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Infertility, not just a Woman’s problem (Part 1)

Dr Boima
HEALTH ESSUES

Infertility is often thought of as a women’s condition. We are told in the past when a couple could not conceive, all fingers would point towards the woman. So unfair was our culture that all sorts of derogatory terms implying infertility were formed around and used to refer to a ‘woman’. I seriously hope this mentality does not exist anymore in this century, as it is far from being the truth.

What is infertility?
For fertility to be successful there are requirements that need to be met.

A woman should be ovulating (releasing eggs from the ovary)

A woman should have patent fallopian tubes for the egg to move after release

A man’s sperm should be of good quantity and  quality and be able to move and fertilize the egg in the fallopian tubes

A woman should have a uterus where the fertilized egg will implant and grow into  baby

Infertility ensues if there are problems with any of the steps above.


By definition, infertility is the inability to get pregnant after one year of trying (unprotected sex). However, women who are above 35 years of age should get worried and seek medical help if they have not managed to conceive by 6 months. According to the report released by Centres for Disease Control and Prevention (CDC), about 10% of women of child-bearing age in the United States are infertile. Infertility is not only due to women’s issues. In fact, men contribute an equal share to this condition as do women.  About a third (33%) of causes has been implicated on a woman, about a third (33%) to a man’s factors and the last third (33%) to both or unidentified causes.

Woman’s causes

Most cases of female infertility causes are due to ovulation problems. Conditions like polycystic ovarian syndrome (PCOS) and Primary ovarian insufficiency (POI) lead to hormonal imbalances and hence interfere with ovulation.  Without ovulation, there are no eggs released for fertilization. Signs that can alert that a woman is not ovulating normally are irregular or absent menses.

Blocked fallopian tubes – there are conditions that affect women that can lead to scarring or adhesions of the tissue surrounding fallopian tubes like pelvic inflammatory disease (PID),  endometriosis, recurrent STIs or previous surgery e.g. ectopic repair.

Uterine problems – conditions that affect the uterus like fibroids can make it impossible for sperm to reach and fertilize the egg or implantation. They can also increase chances of recurrent miscarriages in cases where conception had taken place.

There are other risk factors in a woman that are not absolute causes, but increase chances of a woman not being able to conceive.

Age – the older a woman gets, the lesser their chances of conceiving easily. While 35 has been used as the cut of age, studies show that chances of conceiving actually declines rapidly every year from the age of 30.

Smoking – studies have shown that smoking affects hormone production. This can make it harder for women smokers to get pregnant

High alcohol intake

Stress

Over/underweight

Man’s causes

Infertility in a man is due to problems that affect his sperm production and transportation. Conditions that affect sperm production are either genetic or congenital like undescended testes or acquired e.g. testicular torsion, infections and varicocele. A varicocele (dilated veins in the scrotum) can make the testicles hotter than normal and this can affect the quality of the sperm produced.

Damage of the reproductive system – due to radiation, blunt injury e.g. in sports

Medications – like chemotherapy

Smoking – smoking is a cause of erectile dysfunction (ED). A man with ED can’t have and maintain an erection that is adequate for satisfactory sexual performance which can affect reproduction. Smoking also

damages the DNA in sperm

Heavy alcohol use

Medical illnesses – like mumps, kidney disease, and hormone problems

Advanced age

Diagnosis
Finding the cause of infertility can be a long and emotional process, but patience and cooperation in this condition pays a great deal. Diagnosis is through a detailed history of both partners, physical examination of both partners and tests done on both partners.

It almost does not make sense for a woman to present to a Doctor alone for work- up of infertility. Both partners should be assessed and investigated for the root cause, first by the general practitioner and if need referred to a specialist (Urologist for a man and gynecologist/ fertility endocrinologist for the woman).

Woman – first step is to find out if a woman is ovulating or not.  Few changes take place in a woman around ovulation so these should be noted by the patient; changes in morning body temperature, changes in cervical mucus or otherwise an ovulation test kit can be used.

Ultrasound of the pelvis can be done to assess the uterus, ovaries and look for any pathology affecting them.

Hysterosalpingography is a special test that assesses the patency of the fallopian tubes. A dye is injected into the uterus through the vagina and an X-ray is taken to see if the dye moves freely through the uterus and the fallopian tubes.

Laparoscopy – is a keyhole operation in which  a small cut is made in the abdomen and a laparoscope (small tube with light attached at the end) is inserted to assess the uterus, fallopian tubes, ovaries and look for any abnormal tissues or diseases like endometriosis.

