Johnson Progress

Untreated infections of the reproductive tract and harmful lifestyles such as drug abuse are emerging as major threats to fertility.

A leading Ghanaian specialist has warned, cautioning that men and women risk permanent damage to their reproductive systems through causes that are largely preventable.

Dr Edem Hiadzi, an obstetrician-gynaecologist and fertility specialist, said sexually transmitted infections, particularly gonorrhoea and chlamydia, rank among the major causes of infertility in sub-Saharan Africa.

He said the damage can build up unnoticed, because the infections can harm the reproductive system even when a person shows few or no symptoms.

Dr Hiadzi, the immediate past president of the Fertility Society of Ghana, was speaking during a virtual Merck Foundation health media training for Zambia, Zimbabwe and the Maldives, held in Bindura recently.

He rejected the idea that infertility carries shame, stressing that it affects men and women alike.

“Infertility is not a stigma. It affects both men and women equally,” Dr Hiadzi said.

Turning to how the infections do their harm, he said chlamydia and gonorrhoea can go unnoticed while quietly triggering inflammation in the pelvis.

“Chlamydia and gonorrhea are sexually transmitted diseases which may have no symptoms, but leave you with silent infections which will cause pelvic inflammation,” he said.

The silent nature of the infections lies at the heart of the warning.

A person can feel well while inflammation develops, so the harm may only come to light later, when a couple finds it difficult to conceive.

In women, he said, the consequences of leaving such infections untreated can be devastating, including blocked reproductive tubes.

Blocked tubes can interfere with the passage of eggs, which helps explain how infection can end in infertility.

The complications can also raise the risk of ectopic pregnancy, a dangerous condition in which a pregnancy develops outside the womb.

Men are not spared.

Untreated gonorrhoea and chlamydia can cause chronic inflammation of the epididymis, the coiled duct where sperm mature and are stored, and blockage of the vas deferens, the tubes that carry sperm.

A blocked vas deferens can stop sperm from travelling out of the body normally, which explains why the outcome can be so severe.

The result, Dr Hiadzi said, can be a low sperm count or, in severe cases, no sperm in the semen.

The warning extends to lifestyle: alcohol, smoking and drug abuse can also impair sperm production in men, adding to the threat posed by untreated infections.

Both infections named by Dr Hiadzi are sexually transmitted, which places sexual health at the centre of the conversation on fertility.

The warnings point to a shared responsibility.

With infertility affecting men and women equally, and with the infections capable of doing harm without any visible sign, the message from the Bindura session is that the reproductive health of both partners deserves attention, and that preventable causes should not be left to chance.

Delivered virtually to audiences in three countries, his remarks placed a spotlight on a problem that often stays hidden.