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The nightmare of fertility treatment costs; what’s the way out?

The recent tragedy that befell a young woman at the hands of her spouse, apparently because she couldn’t conceive, cannot just be wished away. Details of the case have been doing the rounds in the local media.

It appears the man was the one who had a problem, and not the other way round. Either way, there can never be any justification for that level of violence. For starters, natural conception is a two-way affair. Each of the partners must have a functional reproductive system for conception to occur. The physical evidence of conception is borne by women, which mistakably is the basis for the misconception that women are mostly responsible for any delays in achieving a pregnancy. Nothing could be further from the reality. Men are solely responsible for failure to conceive in about a third of all cases, and contribute to a further third of cases.

Whenever a delay in conception occurs, it must be assumed that either the man or the woman could be responsible. The couple must be assessed together, and the correct diagnosis promptly made. Majority of cases will have a treatable condition, even though some options may turn out expensive and unaffordable for some.

Let’s look at men. The range of issues that can interfere with the ability to father a child is wide. Most men will only require a simple sperm test to make a diagnosis. A minority will need to have more extensive testing. Mild abnormalities only require simple corrective measures, which may involve lifestyle modifications or some form of fertility treatment. In days gone by, men with severe fertility problems could only be helped with the use of donated sperms. But this is no longer the case. Modern advanced fertility treatments mean that majority of infertile men can be helped to father their own genetic children.

So why the violence against women in the face of infertility? It must be partly to do with a culture that puts an unfair blame on women. Are men really unaware that they could be to blame when infertility occurs? If this is the case, we need initiatives aimed at educating men on reproduction, and get them to be openly involved in reproductive matters. We also need to integrate fertility treatment within the reproductive health services. This may address the stigma associated with childlessness, by openly addressing fertility concerns as they arise within couples.

Comprehensive fertility treatment services are hardly available, both in the private and public sectors. Where available within private care, the cost is prohibitive for the common Kenyan. There is hardly any insurance cover for fertility treatment locally either, despite WHO categorizing infertility as a disease. All these factors just raise frustration levels in needy couples, with inevitable psychological sequelae. But fertility-related violence is despicable.Seeking help is the only logical alternative.

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