Infertility: What every couple needs to know

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When two people get married, the next expectation from society is often that they will have a child.

This is the norm in many communities, says Dr Joseph Muhumuza, a fertility expert and gynaecologist at Roswell Women and Children Hospital.

Couples who are able to have a child are considered fertile. So, who is fertile? “Anybody able to reproduce,” says Muhumuza. On the other hand, infertility is the inability to reproduce.

When is a couple considered infertile?

For women under the age of 35, infertility is considered after trying to conceive every day for 12 months without success. If a couple has been together and consistently trying for a year with no pregnancy, it raises questions that need medical answers, said Muhuza as he delivered the lecture on managing fertility at the Bride & Groom Expo happening in UMA Lugogo on Saturday, joined on stage by Dr Castro Kisuule.

For women above 35, the timeline is shorter. If a couple has been trying for six months without conceiving, it’s important to start seeking medical advice. As a woman grows older, the number and quality of her eggs start to decrease, which can affect fertility.

However, if you are younger, say under 35, and have only been trying for a few months, there's usually no need for alarm. Sometimes, it simply takes time.

Myths and misconceptions

In many African societies, the woman is often blamed for infertility, says Muhumuza. But research shows that both men and women equally contribute to infertility, each accounting for about 35% of the causes. That means men are just as likely to be the reason for infertility as women.

Types of infertility

There are two main types that include primary infertility, when a woman has never conceived, and secondary infertility, when a woman has previously conceived but is now unable to, says Muhumuza.

There is also what is known as unexplained infertility, where both partners appear medically fine, but conception still doesn't happen. In such cases, factors like stress can play a role. Managing stress can sometimes be the key to overcoming unexplained infertility.

When trying gets tough

If conceiving becomes difficult, the first step is to stay calm.

"The pressure is usually big," says Dr. Muhumuza, "and stress alone is enough to affect a woman’s ability to conceive."

Next, it’s important to seek expert medical help. Doctors can investigate the underlying causes and recommend possible solutions.

Common causes of infertility in women

The most common issue is blocked fallopian tubes, usually due to recurrent infections.

Also, blocked tubes may result from pelvic inflammatory disease (PID), often caused by untreated infections or complications from unsafe abortions.

Another increasingly common condition is endometriosis, which causes extreme pain during periods.

“Painful periods that require injectable painkillers are not normal,”  Muhumuza explains. Endometriosis can cause scarring and inflammation, affecting a woman’s fertility.

What about men?

For men, fertility largely depends on sperm health. A healthy sperm count is at least 15 million sperm per millilitre, and the sperm must move in a straight line. Sperm that swim in zigzags or circles are less likely to result in conception. But there shouldn’t be so much worry.

“Infertility in men is a little easier to investigate,” says  Muhumuza.

“We simply examine the sperm. As long as the count is adequate, the shape is normal, and the movement is good, then fertility is not usually a problem.”

Solutions are available

Thanks to advances in medicine, infertility is now easier to manage. Couples who struggle to conceive naturally have options. “With both natural and assisted reproduction, there is no reason for a couple not to have children,” says  Muhumuza.

“Even at 50 or 55, it is still possible to conceive with the right medical support.”

Assisted reproductive methods like IVF (in vitro fertilisation) are becoming more accessible. The main challenge remains cost, but the possibilities are real.

The Bride & Groom Expo 2025 kicks off this Friday and runs through Sunday at UMA Showgrounds. Tickets are just Sh10,000 per person. The event is proudly sponsored by Pepsi under Crown Beverages, The Looks Bespoke, and Bella Wine, with partners like Entikko Safari Lodge, Café Javas, Roke Telkom, Dream & Dress, Fontis Residences and Hotel, and Izu Treats.

Follow all the updates on Vision Group’s platforms under the hashtags #VisionUpdates, #BrideAndGroomExpo #BrideAndGroomExpo2025.