WHO suggests that worldwide, about 8-12 per cent of couples suffer from infertility, and its incidence rate varies worldwide. Despite increasing access to infertility treatment services and specialists, dealing with infertility is one of the toughest challenges women face across India .
The infertility issue is serious yet neglected, and it is frequently overlooked in public health discussions, which may cause a huge adverse impact on people’s reproductive and productive life in the long-term. Across India, couples are facing the infertility heat. The Indian Society of Assisted Reproduction says as many as 27.5 million couples , about one in six couple in urban India are impacted by infertility.
Infertility in India
The country’s rising infertility rate is a big issue, particularly in south Indian states. This high infertility rate in southern states may also contribute to overall total fertility rate (TFR) decline.
The estimates of the Census of India (1981, 1991, 2001) show that infertility in India has increased among reproductive – age couples. It has risen from 13 per cent in 1981 to 16 per cent in 2001 among ever- married women.
It has been observed that the infertility rate has declined between 1998–99 and 2005–06. Furthermore, another study from India found that about eight per cent of currently married women suffered from primary (inability to conceive) and secondary infertility , of which 5.8% per cent were secondary infertile (inability to bear a child after having an earlier birth) .
The infertility rate is higher in developing countries due to sexually transmitted infections and a lack of adequate and modern medical facilities.
Research studies across the globe have revealed that the living environment of a couple such as frequent exposure to heat and noise etc have adverse effects on the couple’s reproductive life.
People with high body mass index (BMI), that is, excess weight, have a major impact on menstruation. They are also affected in terms of infertility, miscarriage, pregnancy, and labour.
The Risk of Infertility
Cigarette smoking, alcohol consumption, induced abortions and prior contraceptive use also increase the risk of infertility.
Working women have a high rate of infertility, which must be primarily due to a stressful work environment, which significantly impacts the menstrual cycle. Stressful life events like work stress and family pressure are associated with menstrual disorders, which lead to polycystic ovarian syndrome or disorder, and ultimately result in infertility.
The alarming trend of infertility requires establishing an infertility management chain. This chain should include trained doctors, counsellors, and health professionals. They can provide information on the cause and treatment at a reasonable cost.
Primary fertility decreases with age and is higher among younger women, while secondary infertility is higher among older women.
Increasing education among girls leads to a low risk of infertility, especially secondary infertility. Rich and upper-caste women face a high risk of secondary infertility. In contrast, poor and lower-caste women have an increased risk of primary infertility.
Overall trends show that primary infertility declined, but secondary infertility increased massively in the last three decades. Enhancing the current health and reproductive programmes, educating people about improving their lifestyle choices and sexual behaviour and calling attention to a significant shift in fertility dynamics.
(Dr Naresh Purohit is advisor for National Reproductive and Child Health Programme. The views expressed are that of the author.)