17 September 2012
Of 60–80 Mn Infertile Couples In The World, 15–20 Mn Are Indians
Infertility is affecting more and more couples nowadays due to lifestyle–related causes.
Though many people still think of infertility as a woman’s problem, close to half of all cases of infertility involve problems with the men. In fact, about 20% to 30% of the time, a man’s low fertility is the main obstacle to conception, say experts.
"In the past, female infertility accounted for 60% cases, male infertility for 25%, while combined factors were responsible in remaining cases. However, today the male factor is prevalent in 50% cases. One in every five healthy men, in 18 to 25 age group, suffer from abnormal sperm count. In every 100 couples, 40% males suffer from infertility, compared to 50% women. In the remaining 5%, the cause are common in both men and women," said infertility expert Anil Chittake of Aditya Birla Memorial Hospital. (ABMH).
According to a report by the International Institute of Population Sciences, infertility was growing at an alarming rate, especially in metros. It has been estimated that, globally, of the 60–80 million couples suffering from infertility, about 15–20 million are in India alone.
Highlighting the causes of infertility among men, Chittake said, "The most common reason is low count and motility of sperm. Other medical reasons are problems with ejaculation of semen, cancer of the genital system or exposure to chemotherapy or radiation therapy, diabetes, mumps in adolescence or immunological infertility where antibodies are formed against the sperms."
According to experts, the treatment options for male infertility are: medical (hormones, multivitamins and antioxidants) for a period of three months; surgical (varicocle litigation in properly selected cases); IUI (intrauterine insemination); and IVF (in vitro fertilization)/ICSI (intracytoplasmic sperm injection of eggs).
Similarly, experts point out an alarming growth of infertility among young Indian women over the last decade. The rising statistics is due to social changes that have been taking place over the past decadeand–a–half.
"More women are focusing on their careers and are marrying late. The very process of planning a baby is delayed. Even today, most women are unaware of the exponential decline of fertility after the age of 35," experts in the field said.
Elaborating further, IVF specialist Seema Jain said, "Latest research indicates that 10% urban Indian couples in their reproductive age are infertile. However, among women of 35 years of age and above, it is as high as 30–40%, because women are born with a fixed pool of eggs: one to two million at birth, 3,00,000–5,00,000 at puberty, which reduces to about 25,000 when a woman turn 37, and further goes down to 1,000 by the time she hits menopause."
"From the age of 32, the ability to conceive per monthly cycle decreases gradually but significantly, and goes down rapidly after 37. This shows a decrease in the egg quality. Lack of sexual activity is also a contributing factor," said Jain. So it’s very important that both men and women go for a check–up at the right age to enjoy parenthood, she added.
"Earlier, most of my patients, who used to opt for IVF treatment, were in the age group of 38–45 years. But in the last five years, I have observed a shift in the age group of women seeking this treatment. Today, about 70% of my patients are in the age group of 23–32. This trend is visible only in urban areas", Jain said.
In women, the cause of infertility includes tubal disease, ovulatory dysfunction, endometriosis, immunological factors, congenital abnormalities and sexual dysfunction or unexplained factors. Techniques such as in vitro fertilization and embryo transfer (IVF–ET) and intracytoplasmic sperm injections (ICSI) have superseded older therapies, and in some cases have provided a back–up when all other therapeutic options fail.
"With advances in technology, the success rate of assisted reproductive technology has steadily increased in the past few years. Today, the success rate of all of these is around 35–40% and take home baby rate per cycle varies between 20–30% and cumulative pregnancy at the end of four attempts is between 60–70%", Jain said.