Source: Rwanda Focus
Infertility or the inability of a couple to become pregnant after 12 months of unprotected intercourse comes off as every woman's nightmare. The idea that one cannot bring forth an offspring to the world is shocking in as much as it is disheartening! As children, most girls dream of having a baby of their own something that is usually displayed in the way they play with dolls and not toy cars.

And whereas some grow to live this dream, to others it turns into a big illusion. Infertility struggles aren't unusual - but how long does it take to get pregnant and when should you worry? The popular celebrity couple Khloe Kardashian and Lamar Odom are currently going through this struggle as recently Khloe 28, opened up about it. So what are the different causes of infertility?

Failure to ovulate

Khloe, revealed that after a year of trying to conceive she went to the doctor for help and it was then that she discovered her cycle wasn't working as it should.

"I found out I don't ovulate and my uterus lining isn't thick enough and I have to take pills to make my uterus lining thicker, and if that doesn't get thicker I cannot carry a baby - sometimes it just doesn't happen." Experts say Ovulation disorders are one of the most common reasons why women are unable to conceive, and they account for about 30 per cent of women's infertility. Fortunately, approximately 70 per cent of the cases can be successfully treated by the use of drugs recommended by a gynaecologist. Hormonal cases are some of the ovulatory problems common and they are a result of failure to produce mature eggs in which case the chance of fertilisation is too minimal. Scarred Ovaries which come because of physical damage to the ovaries through multiple surgeries, for repeated ovarian cysts may also result in failed ovulation since they may cause the capsule of the ovary to be damaged or scarred, such that follicles cannot mature properly and ovulation does not occur. Some women experience Premature Menopause when they cease menstruation and begin menopause before the normal age.

It is understood that their natural supply of eggs at that age has been depleted. This possibility could also come as a genetic issue. Although currently unexplained, follicle problems - as they are referred to - occur when a woman produces a normal follicle, with an egg inside every month but the follicle fails to rupture. The egg, therefore, remains inside the ovary and proper ovulation does not occur.

Dysfunctional Fallopian tubes

Poorly functioning fallopian tubes account for a number of infertility cases. They can however be treated through surgery and there are several success stories owing to this. The main causes of tubal damage include; Infection which can be caused by both bacteria and viruses and are usually transmitted sexually. These infections commonly cause inflammation resulting in scarring and damage. Abdominal Diseases like appendicitis which cause inflammation of the abdominal cavity can also affect the tubes leading to blockage. Previous Surgeries are an important cause of tubal disease and damage.

Pelvic or abdominal surgery can result in adhesions that alters the tubes in such a way that eggs cannot travel through them. An ectopic Pregnancy

- pregnancy that occurs in the tube itself - is a threat because even if carefully and successfully overcome, it may cause tubal damage. Some women may be born with tubal abnormalities, usually associated with uterus irregularities known as congenital Defects, these are however rare cases.

Sometimes infertility can be caused by other factors like an abnormal uterus. Conditions such as fibroids may also lead to obstruction of the uterus and fallopian tubes. Also some behaviour factors are responsible for this disorder. Certain behaviour such as addictive smoking, alcohol intake and other drugs can lead to failure to conceive. Being overweight and underweight can also lead to infertility.

Remedy in Kigali

Dr. Mohamed Okasha an Obstetrician and Gynaecologist at BAHO clinic says currently some of the complex solutions to infertility in women like In-Vitro Fertilization commonly known as IVF are not available in Kigali. However, there are trials ongoing at King Faisal hospital to figure out some treatments. He adds that for ovulation cases in their client, an induction of ovulation through giving oral medication or injections is done.

For dysfunctional tubes, Okasha reveals, a Laparoscopy - which is an operation performed in the abdomen or pelvis through small incisions with the aid of a camera is carried out. There are no specialised maternity and fertility clinics in Kigali but it is important to note that there is hope for them to come up in the near future. However, one should know that sometimes failure or delay to get pregnant may not necessarily mean they are infertile. But in case of doubt and suspicion, always visit a gynaecologist so that a test is done for proof. Like Dr. Okasha says: "Not all infertility cases are the same. The hope lies in discovering what the problem is first."

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