The International Women’s Day is marked globally on March 8 to celebrate the social, economic, cultural and political achievements of women. This year’s theme is ‘Pledge for Parity,’ a reminder to intensify women’s global effort to ensure gender equality, especially regarding status or pay. As much as I am not an advocate of gender equality, I am also not against it. One cannot but commend the roles of women in various endeavours of life. Women have proved themselves beyond measure in various sectors, including politics, banking, the academia, research, science, medicine, engineering and law. Their multiple responsibilities amidst their career pursuits as wives, mothers, and role models cannot be ignored but applauded. One often wonders where such derogatory and chauvinistic terms such as ‘weaker sex’ come from.
From the point of a reproductive endocrinologist and infertility experts, one of the most frequent questions I’ve had to answer was, ‘why can’t I get pregnant’? Surprisingly, this single question is usually asked by women in their late 30s or early 40s; women at the peak of their careers. As much as the education of the female child is of utmost importance, emphasis on career seems to hurt a woman’s fertility. Although this statement seems ambiguous and no direct causal implication can be inferred, during my practice, I have observed this pattern. Many women seemingly do not have any organic causes of infertility, just that age has set in. With advancement in age, the reproductive functions become impaired, particularly ovarian functions. The quality of the eggs diminishes as age advances. Also, in those susceptible (genetic predisposition) the onset of uterine fibroids and other uterine problems are common among women in this age bracket. Although not all fibroids can negatively impair fertility, the presence of submucous has been implicated as a causal etiology. Women in their late 30s and early 40s also tend to experience hormonal imbalances, stemming from work-induced stress (elevated prolactin), poor sleep, improper nutrition, exposure to work-related toxins, environmental pollution, cosmetic-induced toxins and by default, perimenopause, and early menopause.
Most fertility experts will agree that the best time for a woman to conceive is in their late teens and early to mid-20s when incidence of chromosomal aneuploidies associated with birth defects — mongolism/Down’s syndrome — is minimal, in contrast to women of advanced age when such is common. In the early to mid-20s, women tend to be at their prime at attracting male suitors, but it coincides with a period when a majority of them are enrolled in schools/universities with keen instructions from their parents (especially mothers, God bless them) to concentrate on academics and career. Not surprisingly, after their high/secondary schooling and first degrees from universities; in other to be more competitive and attractive to employers, the majority go on to attain second degrees, fellowships and doctoral degrees before giving thought to marriage and childbearing. Even those married tend to voluntarily delay childbearing in other to achieve their career goals, tilting their ages to the late 30s or early 40s when their ovarian reserves would have been diminished. It is worthy of note that about this time, systemic disorders such as hypertension and diabetes is prominent which could also affect their chances of achieving conception. Sedentary lifestyle, lack of exercise (due to busy workload), junk-eating, smoking and alcohol consumption (to relieve stress; work-related social gatherings) are common among career women and are contributory to cardiovascular problems which affect conception directly or indirectly.
The WHO described infertility as a disease. It is a misnomer, as childbearing is a fundamental right of every woman. Except where decisions are taken primarily not to pursue this God-given role (in certain cultures), procreation is a delight and a fulfillment of a woman’s worth. In some cultures and societies, childless women still suffer discrimination, stigma, and ostracism. As such, a central difficulty associated with infertility is that it can transform from acute, private distress into a harsh, public shame with complex and devastating consequences.
An inability to have a child or to become pregnant can result in being significantly isolated, disinherited or assaulted. This may result in divorce or physical and psychological violence. Stigmatisation is a significant issue in sub-Saharan Africa where women are valued and more acceptable within the society when they are married and have given birth. They are seen as more responsible and capable of occupying certain men-designated roles (e.g., board of directors, National Assembly, ministerial appointments, governorship, presidency).