Let’s open up about infertility


A former boyfriend once told me he was ready to marry me — but before he made our union official, he said, we would have to get going with conception immediately. He coyly added that, as soon as I was with child, he would send his family to pay my lobola. Shocked by his arrogance, I said no. He was eager to explain his reasoning, so I heard him out. He said he had to be sure that I was able to give birth — he did not want a barren wife. I told him to take a hike. But for the longest time afterwards, I wondered how a man could be so arrogant. I wondered if it had ever occurred to him that men, too, can be infertile.

I was reminded of this incident when a friend experienced a fertility crisis. It was that time of the month and Matilda was not happy about it. She and her husband had been trying to conceive for two years, to no avail. The sight of her menses was painful for her. She was anguished and all I could do was try to comfort her.

At first, Matilda had regarded her problems conceiving as a challenge that she would overcome in time and with dedication. She made lifestyle changes, accompanied by prayers and fasting. After months passed without the desired result, the realisation that she was unable to conceive sank in — along with a terrible sense of failure and depression.

Pressure from her in-laws only made things worse. During one of our conversations, she confided in me about her shame. She described her mother-in-law looking at her with disdain and disgust, as if she were less of a human being because she was not impregnated.

Still, she and her husband soldiered on in their desperation to conceive, and resorted to seeking medical treatment. When prescription medication failed, Matilda’s doctor referred her to a gynaecologist. She was examined thoroughly and even subjected herself to invasive medical tests. The results of these tests showed that she was able to procreate. Naturally, Matilda wanted to dance for joy, so relieved was she.

But when the gynaecologist said she would have to run tests on Matilda’s husband, Matilda recalls that “the air in the room became so thick, I nearly suffocated”.

Matilda, her husband, her mother-in-law and many other people are oblivious to the fact that a man can be infertile. According to a medical professional at the Johannesburg-based Medfem Fertility Clinic, “traditionally, infertility has been thought of as a female problem, but this is far from the truth. A male problem can be identified in nearly half of all couples who experience difficulty conceiving.”

In an article written by Xanet van Vuuren, she quotes Dr Merwyn Jacobson, a reproductive specialist at the Vitalab fertility clinic in Johannesburg, as saying: “Infertility in men is a genuine medical issue and accounts for nearly one half of all infertility cases.”

The causes of male infertility vary, he adds. “Lifestyle choices as well as hormonal, physical and psychological problems may result in anything from complete absence of sperm to a low sperm count, abnormal sperm shape, problems with sperm mobility or sperm that’s completely immobile … Medical disorders can also reduce male fertility.”

For a while, Matilda’s husband refused to undergo tests to determine whether he was fertile. “He was petrified at the thought that something could be wrong with him,” she told me. When he eventually agreed, the tests confirmed that he had a zero sperm count. He was diagnosed with azoospermia.

The American website fertilityauthority.com defines azoospermia as a condition in which a man “produces no sperm or very little sperm in his ejaculate, giving him a zero sperm count. Azoospermia can result from a problem with sperm production or sperm delivery.”

Matilda’s husband took the news hard, seeing it as a slight to his manhood. This was despite being told that there were treatment options available to him, such as assisted reproductive technology or having his sperm surgically extracted for artificial insemination to take place.

This raises the question: Isn’t it high time that we dealt with the taboos around men and procreation? The journey to conceive should always be a shared responsibility.

Palesa Lebitse is a writer, feminist and law student with an interest in human rights

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Palesa Lebitse
Palesa Lebitse
Palesa Lebitse is a liberal feminist who regularly writes for the M&G.

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