Perhaps this holiday season many women and families are planning to conceive and have babies next year; after all, it is the season for this sort of thing. But something is afoot. Young women today are not conceiving… at least not in the numbers they should, according to national statistics. The rate of infertility in young Kenyan women in their early 20s has been sky rocketing lately, leaving many a couples distressed—with more questions than answers. According to the African Institute for Development Policy (AFIDEP) policy brief in August 2011, the total fertility rate in East Africa Community (EAC) has declined from 6.2 to 5.4 children per woman between 1992 and 2001. Kenya has the lowest level of fertility with 4.6 children per woman in EAC and recorded the fastest overall rate of fertility decrease in the region. The AFIDEP policy indicates that Kenya has the lowest fertility rate, as compared with her neighboring (EAC). Uganda, however, had the highest rate of fertility with 6.7 and average number of births per woman exceeding 5.0 in five other countries in the broad Eastern Africa region. Anita Mukami* got married eight years ago at a tender age of 24 years, but after her wedding, efforts to conceive bore no fruit. She, and her husband, have visited the gynecologist and obstetrician to check on the problem but were told that everything was fine.

“I have tried so many things, herbal medication, fertility boosters, avoiding all contraceptives, and I have even gone for prayers. My husband is very supporting and he doesn’t seem bothered about our lack of a child, but I desire to be a mother, so I do not give up trying and I continue visiting my gynecologists,” she cries. Because of this alarming dip in natural conception, young couples are considering alternative means of reproduction. Organizations that fashion themselves as “reproductive health centers“ are mushrooming around town to address this ‘crisis’, and apparently these centers are making a killing in the business of sperm and ovary donation—thriving on some other’s misfortune.

The reasons for this new phenomenal are numerous, and they all revolve around lifestyle and what we consume daily, in form of food or medicine. Dr Simon Nyangena, a pathologist at Aga Khan hospital, attributes infertility to wrong medications. He adds that temporary infertility may occur as a result of usage of certain medications and that in most cases, fertility is restored when the medication is stopped.

He also observes that endometriosis, one of the culprits of infertility, occurs when the uterine tissue implants, and grows, outside of the uterus often affecting the function of the sperm, egg and ovaries, uterus, and fallopian tubes. “When I check the medical reports, it is a fact that nine out of 10 cases of primary ovarian insufficiency remain a mystery, so spontaneous chromosomal abnormalities are assumed to be the cause,” he adds.

The doctor stresses that this condition is only defined thus when a woman who is less than 40 years old misses her menses for four months or more. The condition differs from menopause in that there is varying and unpredictable ovarian function in approximately half of the cases of cases, and about one in 10 of women conceive and deliver a child after they have received the diagnosis.

“I have attended to similar cases; the most recent one was of a 30-year old woman who presented her history of loss of menses since she stopped taking her oral contraceptives in order to conceive. She had also reported taking oral contraceptives to regulate her menses at 18 years of age,” he says. When asked about fibroids, which is the most common known contributor of infertility, he noted that uterine fibroids are benign tumors in the wall of the uterus and are common in women in their 30s and 40s. He adds that fibroids rarely cause infertility by blocking the fallopian tubes. More often, fibroids interfere with proper implantation of the fertilized egg. However, he points out that most women always think this is the cause of their infertility, but it normally is not the reason. Anita thought she had fibroids when he visited Nairobi Women’s Hospital for a check-up. She was surprised when the doctor confirmed to her that she didn’t suffer from fibroids, she was however advised on her nutrition and to check on her weight so that she doesn’t suffer obesity which enhances infertility.

“I had resorted to eating junk food, especially when I was stressed which made me overweight, so I started exercising and even started a healthy weight management programme. I later developed a sharp pain in my stomach, a visit to the gynecologist indicated that I had pelvic tuberculosis (TB),” she says. Dr. Nyangena pronounces that pelvic TB can actually be a cause of infertility, since it is very difficult to detect because it is asymptomatic and thus does not have visible signs. One can suffer from it and not be aware they are sick, while it silently damages the reproductive system. “Young women who are sexually active to go for a Chlamydia testing since it is a common sexually transmitted disease, it is asymptomatic and yet it is easily treated,” he urges.

It difficult for such women to conceive because their ovulation time is tampered with, hence low infertility. “Women have gone to the extent of swallowing tablets to bleach their skin to abusing the morning after pill which is very dangerous to them. These substances may result into barrenness or early menopause,” he advises.

Dr. Muindi advises women to be careful on the cosmetics they use, he says, “They should use substances that are made from organic content. They should also read the contents in any cream or lotion they use so as to go for the mildest.” Dr. Nyangena guidance to the young women having infertility issues is that while unexplained infertility is relatively common, there are some fertility treatment options available. They should not shy away from visiting specialists and gynecologists to get a fertility test and given appropriate treatment.