TRADITIONAL TREATMENT OF FEMALE INFERTILITY: YORUBA PERSPECTIVE

This survey was to conserve knowledge of indigenous medicine through identification and documentation of the recipes and plants used in the treatment of female infertility by the Yoruba people of Southwestern Nigeria. An ethnobotanical survey was conducted using oral informal interviews. The target respondents included diviners/spiritualists, herb sellers, traditional birth attendants, farmers/hunters and other members of the community. The survey yielded 12 recipes recorded with all being orally administered. There were 30 plants distributed in 21 families; 20% of which are climbers, 20% herbs, 23% shrubs and 37% trees. Leaves (26.67%) were the most utilised part while the least utilised are rhizomes (3.33%). Materials of animal and mineral origin were also utilised. It is hoped that the documentation provided from this study will help in the conservation of knowledge of traditional medicine and to serve as a bedrock for further scientific evaluation.

couples experience some form of infertility during their reproductive lives (15-44 years), thus affecting 50 to 80 million people worldwide. Out of this number, 20-35 million couples in Africa are affected. Africa continues to suffer from high rate of infertility especially in parts of West, Central and Southern Africa (Mascarenhas et al., 2012). The rate of infertility in African countries ranges from 15-30% (Umeoru, 2007). In Nigeria, couples suffering from infertility have been extrapolated in some parts being as high as 20% (Okonofua, 2003) and 45% (Adetoro and Ebomoyi, 1991).
The most common cause of infertility is ovulation disorder, which occurs in 40% of women with infertility issues (Jose-Miller et al., 2007). This results from hormonal abnormalities or imbalances. More than 85% of infertile women in sub-Saharan Africa have a diagnosis of infertility attributable to an infection compared with 33% of women worldwide (Mascarenhas et al., 2012).
Presented here are a compilation and analyses of the ethnobotanical information on the plants and recipes used in the management of female infertility in Southwestern Nigeria. Hopefully, this will serve as bedrock for further investigation into the plants to ascertain the phytochemicals responsible for the reported activities as well as possible cultivation of these plants as a conservation method.

MATERIALS AND METHODS
The ethnobotanical survey was carried out across Lagos, Ogun, Oyo, Ondo and Ekiti states (south western region of Nigeria). The map of the study area is shown in Figure 1. Informal oral interviews were conducted using modified recommendations by Martin (1995) in order to obtain ethnobotanical information on medicinal plants and traditional medicine preparations used in management and treatment of female infertility within the study area. The target respondents were randomly selected to include diviners/spiritualists, herb sellers, traditional birth attendants, farmers/hunters, elderly members of the community and other individuals the community regards as possessing handed-down or acquired knowledge of medicinal plants around them. Some of the respondents were materially and/or monetarily incentivised to encourage them to give relevant information. The interviews covered recipes, plant and part used, method of preparation, mode of administration and dosage (Soladoye et al., 2014). The interviews were conducted in Yoruba with repeated visits to some respondents who volunteered to embark on field trips for specimen collection. Study area for the ethnobotanical survey was within the southwestern region of Nigeria. It included Lagos, Ogun Oyo, Ondo and Ekiti states. Field trips were also conducted to collect samples of some of the plants mentioned in the course of the interviews, including both vegetative and reproductive parts from the wild, home gardens and herbal markets with the help of some of the respondents. They were identified and authenticated with voucher specimens deposited at the University of Lagos Herbarium (LUH) and the Forestry Research Institute of Nigeria (FRIN), Ibadan (FHI).

Mode of preparation, administration and dosage of recipes
A total of 12 recipes was recorded (Table 1) for the treatment of female infertility and all are orally administered. The recipes obtained for treating female infertility involve the use of plants, animals and inorganic materials. Part(s) used, method of preparation, administration, dosage and caution are also stated.

Plant diversity
A total of 30 plant species distributed in 21 families were identified for the treatment for female infertility in southwestern Nigeria. These are listed with their local and common names in Table 2. The growth habit of the plants varied from climbers (20%), herbs (20%), shrubs (23%) to trees (37%) as shown in Figure 2.  The plant parts with the most common usage were the leaves (26.67%), fruits (20.00 %), seeds (16.67%) and roots (13.33%). Bark, stem and whole plant each accounted for 6.67% while the least commonly used plant part was the rhizome (3.33%) as shown in Figure 3.   (Schultes, 1994). The variety of recipes recorded in the treatment of female infertility in this study is an indication of the diversity of plant species employed by traditional medicine practitioners among the Yoruba people located in southwestern part of Nigeria.
A total of 12 recipes were recorded to treat female infertility all of which are administered orally. Traditional medicine recipes are generally referred to as "herbal medicines" probably because plants have been said to be the first and only true medicines ever used (Gill, 1992). Items from sources other than plants are, however, included in some recipes. This survey revealed that various plant and animal organs along with inorganic materials are employed in the treatment of female infertility. Table salt and distilled spirit (gin) are examples of inorganic items while local fowl and bat are some of the animals employed in the preparation of the reported recipes. Borokini and Lawal (2014) have also reported the use of inorganic and whole or parts of animals in traditional healing system.
A total of 30 plant species belonging to 21 families with varying growth habits were used in the traditional recipes recorded. The most dominant growth habit was tree with 11 species. Elaeis guineensis, a tree earlier reported by Fashola (2015), was also recorded in this study. Species of shrubs mentioned were 7, some of which have been reported in earlier surveys. Examples include Piper nigrum (Fashola, 2015), Xylopia aethiopica (NNMDA, 2013;Soladoye et al., 2014;NNMDA, 2018) and Ocimum gratissimum (Soladoye et al., 2014). Climbers such as Cissampelos owariensis reported in this study had been reported within the study area (Fashola, 2015). The use of Momordica charantia whole plant in the treatment of female infertility has also been reported (Sharaibi et al., 2017). Soladoye et al. (2014) reported Citrullus colocynthis as one of the dominant plants in recipes for the treatment of female infertility within a similar study area.
The most dominant plant parts utilised in the treatment of female infertility from this study are the leaves. As a result of convenience and sustainable collection, leaves have been widely reported as the most sourced plant part for phytomedicine. In northern Peru and southern India Bussmann and Glenn (2010) and Balamurugan et al. (2018) reported leaves as the main part used to treat various gynecological disorders. However, stem and bark were reported by Fashola (2015) as the most widely used plant part in the treatment of female reproductive health problems in Oyo state, southwestern Nigeria.

CONCLUSION
The results of this study have demonstrated the diverse potentials of plants used for the treatment of female infertility among the Yoruba people of South-eastern Nigeria. This collection of information is a documentation for the conservation of indigenous traditional medicine knowledge as well as a footing for scientific evaluation. Since most practitioners collect their materials from the wild, there is the need to create awareness and educate them on sustainable collection and conservation methods such as domestication for personal use and large-scale trade.