Infertility can be a cultural taboo that makes starting a family more difficult.
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For couples who are struggling with infertility and want to start a family, IVF may seem like a perfectly valid option. And it is—for those who can afford it.
In many parts of the world, access to infertility treatments is impacted not only by cost, but by religious restrictions and long standing social biases.
In the Middle East, infertility specialists have noted a rise in infertility. The Muslim culture places a high priority on families and raising children such that the inability to have children may result in many instances of social and cultural exclusion.
Additionally, there is a religious bias against adoption. In-vitro fertility is available to varying degrees, but there are religious constraints on the use of donor sperm and, to a lesser degree, on donor eggs in many locations. Iran and Turkey are the most liberal when it comes to donors, but even so, the social pressures relegate these treatments to a high degree of secrecy, particularly with donor sperm, even from one’s own family members. In some cases inheritance can be thrown into question if it is discovered that donor sperm had been used. Cost is another big barrier, but progressive policies in Egypt and Turkey have provided subsidized IVF for many couples. Meanwhile, limited resources make access and affordability a major obstacle to many other couples throughout the region.
Throughout much of the world, there is an association between male fertility and masculinity. There is a misconception that if a man is infertile, he is probably impotent, since, in simple terms, having sex is what results in pregnancy. In many African nations this stigma often prevents men from seeking evaluation. Furthermore, this tendency results far too often in casting blame on the woman for the infertility, when in many cases she is normally fertile.
Unfortunately this can spill over into domestic violence in extreme cases of ignorance and frustration. In Kenya, a recent domestic violence incident made the news when Mwende, who lives 35 miles southeast of Nairobi, was the victim of assault by her husband. After nearly five years of marriage hadn’t resulted in a child, Mwende’s husband allegedly attacked her with a machete and cut off her hands. His fear of the social stigma surrounding infertility was that severe—possibly in part because Mwende’s husband had been told by a local clinic that the infertility was on his side.
In other countries, however, male infertility is slowly becoming more of a topic open to discussion. A man from Tajikistan, interviewed by Radio Free Europe, noted that his “masculinity was hurt” when he learned that the reason he and his wife couldn’t have children was because of his own infertility. Whereas the traditional solution for childlessness in Tajikistan is to find a new wife, this military man opted to get medical treatment. Today, he and his wife have two children—one biological and one adopted.
According to the Radio Free Europe investigators, one in five marriages in Tajikistan are affected by infertility. Because of cultural taboos, these cases generally lead to divorce rather than medical assistance.
Luckily, there are increasing opportunities for infertile men in the country to receive confidential treatment that can help them start the families they want.
Cultural taboos surrounding infertility aren’t just happening abroad, either. In the US, assumptions about race and culture can be a significant factor when it comes to dealing with fertility issues. Lawyer Heather Lawson described to The New York Times her issues with being the only black person at fertility clinics. She also noted having to deal with the assumption that black families have no trouble having children—despite the fact that more married black women suffer from infertility than married white women, according to the National Survey of Family Growth.
Infertility can happen to both men and women no matter where they live or what their cultures believe about it. Building a family despite infertility can be a challenge, but there are options out there despite the barriers many couples have to overcome.