CONDITIONS
Infertility
Infertility
Infertility means not being able to get pregnant (conceive). Infertility is when a woman is not able to become pregnant after she has been trying regularly for 1 year. Trying means having vaginal sex (where a man’s penis enters a woman’s vagina) without using any protection (birth control).
Couples facing infertility should not think they are alone. There are thousands of people who face this challenge of childlessness. Infertility can happen in both men and women. It may either happen because of a problem in partners at birth or would have developed sometime at later stages. Many times, infertility can also have no known cause. Nowadays, there are multiple options of increasing the chances of becoming pregnant. These are safe as well as effective.
What is the scenario of infertility in India?
India – with a population of 1.4 billion, is the most populous country in the world now. However, even with such high population, having a baby is problematic because of the decreasing rate of fertility (the ability of having a baby) in India.
Even in cities (urban areas) of India, the fertility rate is somewhat lowest in the world. Nearly 2.75 crore people are actively trying to have a baby but are not successful. The impact of living with infertility is that it has the ability of wrecking marriages and even people’s lives. The reason for this is because in Indian a woman’s worth is often measured by her childbearing capability.
What are the causes of infertility?
There are certain steps which lead to the formation of a baby. If any of the steps are missed – ovulation (when an egg is released), fertilization (when sperm joins with the egg), and implantation (when the egg takes hold in the uterus), it might result in infertility.
The causes of male and female infertility are different.
What are the causes of male infertility?
- Conditions that affect how much sperm is made or sperm quality. Sperm are cells in men that is very important for having a baby as it carries all information about the father into the mother (when sex happens). If quality of sperm is hampered due to lifestyle habits like smoking or health problems like diabetes or cancer treatments, then fertility may be hampered.
- Problems with sperm reaching the female reproductive tract. Once the sperm enters the uterus, it may not reach the required place (fallopian tubes) where fertilization occurs.
What are the causes of female infertility?
These may be because of fluctuation of hormones in the female body or due to some part of the reproductive system not working properly.
- Ovulation disorders: These conditions affect the release of eggs from the ovaries.
- Conditions of the uterus: Some growth such as uterine polyps (growth inside uterus lining), sometimes fibroids (tissue collection in uterus) can block the fallopian tubes, the area where an egg and sperm meet.
- Other causes: Fallopian tube damage or blockage, endometriosis (when the tissue like the inner lining of the uterus grows outside of the uterus), when the ovaries (makes the egg) stop working as they should, or certain types of cancer.
What are the risk factors for developing infertility?
A risk factor is something that may not directly cause that disease but may increase the chances of developing it. There are some risk factors that affect both male and female infertility. These are:
Age: As women age, fertility slowly declines, especially in the mid-30s. It drops lower and quickly after 37 years of age. The quality and number of eggs reduces as age increases and this affects fertility. Even men over age 40 may be less fertile than younger men.
Tobacco use. Smoking tobacco has many negative implications – it lowers the chances of pregnancy or if a couple is undergoing medical treatment, it might make it less effective. It also increases the risk of miscarriages. In men, smoking increases the risk of erectile dysfunction, and a low sperm count.
Marijuana and alcohol use: Marijuana or alcohol use may affect fertility by increasing risk of miscarriage and stillbirth (when the baby born at the time birth is not alive). For women, there is no safe level of alcohol use when they are trying to get pregnant or during pregnancy.
Being overweight: Not exercising and sitting all day at one place (An inactive lifestyle), may cause infertility. Being more than the proper weight may also result in lower quality of semen, the fluid that contains sperm.
Being underweight: Some people have the fear of gaining weight and hence are always with very low weight (anorexia). Such people might get fertility problems.
What are the symptoms of infertility?
The clearest symptom of infertility is not getting pregnant after trying for more than a year. Many couples eventually will conceive — with or without treatment. Following symptoms may indicate infertility and consult a doctor in that case.
In women symptoms may include:
- Irregular menstrual cycles, absence of periods, or abnormal pain or bleeding during your period
- Painful sex or bleeding during sex
- Miscarriage after pregnancy again and again (more than 1)
In men, symptoms may include:
- Problems ejaculating (removal of semen at climax) or keeping erection for a long time
- Symptoms of a hormone problem, such as changes in hair growth
- If the testicles are smaller in size than normal adult size (4 x 3 x 2 cm)
Can something be done to prevent infertility?
Couples
Men
- Stay away from drugs and tobacco and avoid drinking a lot of alcohol.
- Although not foolproof but taking frequent baths in hot water may affect short term production of sperm production and movement.
- Pollutants and toxins contain pesticides, lead, cadmium and mercury and their exposure can affect the body’s ability to make sperm.
- Work out. Regular exercise may improve sperm quality and boost the chances of a pregnancy.
Women
- Like men, smoking, alcohol, and drugs consumption may have bad effect on the fertility and on the health of an unborn baby.
- Limit caffeine: During pregnancy, the intake of caffeine is restricted but this is also suggested by doctors for women who are trying to get pregnant. Even some packaged foods contain caffeine. High caffeine effect may include miscarriage or preterm birth.
- Exercise safely. Regular exercise is key for good health. Just don’t over-exercise because it may indirectly affect infertility.
- Get a healthy weight. It’s always preferable to be healthy but especially when one is trying to get pregnant. This helps in the long run for a healthy pregnancy.
Even after all these measures, consult your doctor for infertility. Infertility treatment depends on:
- The cause of infertility.
- The time period of being infertile.
- Your age and your partner’s age, if you have a partner.
- Personal preferences.
If pregnancy doesn’t happen after a year of unprotected sex, couples often can still become pregnant through infertility treatments called assisted reproductive technology. But treatment will involve a lot of money, mentally and physically preparing the body for the treatment and time. Understanding all the options before going into these treatments is important.
References
- India population (Nov 14, 2023). https://www.worldometers.info/world-population/india-population/
- Nijkang NP, Anderson L, Markham R, Manconi F. Endometrial polyps: Pathogenesis, sequelae and treatment. SAGE Open Med. 2019 May 2;7:2050312119848247.
- Kundu S, Ali B, Dhillon P. Surging trends of infertility and its behavioural determinants in India. PLoS One. 2023 Jul 25;18(7):e0289096.
- Anita A. Galdieri, PharmD, RPh. (Nov 14, 2023). WebMD https://education.webmd.com/viewarticle/996556?mmtrack=2881-5589-10-1-5-0-2#3
- Infertility care (Nov 14, 2023). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/syc-20354317
