Infertility is a dilemma facing childless couples all over the world. They have to decide whether to seek the help of medical science to conceive a child and when they do, they are often faced with a whole range of ethical, moral or practical questions.

It’s no exception in the conservative Arab Gulf states where the issue takes on another dimension because of the social stigma attached to infertility.

To some in this part of the world - especially among the older generation - infertility is a "shame" and its treatment is still not widely accepted.

For these women, not getting pregnant could mean jeopardising their marriages. “I heard my mother-in-law tell my husband to find a second wife because I could not conceive a child two years after marriage,” a 28-year-old local woman, who preferred to remain anonymous told Jazeera.net in one of the waiting rooms of Dubai’s Gynaeocology and Fertility Centre.

“It was very difficult for me and I spent many sleepless nights feeling depressed,” she said.

The clinic is one of many in this cosmopolitan city. It’s a place where there is potential for new life. But there is so much darkness behind its doors at least for many local women who suffer from the stigma attached to assisted pregnancy.

“It was not until a year and a half after I gave birth to my child that I even began to hint to my family that I went to a doctor, a lady doctor, for consultation. Of course, I didn’t mention anything about receiving treatment,” said another local woman who also refused to give her name.

Medical treatment for infertility
is still a taboo to some in the Gulf

“They (the family) just won’t understand that it is some form of illness which requires a cure or some form of treatment,” the woman continued to say.

“First of all, they would not look at me as a woman anymore. Second, they fear that such treatment may result in some kind of mix-up. They would raise questions about whether the test-tubes are labelled correctly, whether they did not mistake someone else’s eggs with mine, stuff like that.”

Legitimate concerns. In July 2002 a white British couple made headlines when they had black twins after a blunder at a fertility clinic.

That incident sparked an unprecedented legal debate over how it could happen and who were the “lawful” parents. It wasn’t the first case of its kind. And more are expected in the future.

Such a mishap would run contrary to Islamic law which forbids treatments that blur the marital and parental ties, like using donor eggs or sperm from outside the marriage relationship.

“We take these concerns into account and we try to be more than careful here at the clinic,” the centre’s deputy director Dr Pankaj Shrivastav said.

This centre has had its own share of achievements. Eleven years ago, the first child was born to a couple treated here. Since then, over 250 babies have been born.

Success, however, is not always guaranteed. And in a society where large families is the norm, expectations run high.

‘We actually get 18 year-old girls who come for fertility advice within three to four months of their marriage. They are purely unrealistic,” Dr. Shrivastav said. ‘This is due to the society around her, the cultural values. For example, a girl gets married and gets her period a month later … everyone smiles and they tell her not to worry. Then she gets her second period and her mother-in-law’s eyes go up and the girl gets tense about the whole thing.”

Being unable to conceive is a nightmare in itself. And it is made worse by social and cultural pressures and the fact that these women, at times, have to deal with their suffering alone.

“That is the reason we set up a patient support group at the clinic… to allow these women to talk to specialists or to other women who are going through the same devastating experience,”  explained Lalitha Ramkumar, the head of the group.

“Traditional Arab society is much more closed about certain issues. It is often considered a taboo to discuss the topic of infertility openly even among their family members. And these women often suffer from some sort of sense of guilt for denying their husbands children.”

In such a society, women are often blamed and shunned when they can’t bear children. “The male infertility factor is always forgotten here,” Dr. Shrivastav said. “Men, particularly in this part of the world always seem to think that they can never be the cause of the problem even though in at least 40 percent of the cases, it is the man who has the problem.”

However, cultural attitudes are changing. ‘We are seeing more and more women openly fighting this old way of thinking,” said Dr Amal Al-Shunnar, a fertility specialist. “Also, there are many families here, especially the educated ones, who understand the problem in a scientific way."