Having children or completing families is no longer considered a social necessity but an event to be considered convenience. People want children, but career has taken precedence. This adherence to convenience has made infertility rise to mammoth proportions without even realizing what we are leading ourselves to in our quest to achieve our goals. Dr Priya Khamatkar, Fertility Specialist, Cloudnine Group of Hospitals, Mumbai (Vashi), talks in detail. This brings us to another question - Is the declining Fertility rate in India for real? Surprisingly the answer is yes!
Facts About Declining Fertility Rate In Younger Generation
India, the second-most populous country globally, is having a steady decline in fertility rate for some time now. Recently, the Sample Registration System (SRS) Statistical Report (2018) and global population projections made by the Institute of Health Metrics and Evaluation (IHME), US released statistical figures estimating the Total Fertility Rate (TFR) in India. According to the report, TFR was 2.2 in the year 2018 and is showing a continuous declining trend wherein a replacement TFR of 2.1 would soon be reached for India as a whole. This may lead to stabilizing the population may be good news for the policymakers, but it also points to the disconcerting trend of young couples unable to procreate.
Reasons Of Declining Fertility Rate In Younger Generation
If we try to summarize the reasons for which a couple visits an infertility specialist, a few of the most common reasons would be:
- Polycystic ovarian syndrome (PCOS)
- Male factor
- Poor ovarian reserve (even at young age)
- Unexplained infertility
- Tubal factor
- Loss of libido or sexual drive.
Other factors include increased mobility, late marriage, financially independent women and overall prosperity. These may be the diagnostic terms, but what is important is to know how these came to exist and are on the rise in today’s times. Some of them may have genetic predisposition but many are the result of faulty lifestyle choices. The way we live has a lot of impact on our health.
Major Determinants Of Declining Fertility Rate In Younger Generation
Obesity today is the new epidemic. It is the direct result of faulty lifestyle choices in both men and women. Though it is one of the correctable factors, it’s the most prevalent one. In fact, about 40% of men or women approaching for infertility are obese. Obesity in women leads to irregular periods, hormonal disturbances which may cause ovulatory disturbances, loss of sexual drive. It can also act as fuel to the most common cause of infertility which is PCOS. In men, obesity causes loss of libido or sexual drive, hormonal imbalance impacting the sperms, their quality and quantity both thus leading to fertility issues. It leads to lifestyle disease like hypertension and diabetes, which in turn causes ejaculatory dysfunction and hence infertility.
2# Sedentary lifestyle And Habits
Inactive lifestyles, unhealthy diet, work-related stress and performance pressure. Alcohol, Smoking are not good either. Smoking leads to increase in the oxidant levels and thus cause damage to the DNA of the sperm leading to reduced capacity to fertilize the egg. In women, it causes early destruction of eggs leading to poor quality and quantity of eggs, again contributing to Infertility.
Stress again is a major contributory factor which you cannot quantify. As a result, it has different implications in both men and women, leading to hormonal imbalance, specially prolactin levels which are found in almost 1/3rd of the cases, thus again leading to a cascade of problems finally leading to infertility.
4# Pelvic Inflammatory disorders
These disorders are one of the commonest causes leading to tubal factor infertility. Over 30% of women have been diagnosed with sexually transmitted infections. Lack of knowledge about contraception and failure to use condoms, not only increases the chance of STI but also lead to unwanted pregnancies which result in induced abortions and can in turn can lead to serious infection and thus infertility.
These are all the factors which are correctable by lifestyle modifications. However, there are still some factors which can lead to infertility and may need specialist intervention, like: PCOS, poor ovarian reserve, endometriosis, uterine abnormalities, fibroids, genital TB, sperm related abnormalities like azoospermia, teratozoospermia, oligozoospermia etc. Awareness of these conditions can help early detection and solution.
With the changing social norms and our lifestyle, we as a generation are more aware of our expectation from life and having children has taken a backseat and is charted way below our career and life goals. The decline in the Fertility rate is alarming. To have a child or not is a personal choice. But to be able to make it a choice, we have to take timely steps so that we don’t end up having no option.
With inputs from Dr. Priya Khamatkar, Fertility Specialist, Cloudnine Group of Hospitals, Mumbai (Vashi)
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