Author: Dr. Ramin Matin (MBChB, MMED OBGY) | Medical Director at UMC Victoria Hospital
Infertility is a significant reproductive health concern in Uganda, affecting a notable proportion of couples. This issue encompasses a range of causes and presents numerous challenges for those affected.
A study analyzing data from the Uganda Demographic and Health Surveys (2006, 2011, and 2016) found that the overall prevalence of infertility among women aged 20 to 49 years was 6.4%. Primary infertility, which refers to women who have never conceived, was reported at 1.4% in 2006, decreasing to 0.7% in 2011 and slightly increasing to 0.8% in 2016. Secondary infertility, which affects women who have previously conceived but are unable to do so again, remained relatively stable at 7.4% in 2006, 6.9% in 2011, and 7.1% in 2016.
The causes of infertility in Uganda are multifactorial, involving both biological and socio-cultural factors. Among the most common causes are sexually transmitted infections (STIs) and pelvic inflammatory disease (PID), which are especially linked to tubal factor infertility in women. Untreated infections such as chlamydia and gonorrhea can result in PID, leading to scarring and blockage of the fallopian tubes.
Polycystic ovary syndrome (PCOS) is increasingly recognized in Uganda as a cause of infertility. It leads to hormonal imbalances that interfere with ovulation. Uterine and ovarian conditions, such as fibroids, ovarian cysts, and endometriosis, also play a role. Uterine fibroids are particularly common among Ugandan women and may interfere with implantation or cause pregnancy loss.
Male factor infertility, although often under-diagnosed due to social stigma, is another critical contributor. It may result from low sperm count, poor sperm motility, infections, or anatomical abnormalities. STIs and infections such as mumps orchitis, which affects the testicles, are also known causes.
Postponed childbearing is becoming more prevalent due to urbanization and changing lifestyles, with many couples delaying marriage and starting families. However, fertility naturally declines with age, especially after 35 years.
Unsafe abortions and inadequate obstetric care can cause uterine damage and infections, leading to infertility. This is a particularly significant problem in rural areas where access to quality reproductive health services is limited. Environmental and lifestyle factors also impact fertility; exposure to toxins, alcohol abuse, poor nutrition, and smoking may reduce reproductive potential in both men and women.
Additionally, certain cultural and traditional practices, such as female genital mutilation or the use of traditional vaginal herbs, may damage reproductive organs or disrupt the natural vaginal flora, further complicating fertility.
Treatment for infertility depends on its underlying cause. It is essential to seek medical assessment at a hospital to determine the appropriate course of action.
