It’s a well-known fact that couples are delaying having children and opting to start their families later in life than their parents or grandparents did. About half of the millennials (25-34 years old) are now postponing the birth of their first child as marriages are happening late due to career progression opportunities. However, they need to be aware that fertility is one of those things that does have finite limits. Unfortunately, the period of greatest advancements in these pursuits often directly coincides with that period of time when female fertility has reached its peak and is beginning to decline — usually in the late 20s to mid-30s. This means that more women are having difficulty getting pregnant when they do decide the time is right. According to the Indian Society of Assisted Reproduction (ISAR), infertility affects about 10 to 14 percent of the Indian population, with one out of 6 couples being affected in larger cities.
Facts about fertility
The younger generation needs to know about the various environmental and acquired factors causing a decline in fertility in the present reproductive age groups of 25 and 34 years.
Lifestyle-related issues in women lead to problems of obesity, irregular periods and later issues with ovulation or no ovulation. PCOS also leads to issues like acne and excessive bleeding. In men, a sedentary lifestyle leads to obesity, a decrease in sexual drive, alters sexual hormone balance, and further impacts the quality and motility of sperms. DNA fragmentation of sperm is higher if a male is obese. Diabetes and hypertension add to the woes, causing erection and ejaculatory problems in men who had a normal sexual life before. Premature ejaculation is a common problem nowadays due to our lifestyles.
Stress increases cortisol hormones thereby altering the reproductive hormone balance leading to fertility-related issues. Stress also increases the prolactin hormone production by the pituitary gland which delays or prevents ovulation leading to irregular periods or scanty periods leading to infertility.
Smoking at a younger age leads to the early destruction of eggs in females, reduced fertility, and increases the risk of premature menopause. In men, smoking increases DNA damage and damaged sperms lack the capacity to fertilise.
Emergency contraception has high doses of hormones; it alters the menstrual cycle, ovulation and causes nuisance inter-menstrual spotting.
Sexually transmitted diseases like herpes and pelvic inflammatory diseases cause fallopian tubal damage and infertility in women. Herpes also causes miscarriages, premature deliveries and poor pregnancy outcome. Whereas in men, sexually transmitted diseases due to previous exposure can be asymptomatic in men, but they can infect their wives, causing infertility in them. The use of condoms plays a huge role in preventing future problems.
Lack of knowledge about fertility window and contraception leads to unwanted pregnancies, repeated induced abortions which can lead to irreversible infertility.
Poor dietary choices like frozen, instant and packaged food items with preservatives, refined sugar and simple carbs aggravate hormone imbalance in polycystic ovarian syndrome. A lack of probiotics in these foodstuffs alters the pH balance in the vaginal bacterial flora which is very essential in preventing vaginal, cervical and uterine infections that leads to infertility later on. In men, a poor diet, sugar-rich foods, excessive alcohol, and smoking can increase the free oxygen radicals and increase mitochondrial damage in cells. So there is decreased sexual drive and also reduced sex hormone production leading to reduced sperm production.
(The author is an OB/GYN, fertility specialist.)
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