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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

A Star is rising

29th June 2021
Star Phalane

Having made his debut appearance in a singing competition, My Star, from 2010 till 2015, Star Phalane has been constantly and effortlessly reaching for the stars.

Who can forget Star’s dance moves and stage presence? Without faltering, he was one of the few contestants one can’t remember to forget, even to this date.

He stood out in his own right, but even with that being the case, he was shamefully kicked out of the Top 10 of the singing contest. He never clinched the grand prize, but that wasn’t much of a big deal because, failure can be a blessing in disguise if more effort is put to it and you have the right mind set.

It is fortunate that the young lad is tenacious and is alive to the fact that every cloud has a silver lining, had it not been for this, we’d not be here celebrating his fighting spirit.

Star has, against all the odds stacked up against him, managed to get his act together and focused his eyes on the ball. Now a jack of all trades, Star has bragging rights to being fashion designer, entrepreneur, MC, choreographer and a singer. He is a force to reckon with, and his works speaks to the versatile creative he is. He doesn’t bite off more than he can actually chew nevertheless.

In an exclusive interview with Weekendlife this week, Star revealed that he is a self-taught fashion designer even though there is a small crop of well-established designers he learns few flairs and elegances from. This form of learning doesn’t cost an arm and a leg unlike enrolling for fashion and design course, we’re not against the lads choice of learning, cause we believe education is not only found in a classroom set up.

“Most fashion designers studied design at school and it is only a small portion including myself that are self-taught. I believe it goes back to individual talents that people are born with. It was upon me to develop and bank on this talent. I leave room for learning from others though, it works in my favour.”

Star’s designs had many prominent public figures salivating and day dreaming about wearing one of his creations. The likes of Annah Mokgethi; Minister of Nationality, Immigration and Gender Affairs, socialites such as Vincent Matthys as well as rapper; Baxon, have all line up around the corner to be seen in Star’s creations.

With all the success the young talent has and all the famous and high ranking people after his talent, Star is humble and down to earth. It is probably for this reason that the universe is giving back to the lad tenfold especially after being knocked down so many times in the past. Star doesn’t look down on others nor does that mean he thinks any less of him and the God given talents he has.

“I don’t think my designs are different. I am the one who’s different in a special way and obviously that doesn’t mean I’m better than any other fashion designer. I can also let the cat out of the bag on how to produce better designs. One ought to network and be consistent on their work. This means being able to survive against all odds, it’s a pandemic year and designers should be able to tell a story through their designs,” Star said.

It is not so common in Botswana to find male fashion designs. Stereotypes labelled fashion designing to be female’s hobby if not business. But there are ways to express authenticity and what life has to offer. It can be on paper (sketch), on clothes (designing) or on record (melodic). Star is amongst few male designers resolute to stamp out these pigeon-holes.

Above and beyond fashion designing, Star is also a singer and choreographer. He is not as right as rain, but he definitely leaves a mark once on stage. His incredible moves can be traced back to Mophato Dance Theatre. This dance assemble is the country’s first Afro-fusion and Contemporary dance company, that has been selling Botswana through dance.

The group has performed in New York, South Africa, Zimbabwe, Lesotho, Ivory Coast, Canada and Japan. Currently a lead dancer and singer with the group, Star is also the company’s costume designer.

“I started off as a professional Latin dancer and a street dancer. Eventually, I was employed by Mophato and subsequently became a member. That was a dream come true. So with time I starred as a lead singer in most of the musical plays the group participated in. It was magical and really motivated me to see a dance group appreciating my skills. I explored my creativity and loving each and every bits.”

Like riding a bicycle, Star never forgot how to sing. Just recently, he was announced as a finalist on the revamped My African Dream singing competition. He told Weekendlife that it wasn’t really smooth sailing as he was against the best talents, but having weathered the storms, the competition was a learning experience. Star is currently working on an Extended Play (EP).
We look forward to the rising star in Star.

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WeekendLife

Real You Network creates an inclusive environment for LGBTI+ persons

3rd June 2021
Real You Network creates an inclusive environment for LGBTI+ persons

The month of June marks a time of celebration and reflection for the LGBTQ+ community and allies. LGBTQ+ is an acronym for lesbian, gay, bisexual, transgender and queer or questioning. These terms are used to describe a person’s sexual orientation or gender identity.

