Poverty Limits the Use of Artificial Insemination
Artificial insemination remains rare in Morocco, a poor country where procreation is considered a gift from God; only 400 couples a year undergo the procedure.
At a first glance, the figure may seem encouraging, as the first in-vitro birth in Morocco was in 1992. But thousands of the country's poorer couples are bitter because they cannot afford the procedure.
In 1994, only 10 percent of Morocco's 268,740 infertile couples could afford artificial insemination, according to census data. The data also showed that 13,500 infertile couples use some kind of fertility drug. A single in-vitro operation costs 20,000 dh ($2,000), says Mohamed Yaakoubi, President of the Moroccan Fertility and Contraception Association.
A study conducted by Dr. Yaakoubi and Dr. Mohamed Bennis, an obstetrician, revealed that the operation's success rate in the seven Moroccan centers that perform the operation is between 65 and 70 percent, after three attempts. Some 66 percent of the Moroccan couples who can afford the procedure have undergone the operation once, 30 percent have done it twice and only 3.3 percent have been able able to afford it for a third time.
The sterile families are generally looked at with sympathy and pity among the Moroccan society. However, infertility is often mentioned as one of the major causes of divorce.
”After 10 years of marriage, during which we tried every possible way to have children, my husband decided that we should divorce", said 33-year-old Amina Bentarkhan, who could not afford artificial insemination.
According to the 1994 population census, three out of every five infertile couples divorce. The numbers are disturbing since 12 percent of Morocco's 2.2 million families are infertile.
Dr. Abdel-alim Zouari, a gynecologist, attributed the high sterility rate to sexually transmitted diseases that are improperly treated, or left untreated, by many poor and illiterate Moroccans.
Moreover, some Moroccan families still shy away from undergoing an artificial insemination, arguing that sterility "is an act of God."
"Procreation is a gift from God. It is up to God to decide and we must not interfere with the divine decisions", said Mubarak Assimi, who has been married for 18 years without trying to treat his sterility.
Mubarak cites a verse in the Koran in which God says: "He offers to whom he wants male babies, He offers to whom he wants female babies and make whom He wants sterile."
Mohamed Sha'air, a Muslim theologian, lashed out at such beliefs, saying that artificial insemination does not contradict the precepts of Islam. He added that the verse cited by Assimi has its own context and cannot be considered as a rule forbidding the use of scientific means to treat an ailment like sterility. Morocco's health care systems do not cover artificial insemination procedures, which are considered a luxury and not a necessity. Only the Social Coverage Fund will pay for 25 percent of the cost of one attempt.
Moroccan gynecologists urge that ways be found to lower the costs of in-vitro procedures. They also stress the need to launch awareness campaigns to show that artificial insemination does not contradict the teachings of Islam. The Moroccan experts also call on the insurance companies, and the social coverage institutions, to find a way to absorb the fees of sterility treatment and to do away with the outdated law texts which no longer match the requirements of the modern times.
“A cured sterility means a healthy family and a more productive society", says Dr. Mohamed Ibrahimi.
In the Arab World, thousands of families are looking forward to more local scientific competencies to develop the artificial insemination techniques.
Such techniques were used in Egypt in 1986, and in Saudi Arabia, as they do not contradict the Islamic law (Sharia) on condition that they are used between legally married man and woman in order to preserve the family as a key component of society.
© 2000 Al Bawaba (www.albawaba.com)