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

Dr Boima

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



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

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.

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Self-taught fashion designer speaks

26th July 2022

A job, lucrative or not, is a job after all. Sometimes one has to compromise in order to make a living, few people get a job their dream jobs. But once in a while there is an emergence of people who listen to their inner calling to pursue their passion.

The founder and head designer of Butterfly Couture, Chawa July is one of those few people who left their job to pursue their passion. An inspiring fact about July is that she is a self-taught fashion designer, she used to copy patterns from her old clothes until she learnt how to draw them, and she also searched information from the internet to increase her knowledge and skills.

“It all started as a hobby from my love for beautiful dresses and I started adjusting and making clothes for myself. Gradually people around me started to take interest in my craft and the hobby slowly grew into a profitable business,” July said.

The 41 year fashion designer from Molepolole worked her way up in the Procurement space for over 10 years. She worked at Stanbic Bank, Kromberg & Schubert and Clover Dairy as a Procurement supervisor. Her last job before she entered the fashion industry was a Manager for Contacts & Sourcing at a Facilities Management Company.

She established her fashion house in October 2019 and it has become synonyms with elegant wedding gowns and exquisite evening wear. July said when designing she is inspired by various aspects such as the client’s personality, the mood of the event and the theme. She further mentioned that every opportunity is to show her craft so she always aims to please.

“Every Butterfly Couture piece must represent the elegance and the creativity the brand is about,” she said. Butterfly Couture has adorned beauty queens; Miss Botswana 2021/2022 Ambrociah Samboko at Miss Universe in South Korea and Miss Botswana 2019,Oweditse Fafah Phirinyane during her reign of which is the highlight of her career. They have also marked their presence in a few fashion events locally and in the neighbouring countries.”

They showcased at The Grand Palm Wedding Expo, Masa Fashion Show, Miss Botswana Fashion Show and Sacunda plus Size Fashion Show. The will also be showcasing at Gabs July Fashion Show on the 15th of July alongside the South African designer, popularly known as the King of glamour David Tlale.

July also identified that one of the challenges they face in the couture is that, it’s a seasonal business. “There are times in the year when the business is great and challenging. Winter in particular, is difficult time to stay afloat as there aren’t as many events that people are inspired to dress spectacularly for,” she said. She further said that her aim is to be a prime couturier of choice in Botswana.

“Craft like your life depends on it because every happy client is 10 more referrals” is what she said when asked to serve a word of wisdom to people hoping to make it in the fashion industry.

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Gospel awards re-organised

26th July 2022

The Botswana Gospel Music Awards (BOGMA) and the Annual Gospel Awards (AGA) are said to be no longer in existence and a joint venture project has been put up that will carry out the awarding of gospel musicians.

The new entity has been established as Gospel Music Awards, which is a project at this moment is nearer to dishing out the first Gospel Awards under the leadership of the dissolved entities (BOGMA and AGA). “The difference is the same, it is just that the two projects were run by different minds which had differing objectives,” said the project coordinator, Letsweletse Moshabi when asked what the difference was between the two previous awards.

He added that at this junction their focus is on the future of the gospel musicians and they would like to direct their energies to the new project and forgo the past projects. “The Music market especially the gospel genre is too small and that basically means the very small market was experiencing the imbalance in the supply and demand forces. At that stage, supply was more than the demand so the reason for the joint forces is to allow the supply and demand forces to readjust and form equilibrium,” added Moshabi.

The mandate and objectives of the project are to recognize and award gospel music talent, to create awareness of the Botswana gospel music industry and to create a platform where fellow musicians may exchange ideas and network amongst themselves and approach international markets in cohesion.

The first of these joint awards will be held on the 27th August 2022 at Molapo Showcase under the theme ‘Cohesiveness to Build’ where about 18 categories will be up for grabs.

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Makhadzi, Master KG invade Thamaga

18th July 2022

The Kumnandi Ekhaya musik festival will be held on the 30th September 2022 at Thamaga village. The event coincides with the release of famous host, Dj Ngwazi’s first album called ‘spring day’ on the 2nd of September 2022.

The Thamaga born and raised Lefika Lushen Kebatlege is a disc jockey and a music producer signed under WanitwaMos Entertainment in South Africa. Famously known as Dj Ngwazi and formally known as DJ superstar, he has really worked hard to become one of the finest export DJs the country has produced. Internationally, he is described as a DJ from South African because of his works with popular music artist Master KG.

Meanwhile, the music festival will feature South African artists, Makhazi, Master KG, Prince Benza and Mthunzi. They will also be joined by some of the big local artists, Franco, Vee Mampeezy, among others.  “The tickets of the concert will be available at Spar stores, webticket and Kings bar. There will be three categories for VIP tickets, the one that goes for P1000, P1500 and P2200,” said the Kumnandi Ekhaya musik fest promoter Sadie Swartz of Saysay Entertainment.

“We have a new system to tackle the cry of promoters about security at the events. We will have a team of 100 security men, 10 horses and 15 dogs. We also agreed with the police to help with traffic control and no tickets will be sold at the gate to avoid circulation of money which can attract thieves,” said Kagiso Gaodumelwe from All Night Security.

“I started deejaying back in the days when I was still schooling at Kagiso Senior School and I never stopped working towards my career since then. I have a career in South Africa, since 2018 when Master KG took me in and his support as a brother has taken me to places,” said DJ Ngwazi describing his career journey.

“Kumnandi Ekhaya is Zulu language which means ‘go monate ko gae’ in Setswana. The name came about as a way of inviting my South African fans and supporters to my home village Thamaga to come experience the joy that comes with celebrating our freedom and independence. I used isiZulu because it’s the dominant language in South Africa,” explained Dj Ngwazi.

“The concert will be held in an open space which was used for agricultural purposes and we would like to call it ‘Ko Legoleng’. With this concert I want to redeem the dignity of our village because we once had the cases of youth who were terrorizing the community, beating up people in the streets and stealing and these was really a concern in our community because they were tarnishing the village name,” said Dj Ngwazi.

The purpose of this concert is to empower the community of Thamaga and local artist, more especially artist from Thamaga village like, Kgabo Sereto traditional group. There will be a litter picking campaign around the village before the launch of the concert .The sponsors which are already on board are Dladleng Entertainment and Kings bar and there are still more sponsors to be revealed.

”As the Kumnandi Ekhaya musik fest management, we are going to buy food combos and take them to Thamaga village Kgotla so they can be donated to the less privileged and orphans. Starting from October we will be donating pads to all Junior Schools in Thamaga,” said Dj Ngwazi. Dj Ngwazi’s motivational words to other artist and everyone else; work hard, be patient and be determined.

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