Infertility is a widely misunderstood topic among the people and it has led to major crisis in many homes. Some people attach superstitious beliefs to infertility and instead of seeking medical advice or intervention, they resort to fetishism and other forms of minor and major shirk.
Infertility is defined as the inability to conceive after 12 months of regular, unprotected intercourse. Over 80% of normal couples will conceive within a year of trying. A common misconception among the people is that infertility is solely attributable to the woman. On the contrary, men are responsible for about 35% cases of infertility while 20% is due to a combination of male and female factors. Furthermore, another 10% of infertility cases have no identifiable cause. The quality and quantity of sperms produced, as well as the integrity of the male reproductive tract, play major roles in the overall fertility of a couple.
Female factors associated with infertility can be ovarian (eg. Polycystic ovaries), tubal (blockage), uterine (structural abnormalities), cervical (eg. stenosis), peritoneal (eg. adhesions due to previous surgery) or hypothalamo-pituitary disorders affecting ovulation and hormone balance. Couples are advised to visit a gynaecologist after 1 year of trying. The doctor will evaluate the couple thoroughly and request some tests to determine the cause/causes and appropriate treatment plan. Couples who are above 35 years may need to seek help earlier, as the chances of getting pregnant decreases significantly after 30.
Infertility can be physically, emotionally and financially demanding. While passing through the process of investigation and treatment, it is important for couples to develop coping strategies and understand that it is only Allaah who bestows children.
“To Allaah belongs the kingdom of the heavens and the earth. He creates what He wills. He bestows female (offspring) upon whom He wills, and bestows male (offspring) upon whom He wills. Or He bestows both males and females, and He renders barren whom He wills. Verily, He is the All-Knower and is Able to do all things”. (Qur’an chapter 42 verse 49-50)
SOME OF THE COPING STRATEGIES WILL BE DISCUSSED BELOW:
1. RELIANCE ON ALLAAH.
As mentioned above, couples can only try but only Allaah has the power to bestow children. They should read the history of past Prophets of Allaah (eg. Ibrahim, Zakariyyah, etc) who were tested with infertility and learn from their patience and steadfastness. They should continue to pray to Allaah, fast, give charity and do a lot of adhkaar. These measures will also keep them safe from the whisperings of shaitan who will be lurking around to make them commit acts of disbelief.
2. REGULAR INTERCOURSE AND MENSTRUAL TRACKING.
Couples need to be educated on how to track the “fertile days” and have regular intercourse in order to meet this target. This is part of the initial steps they can take on their own, even before seeking aggressive medical intervention. Other simple measures like stress management, weight loss, and healthy diet can improve the chances of conception.
3. TIMELY MEDICAL INTERVENTION
It is important to reiterate that 10% of infertile couples will not have any identifiable cause for their condition. However, the majority will have a cause which can only be detected if they present to the clinic and seek treatment. The couple should cooperate with each other and adhere to the doctor’s recommendations. In worst case scenarios, assisted reproductive techniques can be done, but still, success comes from Allaah.
4. ADOPTION AND FOSTERING
Adoption comes under medically recognized options for infertile couples but we need to discuss it separately because of the ethical issues involved. Adoption is permitted in the shariah but, as opposed to secular laws, the adopted child does not enjoy the legal rights of a biological child. For example, their father’s name cannot be changed and they don’t have access to the same inheritance allotted to biological children. Older women could consider adoption and fostering as a way of simulating the feeling of motherhood. They can also use this act as tawassul to seek Allaah’s favour.
Polygyny is hard to accept by women but this is one of the options open to muslim men if there is a clear female cause of infertility. A man can marry up to 4 wives while the first wife remains under his care and continues to seek conception. Perhaps, Allaah may reward her patience and grant her her own children. Polygyny is a better option than divorce because divorce often results from ignorance, lack of commitment and family/societal pressure.
In conclusion, the management of infertility depends on the cause and varies from one couple to another. There are cases where nothing really needs to be done except to reassure the couple and teach them how to track their “fertile days”. With recent advances in assisted reproductive technology, even couples with longstanding history of infertility can be helped. Above all, Allaah is the ultimate source of provision.