Monday, January 30, 2023

Inside why Botswana male infertility is a social blindspot

For most couples that are grappling with infertility, the story is all too familiar. After trying for many years to have a baby the woman would go through the fertility treatment routine: diagnostic procedures, taking medication and changing diet only to discover that the man’s poor sperm count is to blame.

Male infertility is one of Botswana’s biggest social blind spots. This is despite the fact that men account for more than one in every three cases of couple infertility in Botswana. Dr Ponatshego Gaolebale, Head of Obstetrics and Gynaecology at Princess Marina Hospital says infertility affects between nine and 15 per cent of couples, stating that for pregnancy to occur there must be fertile sperm and egg and a means of bringing them together to allow embryo implantation.

“There are factors which lead to infertility between couples and it differs between a man and a woman. Thirty-Five per cent of cases of infertility are as a result of male factor while the women stand at fifty per cent of cases, whereas 15-30 per cent of cases are not identified.” He further stated that the male factor infertility has four components and is primary testicular disease, obstructive male infertility, hormonal causes and lastly drugs.

He explained that the primary testicular disease, is the commonest cause of male factor fertility, obstructive male infertility can occur at any level of male genital tract and can be as a result of birth defects or inflammatory conditions and said the hormonal causes are very rare but once diagnosed are usually easy to treat. The drug factor occurs when drugs taken for medicinal or recreational purposes can affect both sperm production and function and these include alcohol, tobacco, marijuana, steroids and opiates.

Despite all the facts and figures, fertility in Botswana is still a social frontier where the gender gap is wide and male infertility is hardly ever discussed.

Baboloki Lentswe, an I.T consultant at IT-IQ Botswana in Gaborone says “for men, the idea of being infertile is humiliating and emasculating. A man’s masculinity is strongly connected to his ability to conceive. The definition of male in masculinity terms is can you father a child.  A man can be the strongest most macho man but if he can’t get his woman pregnant then his sense of self as a real man is affected”, he says.

Malebogo Diphole, a Gaborone street vendor and mother of four says infertility is a taboo subject in Botswana, especially if the person to blame isn’t the woman. “The truth is that men deny it and the women carry the blame. Childless women suffer discrimination, often times they are not even regarded as women but as girls even though it’s not their fault. Sometimes men know that they are infertile but to save face they put all the blame on the woman, even at suggestions to try and figure the problem out the man is usually apprehensive.”

She says part of the problem is that couples don’t talk about their fertility problems but it happens even more with men and that contributes to the myth that it is a woman’s problem when in actual fact it could be either one of them or both.

With IVF (Invitro-Fertilisation) clinics springing up all over the world, Botswana has a fertility clinic, Gaborone Fertility Clinic. It is a revolutionary facility with modern state-of-the-art technology to perform complex medical procedures. It also offers services In Vitro Fertilisation (IVF). The clinic opened in April this year and is located in Gaborone. It is the brainchild of pioneering scientist, Dr. Vincent Molelekwa, a reproductive medicine specialist; endoscopic surgeon, obstetrician and gynaecologist among his many caps. Asked what IVF is he said, “It is an assisted reproductive technology that is used to help couples that are unable to reproduce through the normal reproductive process to conceive.”


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