Infertility is a global reproductive health issue affecting young men and women, yet it remains a rarely discussed and often overlooked topic. Despite being recognized as a public health concern by the World Health Organization (WHO), it has not received the necessary attention.
Previously considered a problem confined to metropolitan areas, infertility is now prevalent even in smaller cities like Jammu and Srinagar. The increase in infertility centers in these cities over the past few years reflects this trend.
Experts attribute infertility to various factors. While some point to biological causes, others highlight the impact of social, health, and lifestyle factors such as excessive fast food consumption, smoking, drinking, and drug addiction.
The implications of infertility are significant, causing financial and emotional stress for couples, alongside social stigma. Despite its gravity, open discussions about infertility remain scarce, and there is widespread ignorance among young people. It is crucial to educate the youth about infertility, its causes, diagnosis, and treatment to prevent this public health issue from being ignored and to help young couples achieve parenthood.
In an effort to shed light on this issue, this correspondent consulted leading gynecologists and sociologists in Jammu. Dr. B. R. Bhagat, a prominent gynecologist, explained that the inability to conceive after 12 months of unprotected intercourse is termed infertility. Infertility can be primary, where the couple has never conceived, or secondary if they have conceived at least once before. Presently, 10 to 15% of couples are infertile, with rising rates due to factors like delayed marriage, job insecurity, and global warming.
Infertility is not solely a female issue. Dr. Bhagat emphasized that in 40 to 55% of cases, female factors are responsible, while male factors account for 30 to 40% of cases. About 10% of cases involve both partners, and 10 to 13% of cases remain unexplained.
Age is a significant risk factor for infertility. Female fertility declines after 35 years, and male fertility after 50. Couples should seek evaluation after one year of trying to conceive, or after six months if the woman is over 35. Immediate evaluation is recommended for women over 40.
Pre-conception counseling is essential for couples planning to conceive. Dr. Bhagat advises couples to discuss lifestyle factors, medical history, and any associated diseases. Obese individuals are encouraged to lose weight and quit smoking and alcohol. Optimizing conditions like diabetes, thyroid disorders, and hypertension, along with taking folic acid, is also recommended.
Female infertility can stem from issues with the fallopian tubes, uterus, or ovulation. Diagnostic tests include blood tests, hysterosalpingography (an X-ray of the uterus and fallopian tubes), and laparoscopy. Male infertility can result from congenital malformations, viral infections, or conditions like varicocele. Semen analysis and other tests are used for diagnosis.
Treatment for infertility involves addressing both partners. Dr. Bhagat mentioned that for females with regular menstrual cycles and patent fallopian tubes, treatments like super ovulation and intrauterine insemination (IUI) are options. Blocked fallopian tubes may require IVF or ICSI. For males with normal semen, IUI is advised, while those with azoospermia may need sperm retrieval procedures. Surgical options like vasoplasty and tuboplasty can also be considered.
Prof. Vishav Raksha, a sociologist, noted that social factors like delayed marriage and childbearing due to career and education pursuits, as well as the rise of nuclear families, contribute to infertility. Urbanization and changing lifestyles have also played a role in increasing infertility rates.
Dr. Twinkle Gupta, an Ayurveda expert, highlighted that mental disturbances, improper diet, and lifestyle choices impact fertility. Ayurvedic treatments like Ashwagandha for males and Shatavari for females can enhance fertility. Healthy diet, lifestyle modifications, and practices like yoga and meditation are also beneficial.
To reduce the risk of infertility, Dr. Twinkle recommends maintaining a healthy weight, regular exercise, quitting smoking, and not delaying parenthood when ready. Being informed and proactive about health is crucial.
In summary, addressing infertility requires a multifaceted approach, encompassing medical treatment, lifestyle changes, and social awareness. With proper education and support, young couples can navigate the challenges of infertility and achieve their dream of parenthood.
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