This year, LGBTQ+ allies and corporate companies joined in the celebration and developed new initiatives to support the vulnerable group. On the 1st of June 2021, Botswana’s diamond mining company, Diamond Trading Company Botswana (DTCB), launched a new project dubbed the Real You Network.

This is a platform that creates a safe, inclusive, supportive and welcoming workplace for LGBTQ+ employees to allow them to bring their whole selves to work every day and work to their full potential.

The company stresses and prides its self in coming up with projects that make it the best place for people to thrive in their truest selves, something that is in their inclusion and diversity calendar.

When speaking during the virtual launch of Real You Network, DTCB Senior Human Resources Manager, Stella Moetse said “we will reach success when the talent that we have here in the glass house represents all the different people we have in our society, especially the minorities; and these are people living with disabilities, the LGBTQ+ and not only having them, but in positions of influence and decision making. This will be the true measure of inclusion.”

In September 2017, De beers announced a three-year partnership with United Nations Women; an arm of the United Nations dedicated to Gender Equality and Empowerment of Women and Girls.

As part of this partnership, the group committed to taking a holistic and long term approach to promoting gender equality within the business and communities. DTCB says, the commitment in its group has gone beyond gender to create an inclusive workplace for all.

“Because of this commitment to promote and support an inclusive workplace, DTCB which is part of the De Beers group resolved to be inclusive in its approach. As a result, we have elevated inclusion and diversity to Board level reporting. We promote awareness through training our employees on identified inclusion and diversity topics such as anti-bullying and harassment, unconscious bias and inclusive hiring.”

Moetse applauded and appreciated the role that advocacy groups for LGBTQ+ play in pursuit of their rights in society, indicating that it is not an easy task for them to given societal orientations. “It is commendable however, how they are constantly challenging us to break down any preconceptions, removing structural and societal barriers and biases.”

Technical Services Senior Manager, Prudence Mabua, shared the same sentiments, saying that LGBTQ+ persons face obstacles when it comes to accessing many of their rights, including their right to social protection.

The Real You Network, will allow for an environment of openness and promote a culture of a fully inclusive network open to all colleagues regardless of sexual orientation, gender identity or expression, she said.

“Through events such as this one, our vision is to continue creating platforms that allow for employees and individuals to share lived experiences as this is key in increasing understanding, tolerance and acceptance,” Mabua highlighted.

“There is significant ignorance and resistance to the reality of the existence of LGBTQ+ community in Botswana. While people may not have the intention to be homophobic, the language they use is often offensive. This increases the fear of coming out as people are scared of being subjected to judgement and discrimination.”

Uncovering the main objectives of the Real You Network, Mabua stressed that the platform will enable DTCB to be visible in its consciousness of LGBTQ+ matters and allegiance of the community, hold conversations to sensitize its workforce on LGBTQ+ inclusion and challenge policies and procedures as well as attracting and retaining qualified people of the LGBTQ+ community.

Further, the Network will focus on sustainability and accountability, by achieving continuity by treating inclusion and diversity as a culture not events. It will also focus on acceptance of diversity and ensuring zero discrimination culture within the organization.

Meanwhile, a study conducted in 2020 by Asher and Lyric indicates that most African countries still criminalize and stigmatize LGBTQ+ practices. These countries are anti-homosexuality and protection of LGBTQ+ person’s rights is minimal.

Algeria, Egypt, Morocco, Maldives, Uganda, Iran, West Bank and Gaza, Sudan, Tanzania, Zambia, Yemen, UAE, Qatar, Jamaica, Oman, Malawi, Malaysia as well as Saudi Arabia and Nigeria are some of the countries of the world which criminalizes homosexuality. Nigeria is the only country in the world with cruel treatment of LGBTQ+ persons.

In Nigeria, homosexuality receives up to 14 years in prison, and at most times the death penalty. In some of these countries, discussions of LGBTQ+ rights and gender expression are criminalized, flogging can occur for cross dressing, and homosexual intercourse receives 6 months to 3 years in prison.

Pro-LGBTQ+ organizations are sometimes barred, imitating the opposite sex can result in prison time and buggery receives up to 10 years in prison and hard labour.

Nonetheless, there are other countries (mostly from the West) which promote and protect the LGBTQ+ community. These countries legalized same-sex marriages, protect the community against discrimination, criminalizes LGBTQ+ violence, implement transgender legal identity laws and are safe places for LGBTQ+ persons to live in.

