Africa-Press – Cape verde. More and more women are facing difficulties in getting pregnant, facing uncertain diagnoses, expensive treatments and the need to seek solutions abroad. The lack of advanced treatments in the archipelago and the cultural barriers that make it difficult for men to participate in exams make the situation even worse.
In this report, we tell the stories of Sofia Lopes and Viviana Almeida. One found the answer outside the country and the other is still trying, dealing with the social pressure and emotional challenges that the struggle for motherhood entails.
Sofia Lopes is 35 years old. For four years, she says, she tried to get pregnant without success. She consulted several doctors, received different diagnoses such as endometriosis and dysmenorrhea and followed treatment without results.
Faced with frustration, in 2019, she decided to seek help in Senegal, advised by acquaintances who had successfully faced the same problem in that country.
“When I got there, I did some tests at a clinic that the hostess who welcomed me recommended and received a new diagnosis”.
“The doctor assured me that everything was fine, but prescribed folic acid and another medication to regulate my menstrual cycle. If I didn’t get pregnant within six months, I would have to return to Senegal with my husband,” she says.
However, the treatment was effective in a short time. “I returned to Cape Verde in May and, in July, I was already pregnant. And to think that I spent a lot of money to treat something that wasn’t even available here in the country. In Dakar, I spent very little on the trip, accommodation and consultation,” she says.
And who is still trying?
Unlike Sofia, Viviana Almeida, 29, is still trying. She got pregnant, but had a miscarriage.
“Since I got married, in 2022, I stopped using contraceptives. I tried to get pregnant, but without much pressure. Every time my period was late, I felt hopeful, and when it came, I felt relief and worry at the same time,” she admits.
After the pregnancy loss in 2023, Viviana underwent tests that indicated normality, despite a factor that she claims is not alarming. The doctors recommended calm and prescribed vitamins that she had to order from Portugal, since they cannot be found in national pharmacies.
“Here, they don’t do fertility tests for couples, only for women, which can make a complete diagnosis difficult”, she laments.
Viviana says that she remains strong because of her faith, but confesses that she no longer feels pleasure in participating in gatherings with family and friends due to the pressure to have children.
“People always ask when I’ll have children, and that’s what we’re waiting for and that affects our psychology. But I keep trying, without anxiety, because I know that it can make the process more difficult”, she says.
Demand for help increases due to failed attempts to get pregnant
Expresso das Ilhas tried to find out from the Ministry of Health what treatment options for infertility are in the country, but received no response. However, according to an obstetrician who preferred to remain anonymous, the number of people seeking medical help due to failed attempts to get pregnant has increased. The specialist explains that it is essential to differentiate between difficulty getting pregnant and infertility. “Infertility refers to a period of more than 12 months without conception in couples with a frequent, regular sex life, without any contraceptive method or coitus interruptus. For people over 35 years of age, investigation can begin after six months,” she explains. According to this specialist, however, around 35% of infertility cases have a female cause, 30% are of male origin, 20% result from combined factors within the couple and 15% have an unknown cause. Among the main causes of female infertility, she listed tubal problems, endometriosis, metabolic changes and advanced age. “The ovarian reserve decreases from the moment a woman is born, but from the age of 35 onwards the decline is much more pronounced,” she adds. In Cape Verde, the doctor points out that diagnosing infertility involves detailed clinical examinations and specific tests, for both women and men.
“In the case of men, a sperm count is essential, and if there are any changes, more advanced tests are requested. For women, the tests vary depending on the symptoms and may include ultrasounds, hormone tests and hysterosalpingography to assess possible tubal obstructions”, she explains.
As for treatment, the specialist admits that Cape Verde has limited options.
“We only have ovulation inducers in tablets and some surgical options, such as hysteroscopy to remove polyps or fibroids and myomectomy. In the past, we had laparoscopy, but it is not available at the moment”, she emphasizes.
For those who need more advanced treatments, such as in vitro fertilization, the solution is to seek services abroad. “We also do not have the option of freezing eggs”, she indicates.
Cost causes some to give up on the process
As for the difficulty in getting pregnant, the obStetra notes that anxiety, although not a determining cause, can influence the ability to get pregnant.
“Many women decide late that they want to get pregnant and expect immediate results, which can create blockages. Some give up quickly or resort to traditional methods,” she states.
Despite this, she mentions that Cape Verde is less prone to this type of practice compared to other African countries. The doctor also warned of the importance of acting quickly when there is a suspicion of infertility.
“When a 40-year-old patient comes to me, if we don’t find a treatable cause, I advise moving straight to medically assisted procreation. Age is a crucial factor and we can’t waste time,” she advises.
On the other hand, she highlights that there is a growing number of young people postponing motherhood to invest in their careers and financial stability.
“At the same time that we see an increase in pregnant teenagers, we also notice that more middle-class women are postponing motherhood and we even have some who freeze their eggs abroad to ensure the possibility of getting pregnant in the future”, she explains.
Infertility treatment in the country is expensive, as it involves specific exams and procedures that often need to be carried out in private clinics.
“Hormonal exams, for example, cannot be done at any time in the cycle and are not always available in hospitals. This causes some patients to give up on the process”, concluded the specialist.
Cultural barriers make it difficult for men to adhere to fertility exams, despite greater adherence
In 2022, Emanuel Moreira created MinLAb, a Clinical Analysis Laboratory to combat male infertility.
To Expresso das Ilhas, the company’s CEO states that there has been a growing adherence of men to laboratory services such as sperm analysis.
“In recent years, we have seen an increase in demand for tests such as sperm analysis, which allows us to assess male reproductive health more accurately. We have observed changes in sperm quality, which is also a global trend,” he says.
Emanuel Moreira cites inappropriate lifestyle habits, smoking, excessive alcohol consumption, exposure to pollutants and stress as among the main factors affecting male fertility.
