By Deborah Bamisaye
“My friend, stop crying, please! This is unheard of, how could your sister just treat you like that, ha! – No, No, No! So, she just carried all that the husband of Ngozi brought for her bride price without giving you anything? Nawa o! After you trained that girl throughout secondary school and her university. Hmmm! It is now that she knows you are not the one who gave birth to her, abi? How does she want you to feel?
Hmmm! In the Western world, we have white people who agree before marrying each other that, they won’t be having children. Many of them do that and they stick to their plans. Such is not obtainable in Africa at all. It is a taboo, it is never mistakenly mentioned, never!
Before Wedding Ceremony:
Before a wedding ceremony takes place, some intending couple co-habit and would only go ahead if the lady gets pregnant. Many people in the society frown at this, because of reasons we cannot discuss here. We also have people who would never attempt that but would prefer to get married before they start living together.
Premarital fertility and genetic testing provide crucial information that helps couples prepare physically and emotionally for marriage and parenthood, minimizing health risks for themselves and their future children. It’s best to do these tests at least three to six months before the wedding to allow time for counseling and any needed interventions that could cause infertility, helping to ensure a healthier reproductive journey.
Risks for Africans
This is Africa, not just Africa but Nigeria, this kind of tests may cause problem o.
Are there any risks or downsides to getting fertility and genetic tests before marriage? In all honesty there are risks involved. Premarital fertility and genetic testing are valuable tools but should be approached with counseling and support to address emotional, ethical, and social implications. Also, heeding health advice offered here could be very helpful.
Kindly note that even if an intending couple chooses to get married without these tests, they may have only ‘carried them over;’ not because of impending infertility but because some of these tests are even required when they see the doctors for delays or during pregnancy, so doing them in advance may be of great benefits. It may also be taken as a form of medical check-up, just a normal routine. Life itself is a Risk, so taking the risks before time may be wisdom on its own.
In the society, there are arguments for and against pre-marital fertility tests, even doctors have these to say:
– Prof. Oluwarotimi Akinola, President, Society for Gynaecology and Obstetrics of Nigeria (SOGON), stated that subjecting couples to genital or fertility examinations as a prerequisite for marriage is an abuse of reproductive health rights and privileges. He emphasized that there is no medical test that can guarantee a man’s sexual capability just by physical examination, and such requirements should be revisited as they are not medically or ethically justified.
– Prof. Oladapo Ashiru, CMD, Medical ART Centre, Lagos, supports basic pre-marital fertility testing. He believes it is important for couples to know each other’s fertility potential before marriage. For men, this includes checking for sperm production and possible genital abnormalities. For women, it involves confirming ovulation and normal reproductive organs. He argues that knowing these facts helps couples prepare for or address any fertility challenges openly and early.
Now here is the General Medical Consensus: Nigerian medical experts and clinics recommend pre-marital medical screening, including fertility tests, as a way to prevent future stress and trauma related to infertility. Such screenings can help couples seek early intervention and make informed decisions about their health and marriage.
So, while some Nigerian doctors advocate for voluntary pre-marital fertility testing to promote openness and early intervention, others caution against making such tests mandatory, citing ethical and privacy concerns.
One would naturally agree that it should be a voluntary test and not otherwise.
Now, let’s consider the reasons for which many would not want to do these tests. We will start with the most dreaded reason:
1. The risk of marriage cancellation or relationship strain: In some societies, discovering fertility issues or genetic risks before marriage may lead to calling off upcoming wedding ceremony or family interference, particularly affecting women’s prospects. Many would say: ‘A broken courtship is better than a broken marriage,’ though easier said but difficult to come to terms with. ‘The problem of where do I start from?’ is weighty but when it is overcome and the tests are conducted, one may be surprised that nothing is wrong with both of them in the first place and where there are issues, the truth about the ‘I love you’ and ‘I can’t imagine life without you,’ is openly put to tests.
– Emotional and social impact: If there is a challenge, such as identifying infertility or carrier status for genetic diseases, this can cause anxiety, distress, or depression. It may also lead to stigma or social pressure, especially in some cultures where fertility is highly valued. Matured family members or clerics could offer the needed support here.
– Privacy and confidentiality concerns: Premarital test results must be kept confidential, but breaches can harm individuals’ reputations and future marriage opportunities. This is absolutely so true and that is why marriage is for two matured beings, not the opposite. The doctors also have a role to play when they want to interpret the results and if is something treatable, assuring the intending couple of ‘No cause for alarm,’ would be a soothing balm.
– Limitations of testing: Genetic screening often covers only a few common diseases in a population, so a negative result does not guarantee absence of all genetic risks. Fertility tests may not predict future fertility perfectly – just as Dr. Oluwarotimi Akinola has said.
– Cost and accessibility: Some tests, especially advanced genetic or fertility assessments, can be expensive and not always covered by insurance companies, i.e. for those who may have HMO.
– Ethical concerns: Mandatory testing can raise issues about personal autonomy and informed consent if individuals feel pressured to test or disclose results. That is another cogent factor and that is why reading health journal such as this or seeing counselors would go a long way to help intending couples, see things differently.
It is at this point important to commend some religious houses who mandate some of these tests before wedding, so they can counsel accordingly, in this way, they have helped to mitigate the problem of having children with ‘SS’ genotype (those referred to as sicklers by some.) Those who do not run these tests before cohabiting may regret for the rest of their lives if they have sicklers or contact incurable diseases.
Religious houses that are yet to do same, are advised to make it a priority to conduct some of these tests for safety as God has given us common sense so that we will stop disturbing Him over things we can handle ourselves.
Now, for those who are already wedded and have crossed the pre-marital tests stage, ‘We’ve got your back too’ and whether you are reading this for yourself or your loved ones, following up in the next edition would be very helpful in finding strength and hope.
Until the next edition brings us together again, it’s bye for now.
English