In Senegal, the ordeal of infertility still weighs only on wives

In Dakar, as in other regions of Senegal, infertility is a public health problem, with figures that vary depending on the study and the population. Available data suggest that infertility, whether male or female, affects a significant number of couples [ according to WHO data, the problem affected 17.5% of the adult population worldwide in 2023], and the subject often remains taboo.

It's a silent, painful reality, often unfairly borne by women. Medically assisted procreation (MAP) is a solution. But for now, it's out of reach for the average Senegalese. "I can't pay millions to have a child. I can't afford it," says Abdou, a refrigeration technician.

Assisted reproductive technology encompasses a range of techniques designed to help individuals or couples who are having difficulty conceiving a child naturally. “The state must help us with resources, because assisted reproduction is, for the moment, reserved for the wealthy,” emphasizes Khalifa, a childless teacher living in Yoff [northwest of Dakar].

In the same neighborhood lives Abdou Aziz, 40, who has remained childless since his marriage in August 2021. After consulting a urologist, it was determined that his sperm was too weak to produce fertility. But his family, unaware of the full story, labeled his wife Khady as infertile.

“At one point, I was worthless in the house because I don't have any children. But I can't tell everyone that my husband has weak sperm,” says Khady, born in 2003. Finally, the couple, weakened by arguments over the absence of children, separated in March 2024.

These cases are far from isolated. In the hushed room of a clinic in downtown Dakar, Fatma and Abdou hold hands in solidarity. For six years, no baby's cry has broken the reproachful silence in which the couple ends up brooding. No children's toys disturb the impeccable order that always reigns in their home.

Fatma still remembers her sleepless nights crying under the stigmatizing gaze of her mother-in-law. “I'm really going through hell,” sighs the 32-year-old, the trauma etched on her face. Despite her husband's “understanding,” who helps her overcome this ordeal, the computer scientist has to endure the accusing gaze of a society that is sometimes merciless toward married couples without children.

“I've combined traditional and modern medicine without success. I have sex regularly, three to four times a week. But I've never had a miscarriage. The doctor told me the problem is me,” says Fatma, feeling sorry for herself.

Consequences: The honeymoon at the beginning of the marriage has gradually turned into a bitter one. “My husband still supports me, but for how long? I know he wants children,” she worries, head down.

“I'm behind you,” consoles her husband, Abdou, who still holds out hope of becoming a father one day. “It's God who gives, not the woman. She's sick, but she has my support. I'm going to help her get through this,” he insists with the energy of despair.

On the other hand, Astou, who lives in Liberté 6 [in the center of Dakar], is less fortunate. She has been married for three years, but her in-laws are starting to put pressure on her. For the 39-year-old woman, the hope of having a baby is dwindling as menopause approaches. “I'm taking my treatments, but it's the actions of my in-laws that are bothering me,” she says, looking anxious.

“My in-laws tell me that ' dama aye gaff' [in Wolof, 'I'm unlucky']. My mother-in-law only says insults to me and my sisters-in-law never miss an opportunity to put me down because of my infertility.”

“In short, they advised my husband to take a second wife, failing to repudiate me,” explains the woman, torn between anger and disgust.

Under pressure, her partner, Moustapha, ended up marrying a second woman who, in less than three months, became pregnant.

“Since then, my husband has considered me a rag. He wants me to leave the house, but I still love him,” worries Astou, whose relationship is turning into a disaster.

With its multiple causes, infertility continues to destabilize relationships. Between modern medicine and ancestral beliefs, between hope and resignation, thousands of couples wait for a miracle every day.