Men Too Should go for Fertility Testing

She has to contend with the flak from in-laws for her failure to give them a child. In other instances, the husband, under the insistence of his family or on his own volition, may decide to marry a second wife who can do what the first wife has failed to achieve.

However, as all this plays out, rarely are questions raised about the ability of the man to father a child, or to go for fertility tests as well. There is this misconception that fertility issues are women matters. Society believes that men are prolific, even when they have no sperm count at all or their sperms are deformed or immotile.

After several conversations with men on why  they do not first go for fertility test before pressing their wives to do the same, it dawned to me that one thing a man dreads most is to have someone assess his fertility. Even if infertile, they always want it to be known otherwise.

Yet, in many cases, women go through harrowing and expensive experiences when the infertility problem lies with the man.  Similarly, the cost of doing sperm analysis - the main test done to establish if a man is fertile or not costs under US$20 in most public hospitals in Kenya and other African countries.

Conversely, a woman's hormonal analysis and tubal tests costs at least US$250 in the cheapest private outlet. In view of the cost and the fact that close to 50% of contribution to infertility rests with the man, would it not be better and cheaper for the men to undertake fertility tests before requiring their wives or partners to do so.

But the big question is, why are men putting the burden of proof on women and not going for fertility test when their investigation costs almost nothing?

Troubled by this question, I decided to go for fertility testing just to understand what is involved and to use my experience to encourage other men to do the same.

When I arrived at one of the leading private hospitals in Nairobi and requested to undertake a semen analysis, the nurses at the reception looked at me with astonishment and asked a raft of questions: Has a doctor sent you? Are you having problems getting children? Are you suspecting yourself? Is your wife fine? Are sure you want to do this? All these questions were intimidating to me, but I gathered the strength to go ahead.

One of the nurses cautioned me that issues of fertility are very depressing and I needed counseling first. This annoyed me, since health care professionals rarely raise the same concerns when a woman asks to do a fertility test. They receive neither counseling nor preparation for the outcome of such tests, because the society thinks being infertile is part of a woman's reproductive health problem.

Back to the nurse. Not satisfied with my answer, she referred me to another man, who also being unsatisfied with why I wanted to do this test, referred me to yet another man, who finally allowed me to see the doctor.

The doctor too raised her questions, but eventually requested the laboratory to do the test. When I took the doctor's note to the laboratory technician, he looked at me with astonishment. And then whispered to me, "Your case is special, wait here for me as I prepare the room." At this moment, my nerves were at a breaking point.

After a few minutes, the man came back, beckoned me from other patients in manner that suggested something was wrong with me. I followed him into a room in the hospital's basement. Here, we met three women who were having tea. Without uttering a word, he gestured to them to leave the room immediately. I was then ushered in yet another small cubicle within this room that had a bed. It is at this point the laboratory technician removed a small bottle from his pocket.

"This is where you are expected to place your semen after masturbation," he said, speaking in very low tones. He gave me the option to do it in this small cubicle or a place near the hospital, since the semen is usually expected in the laboratory within 30 minutes from the time the ejaculate is collected. I opted to do it outside the hospital.

However, the whole process I had gone through and the secrecy behind the test confirmed many things. It was abundantly clear that health providers are part of those perpetuating this myth that fertility issues are only a woman's issue.

They are also to blame for the intense stigma and fear around male fertility testing or semen analysis. I wondered if this is the treatment I had to go through, would any other man have the nerves to do it.

Similarly, what I went through was the complete opposite of treatment a woman receives in the same hospital. When she walks into the hospice and requests for hormonal or tubal test, no one raises eyebrows. The only question she is asked is if she has the money for the tests? For women, being infertile is seen as very normal and acceptable thing. For a man, it is out of place and improper.

These perceptions and attitudes have seen many women subjected to physical, emotional, and verbal violence by their husbands and in-laws if they cannot conceive. When in reality, the problem lies with the man, usually glorified as prolific and a hero who has to put-up with a barren woman.

This state-of-affairs needs urgent attention by men and women who believe in gender equality and women's human rights. A robust campaign enlightening the public, men in particularly, of the man's contribution to infertility, and why he should undertake semen analysis, needs to commence immediately.

Until we project issues of infertility as both a man and woman's problem and why men should shoulder part of the burden, then women will remain victims of this unfair societal treatment.

Arthur Okwemba is a Kenyan journalist with the African Woman and Child Feature Service.