Dr. Shilpa Ellur- Senior Consultant - Reproductive Medicine & High-Risk Obstetrician, Milann Fertility Center Bengaluru.

Infertility Surge in India: Rising Concern Among Young Women.

Health

Bengaluru (Karnataka) [India] August 7 : Infertility is becoming a significant health concern in India, impacting not only couples but also a growing number of adolescents and women in their twenties, which was once considered an issue mainly for older women. This trend prompts questions about the underlying causes. Is it primarily due to sedentary lifestyles, or do genetic and biological factors play a crucial role? Indian women experience a more rapid decline in ovarian function than their Caucasian counterparts, significantly affecting their fertility.

Understanding Infertility and Its Effects on Women

Infertility is the inability to conceive after a year of regular, unprotected intercourse. Female factors are responsible for roughly one-third of infertility cases, though determining the exact causes can be challenging.

Irregularities in the menstrual cycle, such as cycles that are too long (over 35 days), too short (under 21 days), irregular, or absent, can indicate problems with ovulation. Often, these irregularities occur without any other noticeable symptoms.

This shift is driven by lifestyle changes, environmental pollution, delayed childbearing, and lack of awareness and healthcare facilities.

Lifestyle and Environmental factors

A sedentary lifestyle and poor diet have increased obesity, causing hormonal imbalances and reproductive issues. The Indian Society of Assisted Reproduction (ISAR) found that 10-15% of Indian couples face infertility, often affecting women in their prime. Alcohol, smoking, pollution, pesticides, and heavy metals further harm reproductive health and reduce fertility.

Hormonal Imbalances

Hormonal imbalance is the major condition that leads to irregular menstrual cycles and disruptions in ovulation. Like:

  • Polycystic Ovary Syndrome (PCOS): The Federation of Obstetric and Gynaecological Societies of India (FOGSI) reports that over 20% of women in their twenties are affected by PCOS.
  • Both hypothyroidism and hyperthyroidism can impact fertility by disrupting ovulation and complicating conception.
  • Chronic stress can also disrupt hormonal balance, impacting the menstrual cycle and ovulation.
  • Primary Ovarian Insufficiency (POI) causes early ovarian hormone and egg loss, leading to irregular ovulation. Pregnancy is rare but possible, with 5% to 10% of women conceiving without treatment.

Structural Issues

  • Structural issues can hinder fertility by blocking fallopian tubes or causing uterine abnormalities, affecting egg transport, fertilization, and implantation.
  • Endometriosis causes painful periods and can hinder fertility by blocking the fallopian tubes with tissue growth outside the uterus.
  • Uterine fibroids can sometimes cause infertility, miscarriages, or preterm labor, though many women with fibroids can conceive naturally.
  • Polyps are noncancerous growths in the uterus that can obstruct its function and complicate pregnancy. Removing polyps may improve fertility.
  • Uterine scarring from previous injuries, infections, or surgeries can increase miscarriage risk and interfere with implantation.
  • An unusually shaped uterus can impact implantation and the ability to sustain a pregnancy.

Autoimmune Disorders

Autoimmune disorders can impair fertility by causing inflammation or medication side effects. Both men and women may develop antibodies that attack reproductive tissues or sperm.

Many women lack knowledge about menstrual and reproductive health, leading to delays and barriers in seeking care.

Conclusion:

Thus, Infertility is a result of spectrum of conditions arising due to our acquired lifestyle, due to genetic issues and extending upto affected general health in both males and females who are contributing equally to today’s era.

The infertility treatment varies from lifestyle modifications, medications, assisted reproduction techniques to infertility related surgeries depending on the cause.

Basic understanding and adopting healthy lifestyle allow to move one step closure to achieve pregnancy.

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