Infertility affects approximately 15 per cent of Indian couples. Late marriages, stressful lifestyles, obesity, high junk food intake, smoking, alcoholism, and drug addiction contribute to the problem.
Infertility is defined as the inability of a couple with normal sexual relations to conceive after a year of trying. Such couples require medical advice and, in some cases, interventions to have a child.
The female partner must have a regular menstrual cycle, a normal uterus, ovaries capable of producing eggs, patent (open) fallopian tubes, normal sperm count, and motile sperms for a normal pregnancy.
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With a double-digit increase, infertility has become a personal and public health issue in India. Infertility causes financial and emotional stress for couples and social stigma.
Causes of infertility in women
There are many causes of infertility in women. Here are some of the common ones:
- Reduced ovarian reserve that is mostly caused by malnutrition in India.
- Polycystic Ovarian Disease (PCOD)
- Any ovarian mass, such as a chocolate cyst or endometriosis
- Blocked fallopian tubes
- Adhesion around the fallopian tubes caused by infection. In our country, tuberculosis is one of the most common causes of such infections.
- Uterine problems like fibroids, endometrial polyps, septate uterus, adenomyotic uterus, intrauterine adhesions, and chronic endometritis
- Chronic cervicitis or recurrent vaginal infections.
- Inability to have sexual relations due to psychological issues.
A non-gender-specific problem
Both men and women may bear equal responsibility for infertility. Only 30 per cent of Indian males have normal sperm qualities, making it difficult for women to conceive. Couples tend to avoid tests, but meeting with an infertility specialist in person can help manage most cases with simple, traditional treatments.
Fertility preservation, or the storage of sperm and eggs for future use, has become possible thanks to advances in reproductive medicine. In addition, stem cell therapy is on the verge of discovering new ways to rejuvenate the eggs and sperm, known as "fertility rejuvenation."
Only true cases that necessitate advanced fertility treatments like IVF, egg donation, or surrogacy should be referred to. Awareness and sensitisation are necessary to make both genders aware of the problem.
Unexplained infertility
Sometimes the cause of infertility in some couples remains unknown even after investigations such as clinical examination, transvaginal sonography, blood tests, and semen analysis.
Medical advances to the rescue
With advances in medical science, such couples can now have a biological child using advanced procedures like In Vitro Fertilization (IVF), which has shown to be successful in about 90 per cent of cases, making it a popular choice for infertile couples.
IVF cycle success rates have increased to around 60 per cent on average over the years. While the cost is about the same as it was about five years ago, the treatment's safety levels have improved, and fewer clinic visits are required. The amount of time the female partner needs to rest has also decreased, making it more comfortable and less painful.
There has been a noticeable increase in the number of infertile couples and fertility service providers in India over the last decade.
Fertility treatments necessitate a high level of attention and insurance coverage. Experts recommend that insurers include intrauterine insemination (IUI), in vitro fertilisation (IVF), or frozen embryo transfer (FET) in their policies. Comprehensive care and coverage for fertility therapy would open up a new vision for all stakeholders in the fertility industry.
(Dr Rutuja Athawale is an Infertility Specialist at Crysta IVF, Bangalore.)
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