Man – after a physical examination, a test called sperm analysis is ordered to check the sperm count, shape and motility in the semen. A sperm analysis is a common test, so a man need not feel uncomfortable about it. If the first analysis is normal, a second sample may be ordered to confirm the results. Two normal tests imply that a man does not have any significant infertility problems.

For comments email agboima@yahoo.com

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WeekendLife

Overcoming the trauma of rape

29th September 2020
Moving-on-after-rape

According to World Population Review, women aged 16-19 are four times more likely to be victims of rape or sexual assault and female college students ages 18-24 are three times more likely to experience sexual assault. Transgender people and those with disabilities are twice as likely to be victims of sexual assault or rape.

From these very statistics Botswana can be found second only to neighbouring South Africa with the highest rape cases in the world. The number of incidents per 100,000 citizens do not take into account the number of cases that have not been reported to authorities. This goes without saying that Botswana may very well be on the same level as South Africa if not surpassing it.

Most of these victims have a hard time dealing with the violence they faced to an extent where it affects their day to day life.

WeekendLife interviewed rape survivor, Patience Ruwona, who was raped at the age of 15. Ruwona shared her gruesome experience and what it took for her to find healing, gather strength and move forward.

“It happened eight years ago and at the time I was only 15 years old. My mother was staying with her boyfriend at the time. So it happened that one day I came early from school. I was still doing form 2. I was the first one to come back from school. The boyfriend was home. So when I was changing into home clothes in my room, the boyfriend came in without even knocking. He then told me my mother has left some money so that whoever comes back first from school can go and buy meat,” Ruwona narrated.

“I then told him I will come get the money when I am done. He went back to his room. So after I finished changing, I went to their room. I knocked and he told me to come in. When I got, I found him half naked with only a towel. That made me feel very uncomfortable because when we were growing, we were taught never to enter an elder’s room when they are not fully dressed. I told him I came to collect the money and he pointed the dressing table.”

Unbeknownst to the young unsuspecting Ruwona, her mother’s then boyfriend would then grab the young lad, rip apart her garments and have his way with her. When Ruwona threatened to expose him, the audacious perpetrator would laugh in her face, telling her that there would be nothing her mother would do about the incident. And true to his words, Ruwona’s mother did not flinch upon hearing the gruesome crime that befell her daughter.

“In the evening when my mother came I told her everything. It was a simple thing to her and she never took it seriously. I told her I am bleeding and she said go and wash up we will talk about this some other time. Just like that suddenly I recalled that man’s words and I truly believed him. Till then I have not told anyone about this. I thought my mother is going to protect me, so if my mother failed to protect me no one else could protect me,” said a distraught Ruwona.

Seeking help after being raped

“Physically I had no desire to have sexual intercourse, I was scared. Years passed by and emotionally I was still battling because there were days I had flashbacks of the rape. It’s like a wound, it can never heal but it can stop bleeding. It never heals. It will bleed another time. I felt uncomfortable around men and I never went for counselling. I never went for anything, I thought I will cope on my own,” she said.

“So one day I decided enough is enough and I decided to speak out. That time I figured counselling would be best.  I later went for counselling and I was doing well. I had to accept it happened and put everything in the past. Forgiving my mother helped me to heal.”

Director of Save A Woman, Babedi Samakabadi, has highlighted that rape is a permanent wound that one has to live with for the rest of their lives.

“The first thing the victim can do is to admit that they have been abused and they should be able to talk about it to whoever they can trust; could be a close relative, a counsellor, a friend or a pastor. It is not easy to take a step towards your healing but it must be done.

Victims of rape, must create a huge room in their hearts to forgive the perpetrators even when they are not sorry, forgiveness will help the victim to make peace with life and the future. Forgiveness will allow the victim to be able to get over the horrible experience and not associate the intimate relations as abuse at all times,” said Samakabadi.

“If one doesn’t allow themselves to heal and move on, dating and engaging in intimate matters are going to be a problem in their lives. As the victim can disclose to whoever they trust like friends or family, they are also advised to seek more especially professional counselling for proper psychological therapy, as the memories of the incident may torment the victim therefore  therapy may assist with getting to live with such memories without being drawn back or life progress being affected . Lastly, the victims must know that issues as these aren’t easy to deal with through our own ability, we need God for strength, wisdom and courage. We have no power to diminish some of the weight in our emotions or the damage done to our souls and hearts, hence we need God to carry us through.”

