Infertility is a significant public health concern that affects both men and women, yet it remains surrounded by stigma, misconceptions and cultural beliefs. Globally, infertility affects an estimated 8–12% of people of reproductive age, with more than 186 million individuals and over 40 million couples living with infertility. Although infertility is not life-threatening, it can have profound psychological, social and emotional consequences, contributing to stress, stigma, relationship difficulties and social exclusion. Despite its impact, there is limited evidence on what South Africans know and believe about infertility, particularly in urban and rural settings in South Africa.

A recent study by researchers from the University of Pretoria investigated the knowledge, attitudes and practices of men and women regarding infertility in Tshwane, Pretoria. The aim was to assess participants’ understanding of infertility, determine their attitudes, explore practices related to infertility, and examine gender differences.

To achieve these aims, the researchers conducted a descriptive quantitative survey at three primary healthcare clinics in the City of Tshwane. Using stratified sampling, they recruited 390 adults, exceeding their target sample size of 377 participants. Data were collected over a two-week period in October 2023 using a self-administered questionnaire that gathered information on participants’ knowledge, attitudes and practices regarding infertility.

The study found that participants generally demonstrated good knowledge of recognised causes of infertility. About 67.4% identified abnormal menstruation as a possible cause of female infertility, 64.2% recognised abnormalities of semen and sperm as a cause of male infertility, 64.3% associated female reproductive tract infections with infertility, 61.1% recognised male reproductive tract infections as a contributing factor, and 71.5% identified psychological stress as a possible cause. Most respondents also correctly disagreed that previous contraceptive use (62.1%) or intrauterine devices (56.0%) reduce fertility.

Despite this generally good level of knowledge, misconceptions remained. Many respondents did not recognise that certain lifestyle factors can affect fertility, with most disagreeing that drinking alcohol (58.8%), smoking (64.2%) and vigorous exercise (61.7%) can affect fertility. More than half believed infertility could result from black magic (56.5%), while 71.2% believed supernatural causes could contribute to infertility. In addition, 30.8% believed men are to blame for infertility, while 30.5% believed infertility is more common in women than in men.

Attitudes towards infertility were largely positive. Nearly 79.5% regarded infertility as a medical condition, 88.5% believed it should be treated medically, 83.2% supported adoption if couples could not have children, and 90.7% considered in vitro fertilisation (IVF) an acceptable treatment option. Most respondents (71%) also believed that both partners should be investigated when fertility problems occur.

The study concludes that men and women in Tshwane generally have good knowledge and positive attitudes regarding infertility. However, misconceptions persist, particularly beliefs that infertility is caused by supernatural forces, that it is primarily a woman’s problem, or that it constitutes a disability. The researchers recommend gender-sensitive and culturally appropriate reproductive health education to address misconceptions, reduce stigma and encourage informed decision-making while respecting cultural and religious beliefs.