“We have to consider that there is a problem that may not be obvious to most people right now, but which could have serious consequences in the long term. The delay in parenthood and the increase in emigration also contribute to this scenario. It is essential that we start thinking about solutions now,” he says.
Despite the growing demand, there are still cultural barriers that make it difficult for men to take fertility tests.
“Unfortunately, machismo still prevents many men from seeking help. There is a misconception that infertility is an exclusively female problem, when in fact, around 40% of cases are male in origin,” he notes.
To reverse this situation, Moreira believes that it is necessary to intensify awareness campaigns on male reproductive health and facilitate access to tests.
The lack of in-depth studies on male infertility in Cape Verde is another challenge, but Emanuel Moreira is preparing a study on the subject.
“I have data, but it has not yet been statistically analyzed, because I want to accumulate data for more years, but I can assure you that we have had several cases that require attention and treatment,” he maintains.
MinLAb has projects to conduct research on the subject, collecting data that will allow a better understanding of the local situation and propose solutions, including laboratory tests and questionnaires on environmental factors and lifestyle habits.
A partnership with the EUGIN clinic in Coimbra, Portugal, which specializes in reproductive treatment, is also on the horizon.
“This will be an important step for Cape Verdean patients who need more advanced treatments. Our long-term vision has always been to bring a link to clinics specializing in assisted reproduction to Cape Verde, and now we are achieving this goal,” says Emanuel Moreira.
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In addition to guilt and shame, other feelings arise
For perinatal psychologist Maria Dias, people are still not aware of the psychological support needed in the “painful journey” of infertility.
“Every month that you don’t get pregnant, there is a symbolic loss that needs to be accepted and worked through. That’s why all those trying to conceive should consult a psychologist,” she argues.
According to the specialist, the desire to get pregnant, combined with failed attempts, can deeply affect couples’ emotions.
When they are faced with a diagnosis of infertility, she explains, the impact is devastating. Couples often believed they were fertile and face a shock that leaves them speechless.Stetra notes that anxiety, although not a determining cause, can influence the ability to get pregnant.
“Many women decide late that they want to get pregnant and expect immediate results, which can create blockages. Some give up quickly or resort to traditional methods,” she states.
Despite this, she mentions that Cape Verde is less prone to this type of practice compared to other African countries. The doctor also warned of the importance of acting quickly when there is a suspicion of infertility.
“When a 40-year-old patient comes to me, if we don’t find a treatable cause, I advise moving straight to medically assisted procreation. Age is a crucial factor and we can’t waste time,” she advises.
On the other hand, she highlights that there is a growing number of young people postponing motherhood to invest in their careers and financial stability.
“At the same time that we see an increase in pregnant teenagers, we also notice that more middle-class women are postponing motherhood and we even have some who freeze their eggs abroad to ensure the possibility of getting pregnant in the future”, she explains.
Infertility treatment in the country is expensive, as it involves specific exams and procedures that often need to be carried out in private clinics.
“Hormonal exams, for example, cannot be done at any time in the cycle and are not always available in hospitals. This causes some patients to give up on the process”, concluded the specialist.
Cultural barriers make it difficult for men to adhere to fertility exams, despite greater adherence
In 2022, Emanuel Moreira created MinLAb, a Clinical Analysis Laboratory to combat male infertility.
To Expresso das Ilhas, the company’s CEO states that there has been a growing adherence of men to laboratory services such as sperm analysis.
“In recent years, we have seen an increase in demand for tests such as sperm analysis, which allows us to assess male reproductive health more accurately. We have observed changes in sperm quality, which is also a global trend,” he says.
Emanuel Moreira cites inappropriate lifestyle habits, smoking, excessive alcohol consumption, exposure to pollutants and stress as among the main factors affecting male fertility.
“We have to consider that there is a problem that may not be obvious to most people right now, but which could have serious consequences in the long term. The delay in parenthood and the increase in emigration also contribute to this scenario. It is essential that we start thinking about solutions now,” he says.
Despite the growing demand, there are still cultural barriers that make it difficult for men to take fertility tests.
“Unfortunately, machismo still prevents many men from seeking help. There is a misconception that infertility is an exclusively female problem, when in fact, around 40% of cases are male in origin,” he notes.
To reverse this situation, Moreira believes that it is necessary to intensify awareness campaigns on male reproductive health and facilitate access to tests.
The lack of in-depth studies on male infertility in Cape Verde is another challenge, but Emanuel Moreira is preparing a study on the subject.
“I have data, but it has not yet been statistically analyzed, because I want to accumulate data for more years, but I can assure you that we have had several cases that require attention and treatment,” he maintains.
MinLAb has projects to conduct research on the subject, collecting data that will allow a better understanding of the local situation and propose solutions, including laboratory tests and questionnaires on environmental factors and lifestyle habits.
A partnership with the EUGIN clinic in Coimbra, Portugal, which specializes in reproductive treatment, is also on the horizon.
“This will be an important step for Cape Verdean patients who need more advanced treatments. Our long-term vision has always been to bring a link to clinics specializing in assisted reproduction to Cape Verde, and now we are achieving this goal,” says Emanuel Moreira.
______________________________________________________
In addition to guilt and shame, other feelings arise
For perinatal psychologist Maria Dias, people are still not aware of the psychological support needed in the “painful journey” of infertility.
“Every month that you don’t get pregnant, there is a symbolic loss that needs to be accepted and worked through. That’s why all those trying to conceive should consult a psychologist,” she argues.
According to the specialist, the desire to get pregnant, combined with failed attempts, can deeply affect couples’ emotions.
When they are faced with a diagnosis of infertility, she explains, the impact is devastating. Couples often believed they were fertile and face a shock that leaves them speechless.
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