uterine cervix.  Ordinarily at the time of ovulation the hormonal environment of estrogen causes secretion of their mucous with special characteristics that will allow repaid mobility of sperm into the uterus and actually guide the sperm up along mucous “threads” They also said that abnormalities of the cervix itself such as low-grade infection or inflammation or abnormal stimulation of the cervix can lead to a viscous mucous plug that will prevent fertilization.

According to Collins (1993) He pointed out some of the causes of infertility which is as a result of mechanical blockage of the fallopian tube, so that the egg and sperm are kept apart.  This is due to infection or abortion.

Idowa (1990) mentioned that fatigue stress, emotional problems plays a big role in infertility.  Okoiser (1988) also said that stressed that ignorance of timing sexual intercourse, drug addiction or abuse of alcohols and even smoking tobacco or cigarette may lead to infertility.  She went further to say it is necessary to avoid excessive alcohol and smoking in other to reduce infertility.

Schroder (1988) pointed out the ill effects of cigarettes and the use of contraceptives, douches as it affects the fertility of people; and can lessen a person’s reproductive capabilities including changes in life-style.  According to him others include family traits, illness, repeated abortion or one that is not properly done, scanty or watery sperm with few fable spermatozoa can cause infertility.

It is also important to recognize that age may be a cause of infertility; fertility decline in women after 35 year of age, the decline being especially sharp after age 40. According to Landis (1960) from age 46 there is only one chance in 500 of a woman becoming pregnant.

According to Kuti (1987) the causes of infertility divided into two major headings.  Physical causes and metaphysical causes.

Physical causes are irregular menstruation, leucorrhoea, worms, inflammation, venereal diseases, faulty uterus and ovaries.

According to him some women normal have irregular menses, painful menstruation, scanty and dirty menses which at times watery with no evidence of ova, while some have lost their monthly period completely.  They say that some worms can disturb the formation of pregnancy or cause abortion.

Arinze (1999) mentioned some worms that can affect fertility such as hook-worm, round worms, tape-worm etc.  He says that these worms cannot be seen or visible by x-ray or any other from completely but disturb the formation of pregnancy.  He went further to say that leucorrhoea is a condition in which the sperm runs out just immediately the gets up after sex.  That it disallows fertilization to take place and is caused either by retroversion or autroversion of the worm.

According to Osagie (1992) inflammation is caused due to some diseases, the vulva or the vagina tube is inflamed.  He says that the commonest symptom of this is bleeding after intercourse or pains during sex resulting to non harmony between the ova and the spermatozoa thus no fertilization.

A lot of medical doctors believe that the major cause of infertility is due to disease and infection.  Osagie (1992) stresses that gonorrhea and syphilis if they are poorly treated can cause inflammation in the womb and thus disturbs the formation of pregnancy and is more serious when it is contracted by a girl at the first appearance of her monthly period or when it cause abortion, serious damage will be done to the uterus and surrounding tissues and some common signs are yellowish discharge after 3 or 5 days of infection as in men.  And also swelling of vulva and stomach problem especially at the lower part a woman’s abdomen.

According to him all these physical causes of infertility are known to the modern doctors while the meta-physical aspect are some spiritual causes of infertility such as goddies of water, gods of wisdom, and god of thunder etc. they can cause infertility of one kind or the other.  For instance, in a community where some women are believed to be under the spell of witches and wizards.  These wicked people can cause a lot of havoc by changing the womb into any form and can plant sinister womb in ovary called hormone of pregnancy.  Thus rendering the eggs infertile.

Another factor is if the horoscope of a woman is barren.  It may be difficult to assist her, for instance, Neptune the sign of Scorpio destroys the fetus and cause frequent abortion.  He also says that uterus develops fibroid, or causes heat in the womb and will not allow pregnancy to stay.  According to Okoye (1997) another factor which is believed by people is the retributive law of justice which is learnt in spiritual philosophy saying “a man reaps what he sows” for (eg) if a man or women is wicked to children or has been destroying them through supernatural powers, he or she is rendering herself barren in her next existence.

Apart from physical and meta-physical causes another major factor is nutrition.  According to Osagie (1987) if one diets strictly and poorly here period may stop and there will be no ovulation.  For instance, during the Nigeria Biafra war, so many young women who suffered from kwashiorkor had their monthly period stopped.  But when they recovered from kwashiorkor, due to proper feeding they had their period back to normal hence were fertile again.

Osagie (1987) agreed with the factor which is feeding properly he stressed that improper feeding followed with smoking and drug addiction can cause polluted blood which will result to infertility.  He said in quote “Life is in the blood and cells make up the blood.  The total nutrition of an individual plays an important role in infertility, according to figures published by the international planned parenthood federation IPPF (1992) fertility declines with increasing age.  The reason given include pelvic inflammation as well as hormonal discharged.  Also according to Bakare (1993) a consultant gynaecologist, the decline infertility begins even earlier than is commonly believed by people.


