Fertility health is a vital part of planning a family, but it’s often surrounded by uncertainty and myths. Fertility is the ability to conceive and bear children, whereas infertility is defined as the inability of a couple to achieve pregnancy after 12 months of regular, unprotected intercourse. While we might think of fertility as a purely female issue, it’s important to know that both partners play crucial roles. With rising rates of fertility challenges in India, understanding what affects fertility and how to monitor it can make a big difference.
We spoke to our expert Dr Sowmya KN, Consultant Obstetrician and Gynaecologist, Gleneagles BGS Hospital Kengeri, Bengaluru, who explained fertility health, how to monitor it, and the various factors and treatments involved, providing a comprehensive guide to navigating this often challenging journey.
Rising Infertility Rates in India
According to the World Health Organization (WHO), infertility is a condition affecting the male or female reproductive system, characterised by the inability to conceive after 12 months or more of regular, unprotected intercourse. It can result from factors related to either partner or from unexplained causes.
“Infertility and subfertility are becoming increasingly prevalent in India, with estimates suggesting that 10-15% of couples experience fertility challenges at some point in their lives. It's important to note that infertility is not solely a female issue; male factors also play a significant role. Approximately 20-25% of infertility cases are due exclusively to male factors, and they contribute to 30-40% of infertility cases overall,” said Dr Sowmya. Addressing this issue requires a comprehensive understanding of the potential causes and appropriate treatments.
Also Read: PCOS, Obesity, And Infertility: Expert Explains Their Connection And What You Should Know
Causes of Infertility in Women
Infertility can stem from issues within either the male or female reproductive system. Dr Sowmya listed some of the factors as follows:
- Tubal Factors: Blockages or obstructions in the fallopian tubes can prevent the egg from meeting sperm. Conditions, such as Pelvic Inflammatory Disease (PID) or previous surgeries can cause such blockages.
- Ovarian Factors: Issues like anovulation, where the ovaries do not release eggs, can hinder conception. Polycystic ovary syndrome (PCOS) and other disorders can disrupt normal ovulation.
- Hormonal Factors: Hormonal imbalances, including thyroid disorders and problems with the endocrine system, can affect fertility.
- Increasing Age: Fertility naturally declines with age. Women’s fertility peaks in their 20s and early 30s and decreases significantly after age 35.
- Anomalies: Structural issues, such as fibroids, endometriosis, or other abnormalities in the reproductive system can affect fertility.
- Unexplained Infertility: In some cases, no specific cause is found despite thorough testing.
Male Factors Contributing to Infertility
Male infertility can be caused by various factors. Here are some factors listed by the expert:
- Obstructions: Blockages in the genital tract can impede the flow of semen. Conditions, such as vasectomy or congenital obstructions can be responsible.
- Chronic Illnesses and Injuries: Diseases like diabetes or injuries to the reproductive organs can affect sperm production or transport.
- Inherited Disorders and Hormonal Imbalances: Genetic conditions or hormonal issues can impact sperm production or quality.
- Lifestyle Factors: Smoking, excessive alcohol consumption, and stress can negatively affect sperm quality.
- Endocrine and Physiological Factors: Imbalances in hormone levels and other physiological conditions can also contribute to infertility.
When to Seek Help
If you are experiencing any of the following symptoms, consult a fertility specialist:
- A woman under 35 has been trying to conceive for a year without success.
- A woman over 35 should seek help after 6 months of trying.
- Either partner has known fertility issues or there are concerns about reproductive health.
Fertility by Age
“Fertility tends to be at its highest in women during their 20s and 30s. After age 35, fertility declines more rapidly, with a significant decrease in egg quality and quantity after 42. For men, peak fertility is generally between 25-30 years old, with sperm quality and volume decreasing after age 30, and a notable decline after 45,” highlighted Dr Sowmya.
Diagnostic Tests and Treatment Options
If conception is not achieved after a year of trying, it is important to undergo fertility testing. For women, this may include:
- Ovarian Reserve Testing: Using ultrasound to assess the health and number of eggs.
- Hormone Levels: Measuring AMH (Anti-Müllerian Hormone), prolactin, TSH (Thyroid-Stimulating Hormone), estradiol, progesterone, and LH (Luteinising Hormone) to evaluate hormonal balance and ovarian function.
“For men, a semen analysis can reveal issues with sperm count, motility, and morphology. Lifestyle modifications, such as managing body weight, quitting smoking, reducing alcohol intake, and improving general health can also improve fertility,” added Dr Sowmya.
Fertility Treatments
Couples facing infertility may consider various treatments, including:
- Ovulation Induction with Timed Intercourse (OI+TI): Medication to stimulate ovulation combined with carefully timed intercourse.
- Intrauterine Insemination (IUI): Introducing sperm directly into the uterus to increase the chances of fertilisation.
- In Vitro Fertilisation (IVF) and Intracytoplasmic Sperm Injection (ICSI): Advanced techniques to fertilise eggs outside the body and implant embryos into the uterus.
- Donor Programs: Using donor eggs or sperm when necessary.
- Surgical Procedures: Techniques like PESA (Percutaneous Epididymal Sperm Aspiration), TESE (Testicular Sperm Extraction), and TESA (Testicular Sperm Aspiration) to retrieve sperm when there are blockages or other issues.
Bottomline
Dr Sowmya concluded, “Infertility can be challenging, but there are many options available to help couples achieve their dream of starting a family. Early intervention and consultation with a fertility expert can provide guidance and effective treatment tailored to individual needs. Remember, every cloud has a silver lining—don't lose hope, and seek the support you need to overcome fertility issues.”
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your own professional if you are dealing with any health issues to avoid complications.]