Study Links Female Circumcision to Infertility

Scientists studying women who have undergone genital circumcision, a practice common across Africa, say women who have had the procedure are much more likely to become sterile.  The findings of the study were published in a recent issue of the journal Lancet, and experts hope the study will discourage the procedure.

The World Health Organization (WHO) estimates that 132 million women and girls across Africa have undergone some form of genital circumcision, also referred to as female genital mutilation.

Each year, the WHO says another two million females undergo the procedure, which involves either sewing their vaginas shut or removing parts of their genitals, or both, usually by nurse midwives.

Experts say the most severe forms of genital mutilation are practiced in northeast Africa.  In northern Sudan, they estimate 90 percent of women have undergone the most mutilating form of the procedure.

When young girls are circumcised, Lars Almroth of the Karolinska Institute's Division of International Health in Sweden says, it's usually intended to preserve their virginity for marriage.

"It's believed that girls undergoing this ...have more dignity.  They are better girls than others," he explained.

Dr. Almroth and colleagues in Sudan decided to investigate reports that female circumcision causes sterility among women who had the procedure as young girls.

The researchers studied 99 circumcised women in Khartoum who were unable to get pregnant and compared them to 180 women who had conceived.

The investigators found that the sterile women had severe damage to their reproductive organs caused by infection, which they trace to female circumcision.

"We think it's complications in childhood, actually," Dr. Almroth added.  "When [there are] complications the girls face immediately after the operation, they usually don't seek medical care for complications.  And if do, they may not name them as complications.  They may seek medical care for diffuse symptoms that maybe the doctor doesn't actuality associate or relate to genital mutilation."

Female genital mutilation has been decried by the international public health community, but it has been powerless to stop it. Now, health officials may have a potent weapon against the practice.

The U.S. Agency for International Development, among others, has been working for the past 10 years to eliminate female circumcision. 

Program analyst Layla Shaaban says in many cultures where female mutilation is practiced, fertility is also extremely important.

"The argument, the possible link with infertility, could become a new, strong argument, an additional argument, as an additional harmful effect of this practice," she said.

The study on female circumcision and sterility was published in the July 29 issue of the British medical journal the Lancet.

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