Effect of Infertility

        The effects of infertility abounds in so many ways. Every individual or couple expects to at least have child to represent them in the next generation or when they are no longer around.

According to Okoye (1991) there are many problems associated with infertility which include anger, depression and loss of self esteem.  He further says that for couples who are infertile. It is a profound sadness that brings months of agonized guilt, soul searching and wild hunt for cause.  These conflicting emotions can destroy a couple’s ability to try again hence the bedroom becomes a combat zone, ie further says that the worst part of it is that the fertile feels angry with his or her partner and in most cases the women are always blamed and the people leaves the couples to start recalling their youthful days looking for one loophole or the other where they might have done wrong.  It says that, this is due to inability to conceive and bear children because children according to a Yoruba adage are the wrapper with which a woman covers here nakedness in old age.

Nigeria men, more often than not, but rather believe that it is the women’s fault even if it is theirs.  The problem is even worse if the woman is a graduate and over 25 years.  It is automatically assumed by the society that she must have undergo numerous abortion while in the university.  This leaves the woman miserable and uncomfortable in their matrimonial homes.

According to Okafor (1987) a lot of women today do not have wrappers to cover their nakedness, their agony is physical and psychological pain that they cannot really express to anyone.  It lingers day and night like a stubborn headache, spoiling everything that could make them happy, some are even frustrated to steal another woman’s baby because they cannot look the society in their face and accept childlessness.

According to him, some men still hope that their wives will conceive but majority cannot take it.  When the fault is confirmed to be the woman’s own, the man starts misbehaving and has his attitude changed for the worse when the husband finally blocks under the pressure from the family and friends, he gatters a child from another woman.

Implication for sex Education

It is important to thought about sex education to both male and female including young people.  According to Ann Furedi he was encouraged to spell out what the reasonable recommendation that sex education programmes should start before sexual activity begins meant in practice.  He confirmed truthfully that “in some areas of Britain some kids are sexually active at age of 11 years”.  The implication for sex education teenage pregnancy; sexually transmitted disease, early marriage among other reasons demand adequate teaching of sex education in secondary schools and tertiary institutions.  This high rate of teenage pregnancy may be due to ignorance, improper guidance on sex and family living and lack of experience of sex and sexuality.

High rate of sexually transmitted infections and reproductive tract infection as one of the out come of sex education, student need to acquire knowledge of not only the various types of venereal disease but also the mode of transmission, aetiology and preventive measures.

Problems of unwanted pregnancy also included as one of the implication of sex education, as a result where by people do not acquire knowledge of sex and preventive measures or the procedure to avoid unwanted pregnancy which may later end up in abortion.

Control measure of Infertility

Managing of infertile couple calls for empathy and patience.  Treatment as well as effective counselling of couples have been found to yield positive results.  Treatment should be based on diagnosis made by a gynecologist.  Couple should be counselled on the correct techniques of sexual intercourse, timing of ovulation, balance diet, adequate rest, and avoidance of tension.

According to Maharama (1990) many childless couples today are able to have children.

Okoisor (1969) suggested some preventive measures such as wearing loose pants and showering with cold water can increase spermatozoa as well as reduction in the amount of alcohol and cigarette smoking.

According to Gregory (1991) a metabolic physician adds that mates should arouse each other properly in order for them to secrete sufficiently and the men to penetrate deeply.  In order to deposit the sperm properly for fertilization to occur.

He also says that women should avoid engaging in active sports exercises to avoid infertility. They should also avoid the use of contraceptives, a detailed history of the menstrual cycle should be recorded and a general examination done to detect any gross abnormalities of the genital trait such as unruptured hymen, partial or complete absence of the vagina or uterus, uterine fibroid tubal and ovarian swelling.  He further stresses that people should consult qualified gynecologist for D & C to avoid injuries or damage to the uterus or damage to the womb.

Those who belong to the school of orthodox medicine believe in herbal medicine for the treatment of infertility. Lambo (1987) in this book titled “herbal cure” claims that he has cured up to 500 people with low sperm count since he went into practice and women who have be regarded infertile by modern doctors.  He also says that even those who are sexually weak have been equally treated with same medicine plus additional herbs to increase potency.

Above all, couples who have been extensively investigated and treated to no avail should be encouraged to go for child adoption as a better alternative that will even help them to relax.  It is important to point out that when no abnormality can be demonstrated, pregnancy will always be possible even after many years.

Summary of Literature Review

This chapter has so far helped to clarify and give a concise understanding of the subject for study.  Each part of the chapter actually reveals the level of relationship in justifying the incidence of infertility on female secondary school students in Idemili North Local Government Area L.G.A of Anambra State.

The general deduction here include the conceptual view of infertility which is regarded by Heroin (1990) as the inability to conceive and reproduce.  Infertility which is world over does not exclude female secondary school students in Oraukwu Idemili North Local Government Area.

Among these causes are the uses of contraceptives, abortion, failure to ovulate, venereal diseases, faulty uterus etc. Infertility posses many problems ranging from physical, social and psychological/emotional problems.

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