Infertility affects one in six couples globally, with around 48.5 million experiencing difficulties in conceiving.

This condition is defined as the inability to conceive a child after 12 months of regular unprotected sexual intercourse. However, the impact of infertility goes far beyond just the inability to have children, affecting couples’ mental, emotional, and physical well-being.

According to the World Health Organization (WHO) report on March 3, infertility affects approximately 10 to 15 per cent of couples worldwide and the prevalence of infertility has increased significantly over the past decades.

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Although the condition affects both men and women, women tend to bear the brunt of the emotional burden, they are often seen as responsible for conceiving and carrying a child.

Dr Hassan Sibomana, Ag. Division Manager, Maternal, Child and Community Health at Rwanda Biomedical Center (RBC), said this medical condition has been evidenced in some couples, however, it is still a private issue to most couples in Rwanda.

"Most affected couples do consult specialists on their own, compared to health facilities attendees, they are not yet open to speaking up as the matter is still considered unusual because childbearing is at high social value,” he said.

Infertility can be caused by a wide range of factors, including age, genetics, lifestyle choices, medical conditions, and environmental factors.

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According to WHO, disorders in the tubal, uterine, ovaries, and endocrine systems are the common causes of the female reproductive system. The disorder affects fallopian tubes, and polycystic ovarian syndrome, causing imbalances of reproductive hormones.

Meanwhile, testicular failure to produce sperm, abnormal sperm function and quality, hormonal disorders, and obstruction of the reproductive tract is on the list for the high possibility to affect the male reproductive system.

On the other hand, lifestyle factors such as smoking, excessive alcohol intake, and obesity can affect fertility, while pollutants and toxins can be directly toxic to gametes (eggs and sperm), resulting in their decreased numbers and poor quality, WHO noted.

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Addressing infertility

Dr Sibomana said, "Almost 80 per cent of data collected is primarily provided by health centres, but infertility information is rarely provided by some individuals, this makes it hard to collect accurate data to know exactly how many are experiencing the problem.”

He said that RBC urges couples to be open about the matter because it is nothing unusual.

According to WHO, emphasising the importance of addressing infertility improves the quality of life of individuals and couples as well.

It mitigates gender inequality as infertility has significant negative social impacts on the lives of infertile couples, particularly women, who frequently experience violence, divorce, social stigma, emotional stress, depression, anxiety, and low self-esteem, WHO states.

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In some settings, fear of infertility can deter women and men from using contraception if they feel socially pressured to prove their fertility at an early age because of the high social value of childbearing.

In such situations, education and awareness-raising interventions to address understanding the prevalence and determinants of fertility and infertility are essential.