“This is what we call delayed humiliation”: Negotiating socio-cultural challenges in the use of Assisted Reproductive Technology (ART) by couples with infertility problems in urban Ghana

Abstract

Childbearing is an important component of marriage, and childless couples often face a myriad of informal sanctions from family and community members. Whilst many infertile couples may resort to Assisted Reproductive Technologies (ARTs) in an effort to mitigate the socio-cultural effects of childlessness, it is a copious concern to also ensure that the very ‘solution’ being used does not turn out to become a ‘curse’ and a source of further ridicule and stigma. They must make choices that are acceptable to their society and in consonance with their own beliefs and values. This study explored the considerations that goes into the decision to use or not to use a particular type and form of ART. The study employed a qualitative approach involving 15 semi-structured in-depth interviews with purposively selected persons seeking fertility treatment via ARTs in Accra. Thematic analysis was used in analysing interview transcripts. We found out that users of ARTs tended to be concerned about the health status of children born using these techniques. Couples, especially male partners, desired a resemblance to the children born out of such procedures and sought to ensure that their use of ARTs remain a secret forever given the implications of disclosure for their status and masculinity, parenthood and indeed kinship in the Ghanaian cultural context. Thus, to a large extent, ART decisions are also gendered in nature. We therefore conclude that though ART usage is on the increase in Ghana, there is considerable apprehension with its use because of the implications of disclosure. There is therefore the need to educate people about ARTs, to address misconceptions to increase the social and cultural acceptability for their use as a viable means of achieving procreation.