Male Infertility from the Developing Nation Perspective
Infertility is an important problem worldwide that is of particular importance in societies of the developing world. In many of these societies, marriage is largely a vehicle for procreation and children a valuable economic resource and insurance for immortality. The problem would appear to be most pronounced in parts of sub-Saharan Africa, in countries that lie in the “infertility belt.” The region includes Cameroon, Central African Republic, Gabon, Democratic Republic of the Congo, Togo, Sudan, Kenya, and Tanzania. In these countries, as many as one-third of couples are unable to conceive. A need exists for more studies to evaluate the incidence, risk factors, and prevention of this disease process in many parts of Africa, and the WHO has been at the forefront of this need for more research into infertility in Africa and developing countries of the Asian subcontinent. Though many infertile unions worldwide suffer from primary infertility, the predominance of secondary infertility in sub-Saharan Africa has been widely accepted. Furthermore, with the high prevalence of the human immunodeficiency virus infection in this part of Africa, the prevalence rates of tuberculosis, sexually transmitted infections, and septic complications associated with deliveries will rise and fuel this epidemic of secondary infertility. There remains a paucity of information on male infertility in sub-Saharan Africa. Though women bear the brunt of infertility socially, research on the continent has shown that a significant proportion of infertility is a result of male factor infertility.
KeywordsMale factor infertility Sub-Saharan Africa Secondary infertility Reproductive tract infections Hemoglobinopathies Genitourinary tuberculosis Varicocelectomy Prevention of male infertility Iatrogenic causes Bilharziasis
We gratefully acknowledge the assistance rendered by Dr. Linda Kalilani-Phiri, Dr. Nenad Spasojevic, and Dr Joseph Yikona.
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