When it doesn't happen

Infertility primarily refers to the biological inability of a person to contribute to conception. This happens when the couple hasn’t conceived after 12 months of contraceptive-free intercourse (if the female is under the age of 34), or if the couple hasn’t conceived after six months of contraceptive-free intercourse (if the female is over the age of 35).

Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term. Generally, worldwide, it is estimated that one in seven couples have problems conceiving, with the incidences similar in most countries independent of the level of the country’s development. The global incidence of infertility is about 13-18%. In India, the incidence of infertility is between 10 and 20%.

In India, although population growth is a major concern, there are a substantial number of infertile couples. Thus, infertility is considered as an important national problem concerning reproductive health. Infertility is commonly due to some contribution from both the male and female partners.

There are many biological causes of infertility, some which may be bypassed with medical intervention. Majority of infertility cases are caused by genetics and are not preventable. However, it is possible to prevent some potential infertility cases by bringing about certain changes to our day-to-day lifestyle.

Things to do

The environment we live in has a huge impact on our potential fertility along with our day-to-day lifestyle. Infertility has lately become more of a lifestyle problem than a medical problem. Knowing what compromises one’s fertility and devising ways to avoid potential hazards is the best way one can help prevent infertility. Here are some helpful pointers:

Firstly, certain habits such as smoking or drinking alcohol could have a detrimental effect on one’s fertility. Smoking has been linked to low-sperm counts and sluggish sperm movement in men, and an increase in miscarriage incidences in women.

Alcohol (especially binge drinking or chronic abuse) affects the fertility of both men and women trying to conceive either naturally or through infertility treatments. Alcohol is toxic to sperm; it reduces sperm counts, can interfere with sexual performance, disrupt hormone balances, and increase the risk of miscarriage.

A well-balanced diet consisting of carbohydrates, proteins and fibres should be consumed. A diet rich in proteins from vegetables rather than from animals combined with a good amount of fibre and iron, less trans fat and sugar from carbohydrates, more high-fat dairy products and less low-fat dairy products, along with taking multivitamins decreases the relative risk of infertility due to ovulatory disorders in women.

Dietary imbalances leading to deficiency of Vitamin C, folate, selenium or zinc can increase the risk of infertility. Women should increase their folic acid intake (found in green leafy vegetables, fruit, cereals, but also available as supplements) prior to and during the first three months of pregnancy, to reduce the risk of neural tube defects such as spina bifida.

A moderate amount of physical activity can help make a large difference in one’s probability of becoming fertile. But excessive exercise can lead to menstrual disorders in women. It can also affect the sperm production in men due to the heat build-up around the testicles.

One should maintain a healthy weight through diet and consistent exercise. One should maintain a body weight close to the ideal number for one’s height to reduce the possibility of hormone imbalances. Obesity is known to cause infertility in males by lowering sperm count through overheating, and in females through the suppression of ovulation.

One should get yearly check-ups for certain medical conditions affecting fertility. Early diagnosis of conditions like pelvic inflammatory disease (PID), endometriosis and cervical cancer may prevent infertility.

Certain medications or herbal remedies could also affect fertility. Such drugs should be discussed with one’s gynaecologist. Additionally, one must give up recreational drugs such as marijuana and cocaine as these have been linked to low-sperm counts in men and infertility in women.

High levels of stress and lack of consistent sleep may increase the risk of infertility. Meditation, yoga and adopting other relaxation techniques like deep breathing and progressive muscle relaxation may also help alleviate stress.

Along with these lifestyle modifications, recent advances in assisted reproductive technologies (ART) have provided greater possibilities for successful infertility treatment. Examples of new technologies include intracytoplasmic sperm injection, oocyte donation, and embryo cryopreservation.

So, if all efforts to conceive a child have been unsuccessful over a period of six months or longer, it is best that the couple consult a doctor. A proper diagnosis of the specific cause of infertility in one’s case will enable the doctor to prescribe appropriate management.

Yes, many drugs can cause impaired fertility in both men and women, including antidepressants, tranquilisers and narcotics. Anti-cancer drugs can cause ovarian and testicular failure temporarily or permanently. Additionally, many drugs can cause miscarriage or fetal defect once pregnancy has begun. Sulfasalazine, a drug that is used in Crohn’s disease, is well known to have an effect on sperm production. Most hormonal supplements, including anabolic steroids, as well as other street drugs, can have an adverse effect on fertility.

So, make these lifestyle changes and make your life healthy and happy.

(The author is a gynaec and infertility specialist attached to Lilavati, D Y Patil and Bhatia hospitals in Mumbai and the Fortis group in Delhi)