The number of young Indian couples who have trouble conceiving a child is on the rise. Here'd why.
Couples whose efforts at conceiving a baby are consistently futile may not be merely unlucky. Often, there is a medical reason for their failure to conceive. Medically termed infertility, it refers to the inability to bear a child even after a year of repeated unprotected sexual intercourse.
Infertility does not refer to a specific disorder. On the contrary, it is an umbrella term that refers to a range of disorders, some of which affect men, while others are specific to women or both. There is something called 'unexplained infertility' where despite all investigations being normal, the couple fails to conceive.
Infertility is rising at a rapid rate -- nearly 30 million couples in the country suffer from infertility, making the incidence rate of infertile couples to be 10 percent. Study reports suggest that one in five healthy young men between the age of 18 to 25 suffer from abnormal sperm count.
According to Dr Ajit Virkud, former president of the Mumbai Obstetric and Gynecological Society and head of gynecology and obstetrics, K B Bhaba Hospital Bandra, "In every 100 couples, about 40 percent of the males suffer from infertility in comparison to 50 percent females. The causes of infertility in about 5 percent are unknown, while in the remaining 5 percent, the causes are common to both men and women."
If you are having problems conceiving a child, chances are one or more of the below reasons may be at play:
In men
These are some common reasons for infertility in men:
- Irregular sperm production: Sperm that are physically abnormal, or exhibit abnormal movement, are hampered in their attempts to fertilise the egg. Similarly, semen with a low concentration of sperm (10 million per millilitre or less) leads to infertility.
- Hampered sperm delivery: An inability to deliver sperm into the woman's vagina can cause infertility. There can be many reasons why this happens. Erectile dysfunction (inability to get an erection), early ejaculation, pain and physical or psychological obstacles during intercourse are some of the causes. Sometimes physical abnormalities such as a blockage or an abnormally located urethral opening too lead to this.
- Medical conditions: Certain medical conditions can hamper sperm production and cause infertility. These can include an undescended testis or a disorder of hormone-producing glands in the brain. Klinefelter's Syndrome, a genetic condition, causes underdevelopment of the testis, leading to inadequate sperm production.
- Infections: Certain infections can affect the quality of sperm and lead to infertility. These include STDs like chlamydia and gonorrhea, an attack of mumps after puberty or inflammation of the testis or prostate.
- Lifestyle: Lifestyle issues too impact fertility. These include obesity and a sedentary lifestyle, illness or dietary imbalances leading to deficiency of Vitamin C, folate, selenium or zinc. Smoking, taking drugs, drinking in excess, using steroids (to enhance muscles), exposure to toxins such as pesticides, or taking hot baths can all have the effect of reducing fertility. Besides, mental and emotional stress too are associated with a poor sperm count.
In women
Dr Virkud adds that the increasing rate of female infertility in rural areas of India is attributed to genital tuberculosis, whereas in urban India hectic lifestyles and erratic working schedules are responsible for conception problems in women.
These are reasons for infertility in women:
- Hormonal disturbances: Polycystic ovary disease (PCOD), a condition marked by excess production of hormones and lack of ovulation, is a common cause of female infertility. Thyroid disorders too induce infertility by interfering with the menstrual cycle. Other hormonal disturbances also interfere with ovulation and prevent conception such as an imbalance in hypothalamo-pituitary-ovarian axis function (fluctuations in the production of hormones by each gland).
- Fallopian tube defects: Damaged fallopian tubes prevent the smooth passage of the egg towards the uterus where it can implant, once it is fertilised. Because the fertilised egg cannot develop and grow, this results in infertility.
- Endometriosis: This is a condition where uterine tissue abnormally grows outside the uterus in other areas of the woman's reproductive system, leading to inflammation, pain and infertility.
- Medical treatment: The use of certain drugs sometimes induces infertility, though this is usually reversed with discontinuation of treatment. Other forms of treatment such as radiation or chemotherapy can also interfere with fertility.
- Lifestyle: Like in men, lifestyle choices also affect fertility in women. Smoking delays maturation of follicles (sacs containing immature eggs in the ovaries), and also leads to problems such as spontaneous abortion. Similarly, excess consumption of alcohol or caffeinated beverages like coffee has been linked to reduced fertility. Abnormally high or low body weight, often the result of a faulty lifestyle, is also known to disrupt menstruation and ovulation, leading to infertility.
Note that there is a positive correlation between obesity and infertility. Hormones are stored in body fat and hence it is important to diet and exercise to achieve better results. Small, frequent meals that are low in carbohydrates accompanied by a walk of at least 30 minutes daily are a must.
So if all your efforts to conceive a child have been unsuccessful over a period of six months or longer, it is best that you and your partner consult a doctor. A proper diagnosis of the specific cause of infertility in your case will enable the doctor to prescribe appropriate treatment to help you.
Reviewed by Dr Anita Soni, obstetrics and gynecology consultant, Hiranandani hospital, Mumbai.