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‘Infertility is not only a medical but also a social problem’

Embryologist Dr Sara Tanwir discusses taboos surrounding infertility in society

Sara Tanwir


LAHORE: Sara Tanwir, a distinguished name in the field of infertility and assisted reproduction in Pakistan, is currently the director of the Tanwir Ahmed Medical Centre (TAMC) in Lahore.

She did her MSc in embryology from the University of Nottingham in the UK where she won the Charles Wallace Scholarship Award. Tanwir is the first female embryologist of Pakistan and has 19 years of experience in the field.

Other than her publications and research work, she has attended conferences worldwide. Not only has Tanwir worked for the successful treatment of infertility, she has to her credit bringing the Ericsson Technology to Pakistan. She conducts workshops regularly and has set up satellite centres of her clinic in various suburban areas of the province to help the masses, ensuring that the reproductive and infertility help is available to the less privileged as well. Her main centres are in Gujranwala, Kasur, Gujrat, Wazirabad, Mandi Bahauddin and Okara. She has so far helped more than 3,000 infertile couples.

Bol News spoke to her about the social taboos and infertility issues.

Who are considered infertile couples?

According to the World Health Organisation (WHO), the couples who have been staying together for at least two years or more, in a stable relationship, and do not produce offspring are considered infertile.

Why are male and female patients reluctant to speak about infertility related issues in Pakistan?

The women are generally reluctant to open up about their infertility because of the embarrassment, shame, grief and feelings of failure that surround the subject. However, generally the male patients on the other hand, treat infertility as a question mark over their masculinity and find that discussing the subject is not just vehemently disliked, but is also not in line with the norms prevalent in society.

What needs to be done to educate the masses that infertility related issues are like other diseases and need to be cured? How could the barriers be removed and why is it considered a taboo?

This points to a lack of education and information surrounding the subject, and the female becomes an easy target. Infertility is laced with shame and feelings of inadequacy, owing in part to the paucity of information. Women are silenced rather than seeking treatment. Most couples will succumb to the shame associated with the subject, and the previous studies have shown that anxiety, stress and depression scales were considerably higher in infertile couples than in fertile couples.

Because of a dearth of education around the subject, people have preconceived notions regarding the treatment, and it is a widely held belief that treatments do not necessarily coincide with the religious beliefs and are considered taboo. Such taboos can create an environment where couples are ultimately denied a fundamental right; the right to get treated. It is shocking that when urged to discuss infertility issues many will find it an anathema. It is important to note that infertility is not only a medical, but also a social problem in our society as cultural customs and perceived dictums may equate infertility with failure on a personal, interpersonal, or social level.

It is imperative that people have adequate knowledge about infertility so couples can seek timely medical care and myths can be debunked. Infertility remains an immediate and painful problem for many. Unfortunately, these treatments are only available for the privileged and not for all and sundry. Hence, infertility awareness must be raised in the community. Testing should be made more accessible. Why is infertility not recognized as a serious concern?

A deeply disturbing concern is that couples who seek medical support in order to combat infertility are most often [confronted by] feelings of shame and inadequacy. It might sound ludicrous but those who sought IVF still feel that their child’s birth is not at par with other children, hence they won’t broach the subject or educate/encourage other infertile couples.

How is your medical centre helping infertile couples?

The impetus behind the TAMC was to set up a clinic that could provide a serene environment for infertile couples. As opposed to a hospital with patients strewn all over the place. [It] seeks to provide individual care and attention to all its clients.

What is IVF and IUI?

IVF is a process involving egg stimulation, retrieval, fertilization and transfer, whereas the IUI injects sperm into a uterus to decrease the sperm’s travel time to the egg.

Can infertile couples decide the gender of the newborn using these techniques?

The gender of a newborn can be determined using these techniques however, the infertile couples are not advised to go for it. This is to reduce genetic-linked diseases.

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