We are a Nation almost one fifth of mankind and produce in any given year more babies than the entire population of many countries. Search long enough and the root cause of all our country’s problems will point menacingly to over population. In short, “We the People”, are a virile, fertile one. Right? Well, not quite.
Estimates vary, but anything between 20 and 35 million couples in the reproductive age in India suffer from lifetime infertility. To put things in the right perspective would be to say that anywhere between 10 and 15 percent of all married couples in India are facing some problem or the other relating to fertility or the lack of it.
Another Myth Buster is the fact that about 40 to 50 percent of these couples suffering from infertility are due to female factors, while alarmingly (it is still a male dominated society after all) 30 to 40 percent of the cases can be attributed to male factors, the rest of the cases being due to the shortcomings of both. And, before we proceed any further, please note, according to almost all the studies made, India is showing alarming deteriorations in almost all the risk factors that are known to be the key drivers of infertility. As a matter of fact, if some demographic experts are to be believed, by the year 2020, we will be facing a full blown epidemic in the eye, and it is already too late to put policies and procedures to rectify the same.
On the face of it, some of the causes that can be attributed to this emerging phenomenon are pretty obvious. The mean age of marriage is on the rise across the Nation. Increasing number of women are joining the workforce and more and more couples are embracing improved methods of contraception, “choosing” to delay childbirth for social and economic reasons. Rapid urbanization of the population with the obvious impact of nuclear families and the stresses associated with fending for the unit too are extracting their pound. Sedentary lifestyle which is leading to ever increasing numbers suffering from obesity and obesity induced diseases is another reason that is keeping the storks away, while marked increase in the consumption of tobacco and alcohol is another major reason for an ailment that is afflicting the Nation.
However, there are clinical reasons behind the spread of the menace as well. Polysystic Ovarian Syndrome (PSOS), endometrial tuberculosis and Sexually Transmitted Infections are running havoc with the conjugal lives of couples. Add to these the fact that South Asian women have poorer ovarian reserve which makes them prone to suffering from earlier onset of infertility and a marked resistance to infertility treatments and the circle of the inability to conceive naturally comes full circle.
There are other peculiarities associated with the problem. If the numbers are to be believed, not even one in a hundred infertile couples seeks medically assisted childbirth or treatment. Awareness and knowledge about infertility is abysmally low, with distressed couples often putting more faith on quacks and charlatans than on scientifically proven treatments. The prohibitively high cost of treatment – one estimate pegs them to be out of reach for more than 80 percent of the couples – is another almost insurmountable hurdle on the path. Again, the shortage of skilled and trained personnel capable to providing medical solace to the couples in need is another burning issue that needs to be addressed with immediate effect in the country. If one were to look at the significant skew that infertility treatment has towards the metro cities – with vast hinterlands having little or no medical facilities worth talking of – and the sheer enormity of the problem comes into sharper focus. Naturally, so-called In-vitro Fertilisation (IVF) centers offering all sorts of panacea have mushroomed in the seamy underbelly of society, which, coupled with the lack of proper regulations and acceptable frameworks for the management of Assisted Reproductive Technology (ART) are seen as major hindrances on the way of infertility treatments claiming their rightful place in the sun.
This piece was originally written for the Express Health Guide 2016.