African culture, for example, predominantly disapproves of the concept of male infertility. Bearing children is the purpose of marriage, and a woman who never gives birth is often ridiculed and shunned. There is seldom any reference made to the male partner, which Vitalab Fertility Clinic's senior programme coordinator Veli Maseko says is significant: “In African culture, the woman is always referred to as being barren,” she explains. “There is never any reference to a man being barren, as he is simply not at fault. Sadly, if a wife can't bear children she is no longer a valued member of society, while the man generally moves on to the next wife.”
But it is not only African culture which discredits the woman when it comes to infertility. In many cultures, fertility is regarded as being a primary function of being a woman. As a result, women tend to carry the main burden of the social consequences of infertility, which include marital instability, stigmatisation and abuse.
Fortunately, technological breakthroughs in infertility treatment are today allowing many childless couples to have children, but infertility clinics can only help couples to conceive once the source of the infertility is identified and acknowledged. While South Africa's ethnic diversity makes it a vibrant and exciting country to live in, it is precisely these different cultural customs and traditions which pose significant challenges when it comes to dealing with infertility. Fertility clinics need to treat both partners when it comes to infertility. Maseko says when men deny they are infertile, infertility is less likely to be effectively treated.
Culture will also dictate what reproductive treatment options a couple can pursue. For example, many cultures and religions believe that assisted reproductive techniques are unnatural, as they remove the spiritual nature of conception. Many people in South Africa would for example rather see a sangoma for help than seek medical assistance. Childless couples often therefore tend to seek spiritual rather than medical assistance when trying to conceive.
Understanding the implications of childlessness within the religious and cultural context is central to the delivery of effective infertility care. Recognising that infertility is a medical problem with often serious psychosocial consequences (i.e. stress, anxiety, and depression) across all cultures is the first step in providing responsible and effective fertility treatment. While Maseko says that the stigma attached to childlessness is slowly waning, the cultural and religious beliefs around infertility still prevent many couples from visiting a fertility clinic for treatment. “We need to create a paradigm shift in the beliefs surrounding infertility, so that more couples can visit a fertility clinic to help them realise their dream of having children,” explains Maseko.
