Lifestyle, late planning for pregnancy, low ovarian reserve cause infertility
| Date :23-Apr-2019 |
By Vikas Vaidya;
Lifestyle, late marriages, late planning for pregnancy, low ovarian reserve, diabetes, hypertension, increasing habits of smoking and alcohol etc have given rise to infertility. Premarital sex and improper use of contraceptives are also reasons behind rising cases of infertility. This is not disease but it has several social, economical and medical impacts. Considering its seriousness, The Hitavada talked to some gynaecologists of Nagpur on the issue to know from them more in-depth reasons and the remedies to improve the situation. Dr Vaidehi Marathe, President (elect) of Nagpur Obstetrics and Gynaecological Society (NOGS) said, “There has been 20-30 per cent rise in the last five years in India which is alarming. Increasing infertility rates are based on the lifestyle changes resulting in stress and obesity caused by lack of physical exercise, sedentary lifestyle, changes in eating habits and pollution accompanied by medical lifestyle disorders like diabetes, obesity and hypertension. Late marriages, late pregnancies are also responsible.
These days we find that the fertility index is going down from the age of 30. This affects not only women but also men too. The most common problems men face are low sperm count, morphology abnormalities and low motility of sperm.” Dr Rajasi Sengupta, a young and dynamic gynaecologist who has spent some years working in Government Medical College and Hospital (GMCH) commented, “An Infertility evaluation involves trying to find out why a couple has not become pregnant. It includes some tests and examination of both partners. If a reason is found it is possible to treat it and successfully overcome infertility. However, in about 10-15% cases, no reason is found whatsoever. Such cases are termed as ‘unexplained Infertility’ and may be amenable to treatment as well.
A couple should consider evaluation for infertility if they have had unprotected sexual intercourse for a period of one year. In case the age of the woman is above 35 years, then they can start it even after 6 months of not using any birth control.” Dr Priyanka Kamble, President of NOGS pointed out, “Apart from late marriages, late planning of pregnancy, obesity another important issue is of Polycystic Ovary Syndrome (PCOS). It is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.” The high risk pregnancy ultimately leading to caesarean, pelvic inflammation. Rise in alcohol, smoking intake by girls from early age, eating junk food, sweets, job stress are another habits of modern era becoming the major reasons for infertility, added Dr Kamble. “I will call it as disturbed lifecycle. These youngsters eat what they like but they are not aware heart does not like the edible food what the tongue like. More than 40% couples go to quacks.
They engage in premarital sex and come for Medical Termination of Pregnancy (MTP) in the second trimester. This period is counted from week 13 to week 28 - roughly months four, five and six. It is very dangerous and risky. Instead of surgical MTP they go for MTP through medication that is more dangerous. To add to their woes, the quacks catch them up leading to incomplete abortion. It may block fallopian tube so ovum can not travel,” Dr Dilip Guha, senior gynaecologist gave horrified picture. Dr Chaitanya Shembekar, Past President of NOGS elaborated on ovarian reserve according to him it is one of the factors that cause infertility. He explained, “I have noticed that there are many causes of infertility however two causes which are becoming very common nowadays are diminished ovarian reserve and male infertility or low sperm count.”
Elaborating about low ovarian reserve Dr Shembekar said, “Low ovarian reserve (Ovarian Reserve is a term that is used to determine the capacity of the ovary to provide egg cells that are capable of fertilization resulting in a healthy and successful pregnancy. With advanced maternal age the number of egg cell that can be successfully recruited for a possible pregnancy declines, constituting a major factor in the inverse correlation between age and female fertility) is a serious issue specially for Asians and Indians. Study by Carlos Iglesias et al in fertility and sterility journal clearly says that there is a 6 year difference between Indian and Spanish women as far as ovarian age and ovarian reserve is concerned. It means Indian women of 30 years age will have same ovarian reserve as that of Spanish woman of 36 years age. This is an alarm bell to all of us. I request everyone to marry early and complete family before the age of 30 years.”
“Human reproduction involves many systems like reproductive, endocrinal, body's defensive system working synergistically. Endocrine system deals with hormones and all hormones are in tune and rhythm. Also in infertility mind and psyche involved along with body. We call a couple of infertile when there is no pregnancy after one year of marriage without using contraceptives with regular sexual practice. Incidence of infertility is about 15 percent and is on rising trend. Why it is so? There are various causes of infertility. Male and female contribute equally,” pointed out Dr Sushma Deshmukh, well-known Gynaecologist and specialist in performing hysterectomy.
Dr Shembekar put another unique point it is about fashion of Oocyte or egg freezing for social reasons. “Social egg freezing is encouraged by MNCs like google and apple. They want their employees to freeze eggs at young age and marry later may be after 40 years of age. But we must try to understand the dangers in this attractive offer. Motherhood should be taken as priority as with advancing age there are many medical problems like hypertension and diabetes. So it is better to conceive at young age. And the fate of Oocytes frozen is not known. They may not withstand the freezing and thawing procedure,” warned Dr Shembekar.