If you or a loved one is in need of help in dealing with rape or gender based violence, the following organisations provide free counselling services;

BOFWA (Botswana Family Welfare Association) 390 0489

BOSASNET (Botswana Substance Abuse Support Network) 395 9119

LIFE LINE 391 1270

MBGE (Men and Boys for Gender Equality) 395 7763

BGBVC (Botswana Gender Based Violence and Support Centre) 390 7659

BOCAIP (Botswana Christian AIDS Intervention Programme) 391 6454

Princess Marina Psychiatric Clinic

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WeekendLife

200,000 Members of International Church Hold Virtual Prayer Service for Covid-19

22nd September 2020
200,000

After its initial outbreak with a cluster of pneumonia cases at a seafood, poultry and live wildlife market in Wuhan City, China, Covid-19 has spread rapidly across the globe. The virus has hammered economies worldwide and brought devastation to many.

On 16 September Shincheonji Church of Jesus, a church with thousands of members in various countries, held a global online prayer service to pray for the victims of the coronavirus and their families, healthcare workers, government officials and for the complete eradication of and cure for Covid-19.

The virtual prayer service was live-streamed to the entire congregation with more than 200,000 members in countries all over the world participating, including the USA, the United Kingdom, South Korea, Australia, South Africa, Namibia and Zimbabwe.

In keeping with social distancing, health protocols and protecting its members from possible exposure to the coronavirus, Shincheonji arranged the virtual gathering for members to pray together in safety and set an example for others.

Prayers were mainly for the healing of those infected with the virus, for overworked healthcare workers who are struggling to fight Covid-19, and for people in economic distress in the wake of the pandemic. The overwhelming online participation from its members worldwide showed the desire and urgency to end this virus and for healing and restoration in communities.

The Chairman of Shincheonji Church Mr Manhee Lee suggested this online virtual gathering and said that all believers will continue to pray at the church’s worship services until the complete eradication of the coronavirus.

At least 1,700 of the church’s South Korean-based congregation have donated their blood plasma for research around an effective treatment. Convalescent plasma has also showed promise as therapy for Covid-19 and is believed to have reduced the severity of symptoms in critical patients.

“In order to defeat Covid-19, we need to embrace, love, and unite,” as global citizens, the church said. “We wanted to do all we can as believers by praying for the people working to prevent the spread of the virus and healthcare workers who are working at the frontlines of this battle against Covid-19 and we believe that God will answer our earnest prayers.”

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WeekendLife

AFRIMMA nominates Vee Mampeezy

22nd September 2020
Vee-Mampeezy

The annual prestigious music awards, African Muzik Magazine Awards and Music Festival (AFRIMMA), has resumed this year. But this time around with a virtual version of it.

The awards that celebrate the originality of African music has unveiled their seventh edition. The awards seek to promote the African talent by bringing together on the same stage African legendary artists to celebrate African culture.

The event was established by the International Committee of AFRIMMA, in collaboration with African Union to reward and celebrate musical works, talents and creativity around the African continent while promoting the African cultural heritage amongst African countries.

However after the Covid-19 global pandemic, the event will not be hosted on a live global stage, but it will be hosted virtually and nominees are expected to deliver their performances virtually. The AFRIMMA Virtual Awards 2020 is set to be the first of its kind in the African music world with performances coming from different artists around the world and audience catching the performances, speeches and award presentations on multiple streaming devices.

Amongst the many who are nominated by the AFRIMMAs is local sensation Vee Mampeezy who has been nominated in the category for Best Male Southern African alongside music giants, Black Coffee- South Africa, Slap Dee – Zambia, Cassper Nyovest- South Africa, Master KG- South Africa, Jah Prayzah – Zimbabwe, Vee Mampeezy – Botswana, Shyn – Madagascar, Tshego- South Africa, Tha Dogg – Namibia and Yanga Chief – South Africa.

Mampeezy has established with WeekendLife that prior to that, he had received an email from AFRIMMA confirming his nomination. They wished for him to perform which he said he will confirm the performance first with his manager, but as for now he is not sure if he will be performing.

“We have accepted the nomination. It is such an honour to be nominated alongside music giants like Black Coffee. I am very excited, others I am not as excited to be nominated alongside them because I have been nominated before with them. I do not mean to say they are not great, they are great in their respective right,” he said.

“We should be excited as a country that Botswana has been nominated as well. Before anything else, the fact that we are there as nominees makes us winners. It is such an honour to be recognised more so that Botswana is a small country with a very small population.”

Famous and most decorated artists the likes of Diamond Platnumz, Mr Flavour, Harmonize, Davido and Jah Prayzah are also amongst the nominees. However, South African based artist affectionately known as Master KG has been nominated six times for Video of the year, Best Male Southern Africa, Artist of the year, Best Collaboration as well as song of the year.

Master KG’s song ‘Jerusalem’ has been making waves internationally, and it was used mostly during the pandemic to shake off the Covid-19 anxiety. The song was nominated after South African Music Awards (SAMA) failed to nominate the young talented artist.

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