These are: Canada, Netherlands, Sweden, Malta, Portugal, Belgium, United Kingdom, Spain, Uruguay, Norway, France, Iceland, Denmark, Australia, Brazil, New Zealand, Austria, Finland, Ireland and the United States.

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WeekendLife

Botswana fades away from Miss Universe pageant

17th May 2021
MISS-UNIVERSE-2013-Tirelo

Botswana once had a story love affair with the world’s biggest premium beauty pageant, Miss Universe. This was in 1999 when Botswana’s first representative at Miss Universe, Mpule Kwelagobe, effortlessly snatched the title.

It was every contestant’s beautiful dream to wear the crown, but winning at first entry was implausible if not magical. Kwelagobe made the country contented, and history was made. Taking a closure significant look at her performance at the Miss Universe held at the Chaguaramas Convention Centre in Chaguaramas, Trinidad and Tobago, Kwelagobe battled it out on and off stage with 84 contestants and showed them dust. She was in the Top 5 spot with South Africa, Venezuela, Philippines and Spain. There are countries which snatch the Miss Universe title every year.

Miss Universe 2019 was a South Africa, Zozibini Tunzi. Mpule Kwelagobe scorecard looked pretty remarkable. She scored 9.05 out of 10 on her interviews, 9.18 swimsuit, 9.36 evening gown, semi-final average 9.19 and 9.48 on the Top 5 question. These results were good enough to earn her the crown.

However, over the years (since the crowning of Mpule Kwelagobe), Botswana has been fading away from participating at the Miss Universe. Between 2002 and 2003, the country did not participate in Miss Universe but in 2004, the country sent a winning title of Miss Universe Botswana to Ecuador, Miss Universe 2004.

In 2010, Mos Syde Worldwide Entertainment Group: an international entertainment and fashion company domiciled in Botswana took over the Miss Universe Botswana pageant after a six-year absence. Tirelo Ramasedi was crowned Miss Universe Botswana 2010, and represented the country in Las Vegas on August 23. As it is right now, Ramasedi is the only former Miss Universe queen still keen in having her name shine out there: she works closely on projects aimed at empowering women and young girls.

Sadly so, 2013 was the last time Botswana participated in Miss Universe. After five years of not participating at Miss Universe pageant, the first Miss Universe Botswana Mpule Kwelagobe took over the franchise. The winner selection of Miss Universe Botswana 2019 was to remark Botswana to Miss Universe 2019, however, was cancelled.

2019 marked another possible six years since Botswana lacked participation in Miss Universe. This drastic zero participation in this premium beauty competition paved way for our neighbours South Africa to sail smoothly at the competition. Zozibini Tunzi became an instant global queen and everyone’s favourite after displaying intelligence, poise and taking up space to be crowned Miss Universe 2019.

The pageant was not held in 2020 due to COVID-19. This will be the third time in the history of the competition in which the event will be held after the calendar year has ended: this previously occurred during Miss Universe 2014 and Miss Universe 2016 (in which Botswana was not participating).

Miss Universe Organization announced early this year that the competition would be held on May 16 2021, at Seminole Hard rock Hotel and Casino in Hollywood, Florida, United States. Zozibini Tunzi will crown her successor at this competition.

Botswana, will not be participating at the Miss Universe 2020, again. The weakening Miss Universe Botswana has been attributed to by internal fights within the organization. But why participate at Miss Universe?

The Miss Universe Organization is a global, inclusive organization that celebrates women of all cultures and backgrounds and empowers them to realize their goals through experiences that build self-confidence and create opportunities for success.

Women participate annually to affect positive change personally, professionally and philanthropically as inspirational leaders and role models. The delegates and titleholders that have participated in the MUO system are able to cultivate their personal, professional and philanthropic goals. These women are forward thinking and motivated not just talk about change, but to initiate it.

Prominent beauty pageants analyst in Botswana Morekolodi Smith took Weekendlife in an exclusive interview that it has been so many years of absence from participating at Miss Universe, and this shows that Botswana lacks consistency and commitment.

“The franchise holders fail to host a national pageant. I think they should hand over the license to Miss Botswana Organization because it hosts the pageant annually. Then the winner gets to participate in both Miss World and Miss Universe. They can maybe crown two representatives. Botswana has faded away from Miss Universe platform and fans have forgotten about it,” he said in an interview on Thursday.

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