The pressure is on wives when couples cannot conceive, as men find it difficult to believe the cause lies with them.
by JENNIFER CROFT and AINAGUL ABDRAKHMANOVA
When a Kyrgyz couple remains childless, it is generally the wife who is encouraged to seek fertility treatment. Husbands commonly reject suggestions they might be infertile, and some even remarry in the hope of having a child.
The state health information service in Kyrgyzstan says that in 2008, the last period for which comprehensive data are available, 5,000 women were on the records as having fertility problems compared with just 2,000 men. Yet doctors say that statistically speaking, the two figures for the population as a whole should be fairly close to each other.
There is some hope of change, however, as the 2008 figure for men was at least a dramatic rise on the 1,300 recorded in 2005, suggesting that more of them are actively seeking medical help.
Nurbek Sadyrbekov, head of the Urology Department at Kyrgyzstan’s National Hospital, told IWPR that the overall statistics for both sexes were understated as they only captured people seeking treatment in the state health system, not those who went private.
The discrepancy between male and female readiness to seek fertility treatment reflects deep-seated attitudes, experts say. Wives are under pressure to conceive and blamed if they do not, while men prefer to avoid the potentially embarrassing disclosure that they have problems fathering a child.
In an interview for IWPR, Professor Natalya Kerimova, head of the Department of Obstetrics and Gynaecology at the Kyrgyzstan State Medical Academy, said women conventionally get the blame when a couple is unable to conceive.
“The man sees himself as the stronger sex and believes he can’t be infertile,” she said.
Bishkek-based psychologist Venera Junusova agreed, sayting “Men think that going to see a doctor means losing their masculinity.”
There is strong social pressure on couples to produce children – traditionally as many as possible, including male heirs to continue the family line. A common toast to newlyweds is to wish them “lots of pairs of slippers” in their home.
In some cases, the man’s relatives urge him to divorce his wife if she does not conceive.
Rather than seek help, Junusova said, men “refuse to believe it to the very end, and start having affairs to prove the opposite”, adding that this was the cause of many marriage break-ups.
Sadyrbekov described a familiar pattern of events that follows when newlyweds have failed to conceive after a year or two, “He dumps his wife and marries someone else. He lives with his second wife but there are no children. Only then does he start wondering what’s going on.”
Esen, a businessman from Bishkek, told IWPR of his experience.
“My wife and I have been trying unsuccessfully to conceive since 2005. We underwent check-ups and were told it was down to me that we couldn’t conceive. Frankly, I think everything’s fine with me,” he said. “I’ve had a lot of women but none of them got pregnant, so I think it’s just matter of time.”
Esen said he had donated money to build a mosque, and believed God would help him and his wife to conceive.
By contrast, Janybek, a taxi driver in Bishkek, is undergoing treatment after putting it off for a long time.
His first marriage broke up because he and his wife did not have children. By this time he had already discovered he had a low sperm count.
Deterred by the cost of treatment, Janybek consulted a urologist only after he married for the third time.
The cost of medical help for either partner is high – IVF treatment can reach 4,000 US dollars, well beyond the reach of many couples, given that the average wage in Kyrgyzstan is about120 dollars a month.