Four facts about infertility everybody in the SRHR&HIV community should know.

The SheDecides movement starts from the principle that every girl and every woman can safely exercise her right to decide for herself what she does with her body, with whom she shares her body and whether she wants to have children. Not being able to have children hinders women’s right to choose. Addressing infertility—and
the subsequent involuntary childlessness—is about expanding women’s and men’s choices and opportunities to lead fulfilling sexual and reproductive lives. We call on all engaged in the SheDecides movement to put infertility on the agenda, to support women (and men) who wish to have children but are unable to.

SheDecides is about addressing infertility. How so?

1. The ability to choose to have children is a basic human right, just like other sexual and reproductive health and rights. The global health and sexual and reproductive health and rights sector should invest e ort and funding in preventing and addressing the consequences of infertility. The right to be able to reproduce and decide if, when and how often to do so has been recognized in many declarations, including the ICPD Programme of Action (1994), but largely neglected.of Action (1994), but largely neglected.
2. Infertility is a highly prevalent condition, globally affecting 15 % of couples of reproductive age. In certain areas prevalence rates of secondary infertility, or the ability to conceive or have a full-term pregnancy after having had children, are much higher (up to 30 %) due to high rates of sexually transmitted infections, post-abortion complications, HIV, and postpartum and iatrogenic infections. A large proportion of infertility cases are preventable, yet infertility prevention hardly receives any attention is sexual and reproductive health programmes.
3. Infertility and involuntary childlessness can completely devastate the lives of the people concerned, especially in settings where being a mother or parent is culturally mandatory.

   -Infertility often leads to gender-based violence, including abusive treatment by husbands, in-laws and other community members, domestic violence, abandonment, and divorce.

   -Childless women and men often suffer from social exclusion, stigmatization and discrimination.

   -In some communities, they may not be considered adults or elders, losing the social advantages that come with the status, due to not having children.

   -Childless people may lose their social security as they have no one to take care of them in old age or when sick.

   -Infertility often leads to economic hardship, as childless couples often spend their incomes on ineffective ‘shopping around’ in traditional and biomedical health care.

   -Infertility can lead to disruption of family life through polygamy, as husbands seek new partners in order to have children.

   -Infertility may lead to additional health risks—exposure to HIV and other sexually transmitted infections (STIs)—as people with fertility problems may attempt to conceive extramaritally.

   What we can do as part of the SheDecides movement

   4. Few SRHR & HIV initiatives address infertility

   –Invest in preventing infertility by preventing STIs, HIV, postpartum, postabortion and iatrogenic infections and sensitizing people about the possible long-term consequences of these infections.

   It is essential to raise awareness about the existence of male infertility AND that male infertility is not the same as sexual impotence, to avoid blaming women only and to involve men more in medical help seeking.

   Support groups for women and men suffering from infertility and involuntary childlessness (self-help groups) are important to decrease the pain, feeling of loneliness and burden of infertility, as recent research in Kenya and Ghana* showed.

   *Conducted with a Small Grant of Share-net International

   –Better inform infertile people about their condition and support them to cope with infertility.

   –Invest in decreasing the stigmatization of infertile women and men, for example by setting up public campaigns that make affected women and men visible, educate and create empathy.

   -Support improving the systematic public health delivery of low-cost diagnostic examinations and treatments (to treat infections, hormonal treatments, or artificial insemination).

   – Make high-tech treatments more accessible and available for infertile couples (like In-Vitro Fertilization). These treatments are currently only offered in private clinics at high costs and are inaccessible for most people.

   Initiatives to support the introduction of more affordable IVF should be supported and further developed (e.g. The Walking Egg Foundation, the only non-pro t organization aiming to increase infertility care in resource-poor areas).

   Read the PDF version of the blog.

   SheDecides is also about HerFertility, let’s act now!