Growing concerns over infertility in Nepal

Infertility is a disorder of the male or female reproductive system characterized by the inability to conceive a baby after 12 months or more of frequent, unprotected sexual activity. Moreover, the inability to become pregnant at all is known as primary infertility, whereas the inability to become pregnant following a previous successful conception is known as secondary infertility. According to a WHO (2023) Report, around one in six adults, or 17.5 percent, struggle with infertility worldwide, demonstrating the critical need to make high-quality, reasonably-priced fertility care accessible to the needy. Per the report, infertility is prevalent in high-, middle-, and low-income nations, making it a significant global health problem. In high-income countries, the lifetime prevalence is 17.8 percent, whereas in low- and middle-income nations, it is 16.5 percent, states the report. In Nepal, infertility is emerging as a growing concern, with infertility rates believed to be higher than the global average due to factors such as poor health facilities, lack of awareness, limited access to treatment, and social, cultural stigma.

Treatment available, cost prohibitive

The term infertility must be changed to subfertility, says Dr Bhola Rijal, a consultant gynecologist and obstetrician with expertise in in-vitro fertilization. This is because treatment options for infertility are available nowadays, though they are beyond the reach of many people because of high costs, significant negative perceptions, and limited availability. Linked with social, financial, mental, and economic aspects of life, infertility can cause significant distress, stigma, and financial hardship, affecting the couples’ mental and psychological well-being. The consequences of infertility can be far-reaching in a country like Nepal where children are seen as a source of economic security and social status. Apparently, the inability to have children can lead to depression, social isolation, intimate partner violence and even divorce. Despite these challenges, many couples in Nepal are hesitant to seek treatment. This is partly due to the cost of treatment, which can be prohibitively expensive for many families, and partly due to cultural beliefs that view infertility as a personal failure rather than a medical condition. In addition, the WHO report has highlighted a chronic shortage of data on infertility in many countries, meaning that the Nepali state also needs to raise greater awareness on the importance of maintaining data on infertility rather than encouraging the practice of keeping the problem under wraps. The government can reach out to affected couples by raising awareness on affordable treatment options for infertility and helping reduce associated stigma. There’s a need to maintain national data on infertility by age and reason to fight stigma and to recreate social norms by mobilizing community education and support groups. There’s also a need to break the silence around infertility and start talking openly about it. By doing so, we can help couples access the care they need and ensure that they receive the support they deserve. Summing up, concerted efforts are necessary to address the issue of infertility by making sure that couples have the resources needed to build healthy families and communities.