Issues and Challenges

Perceptions and Myths about Infertility

(In) Fertility has been a subject of great curiosity for humans since the beginning of time. If we talk about Pakistan, 22 percent of our women are reported to struggle with infertility. Over time, people have come up with various false theories or concepts regarding infertility, which are believed and practiced till date. One reason behind this staunch belief in myths regarding infertility is the result of the massive stigma present around this topic especially in the subcontinent. This stigma is associated with different psychological and social pressures especially for women, giving rise to feelings of shame and guilt. Women have been made to believe that their identity and social strength depends upon their fertility status. Due to this immense fear around infertility, even well-educated women have been made to believe the myths about infertility and practice them despite the fact that they are not backed up by any scientific evidence. It is of paramount importance to address these myths and debunk them. Moreover, it is important to understand that all women form a valuable pillar of their home and society regardless of whether they can bear children or not. In subsequent paragraphs we will try to debunk some of the popular myths that have emerged over the years regarding infertility.
Women are Solely Responsible
Infertility affects women and men equally, however, the general go-to response to a couple not being able to conceive is getting the woman checked up for infertility and even if the gynaecologist declares her perfectly fertile, she is held responsible claiming that the doctor must be incompetent and so another should be consulted. However, it is not as simple as that; there are a number of different medical conditions that affect both sexes and the occurrence of any of these conditions in either partner can be enough to cause infertility. It should, therefore, be remembered that there is also a thing called male infertility that includes abnormal sperm production, genetic defects, underlying viral or bacterial infections or infertility secondary to some systemic diseases such as diabetes. Infertility is not a clear-cut case of a woman being unable to reproduce, the chances of it having something to do with the man are just as much. So, a couple struggling with conceiving should get themselves checked up, instead of just the woman. 
This is a very common misconception that I have heard from a number of people that contraception cause infertility. Contraceptive methods do not cause infertility and there are some birth control options that bring back fertility as soon as they are discontinued. Discontinuation of contraceptive pills, patches, rings and Intra Uterine Device (IUD) causes an immediate return to fertility, while implants and injections take several months. In any case, they do not make women infertile.
Irregular Menstrual Cycle 
Irregular menstrual cycle can occur as a result of various underlying conditions such as hormonal disturbance due to stress, polycystic ovary syndrome (PCOS), medications or gynaecological conditions. Women can have irregular menstrual cycles for a number of reasons and not all reasons guarantee permanent infertility. Conception during those months of irregular cycles can be hard to achieve and women have a difficult time predicting their date of ovulation. It is important to consult your gynaecologist and fix the underlying issues. 
PCOS or Endometriosis 
Infertility due to PCOS or endometriosis is not true in its entirety. In approximately 50 percent of the women with infertility, 10 percent have PCOS and 6 to 10 percent have endometriosis. Although these conditions are not ideal for pregnancy, such women have been able to conceive with medical intervention and fixing the underlying issues. 
Although it is true that fertility decreases with aging due to a number of biological factors such as depletion of viable ovum in the ovary over time, however, youth does not guarantee fertility either. Many young couples face infertility issues and require medical help. On the other hand, many women in their early 40s can get pregnant and deliver healthy babies. 
Showering during Menstruation 
In all honesty, this is a totally absurd notion about infertility! I had personal experience with a number of women both young and elderly, who have advised me to not shower during menstruation or during the first three days and so on. This is not only false, but harmful to health as well. In fact, it is important to maintain hygiene during the days you are menstruating to prevent vaginal and urinary tract infections.
COVID-19 Vaccine
During the times when vaccines got released for public use, a number of people around the world refused to get vaccinated and this was also seen in the South Asian countries including Pakistan. According to the Centre for Disease Control and Prevention (CDC), pregnant women are at higher risk of developing severe form of COVID and getting infected earlier in pregnancy that can lead to severe complications such as increased need for mechanical ventilation, to foetal death. Therefore, it is extremely crucial for pregnant women or those who are opting to conceive to get their vaccine shot in order to protect themselves from severe complication.
Infertility Cannot Be Treated
Although, there are some conditions in which it is difficult to achieve fertility, the notion that infertility is irreversible is not entirely true. A few decades ago, this statement would have been somewhat true but after the technological advances in science, a number of medical options have evolved that have proven to be successful in the treatment of infertility. Treatment options include various medications, surgical procedures and assisted reproductive technologies.
If you are dealing with infertility or god forbid may have to deal with it at some point in the future, cognizance about reasons and issues surrounding infertility is extremely important. It is vital to remember that it does not define who you are or your worth and value. Keeping oneself together during such times is extremely important otherwise it can lead to severe depression and interfere adversely with the daily life activities. Secondly, both partners should be open to the idea that the issue causing them not to procreate could be with either one of them and so they have to deal with it together, like all the other matters of their life. Unfortunately, despite there being an equal probability of a man being infertile, it is quite common among men to not discuss their infertility issues. In fact, it is often considered a question mark on their ‘masculinity’. The first step here is to renounce the ‘standards of manliness’. Talking about it and getting help does not make a man less of a human being; bottling it up or trying to hide behind the woman by holding her responsible, on the other hand, can only make life difficult. HH

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