In recent years the prevalence of couples unable to conceive has increased drastically and over 20% of the married couples account for it. Not only is there a decline in female fertility, but a reduction in male fertility has been on a rise. Of the total couples seeking fertility treatment, around half of the issue lies with the female partner and the increasing trend in loss of male fertility is attributable in the remaining half. The tendency to look for fertility treatment is high, as the need for parenthood and social status of parenthood is more significant in India. However, the awareness of IVF in rural areas is a major barrier.
Though the proportion of women in their reproductive age i.e. 20 to 44 years has increased in the last decade, women over 30 are under the burden of infertility in India.
With the changing lifestyle, increased use of contraceptives and exposure to toxins is linked to further rise in the burden of infertility in India by 2020.
What could be the possible reasons among female?
- Changing and sedentary lifestyle –Women are born with their lifetime reserve of eggs, and these gradually decrease in both quality and quantity with age. Westernisation has only depleted and destroyed the egg quality prematurely in women.
- Increase in the number of working women –With more number of women focussing on work and career, they want to conceive after getting settled. But with the biological clock ticking away, fertility reduces with increasing age decreasing the chances to get pregnant.
- Urban lifestyle ad obesity –With westernisation, many women have been fancying for alcohol and tobacco consumption as a style and status symbol. Depending on junk food and a sedentary lifestyle, people now a day are becoming obese which is one of the contributing reasons for becoming infertile.
- Other clinical factors –Prevalence of medical conditions among women have seen a rise in the last decade –
- Polycystic Ovarian Syndrome (PCOS) –PCOS is very common among Indian women and is estimated to have 22% prevalence rate in India.
- Genital TB –is the greatest risk factor for tubal blockage and endometrial damage resulting in infertility. Over 18% of Indian women in reproductive age are affected by it.
- Sexually Transmitted Infections (STI) –Over 30% of women have been diagnosed with sexually transmitted infections. Infertility due to STIs such as gonorrhea, syphilis, chlamydia and trichomoniasis has been attributed to pelvic inflammatory disease and tubal infertility in women.
- Hormonal imbalances –Indian women have lower Anti-Mullerian Hormone levels (AMH), and higher Follicular Stimulating Hormone (FSH) levels, despite being significantly younger. These hormones are an indicator of ovarian reserve.
Reasons for increasing trend among male
The national capital region has seen a rise in the number of male patients in the past 3 years at IVF centres. 1 in every 3 men is suffering from infertility problem in the metro cities.
Generally, this kind of problem occurs due to less count and degeneration of sperms which are then unable to reach inside the female tube. Hence the female partner is unable to conceive even after countless attempts.
In metro cities like Delhi, Mumbai, and Chennai, over 15% of the male population is infertile, a rate greater than that of the female. Stress, obesity, sedentary lifestyle, smoking and alcohol consumption increases the chances for the sperms to die. The changing lifestyle and the polluted environment is one of the main contributing factors to cause infertility in male and increases the chances of miscarriage.
There are a lot of heavy metals, which directly affects the hormones in the body. Reduction in androgens like testosterone in male and estrogen level in female results in loss of libido. A higher concentration of free radicals in the blood causes a lower sperm quality in men.
With increasing age, the sperm motility and the quality decrease causing fertility issues and loss of libido in men.
Thus, owing to the abovesaid reasons, there is increase in the cases of male and female infertility and thus an increasing trend of IVF. IVF is a great treatment method which helps these patients to fulfill their desire of parenthood. The need of the hour is to understand the importance of a healthy lifestyle to increase and maintain fertility.
Dr. Arvind Vaid, IVF expert, Indira IVF Hospital, New Delhi