Why all newly-married couples must focus on fertility education? Fertility 101

Fertility rates are decreasing at a plummeting rate and have become a matter of concern worldwide. Several recent WHO and UN reports have shed light on fertility concerns, highlighting the need for appropriate measures and timely actions. According to recent research, about 17.5 per cent of the adult population in the worldexperience infertility. Factors such as couples marrying later in life, increased pollution, lifestyle changes, and financial stress have led to delayed parenthood for many.

With the help of comprehensive fertility health education, newly married couples can better understand the factors affecting their fertility, take proactive steps to optimise their reproductive health and seek appropriate assistance, if needed.

Fertility education and tests shedlight on underlying dangers and help couples make well-informed decisions in future. It can offer valuable insights into reproductive health, including identifying potential obstacles to future pregnancies and gaining a better understanding of one's biological clock.

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Female Infertility

Some common female infertility conditions include:

Fallopian Tube Blockage: Scarring or blockages in the fallopian tube can make it difficult for the sperm to reach the egg and fertilise. Furthermore, fallopian tube damage is a by-product of infections such as pelvic inflammatory disease or ectopic pregnancy. Around 20 per cent of infertility cases involve fallopian tube blockage as their main cause of infertility.

Endometriosis: Endometriosis is a condition in which uterine lining tissue grows outside the uterus, most commonly on the ovaries, fallopian tubes, bladder, and/or colon. In some instances, women with endometriosis may not experience any painful symptoms, and diagnosis often requires a laparoscopy or an outpatient surgical procedure.

Endometriosis can lead to the formation of scar tissue between the uterus, ovaries, and fallopian tubes, which can impede the movement of the egg into the fallopian tubes. Additionally, it can give rise to endometrial cysts within the ovaries, obstructing the release of the egg or its collection by the fallopian tube.

Ovulation Problems: Ovulation occurs when healthy eggs are released, which are then fertilised by the sperm. Problems in the ovulation process often stem from hormonal imbalances. The hormones LH, FSH, and estrogen, which are essential for initiating egg release in each menstrual cycle, can disrupt ovulation if they are released at incorrect times or in improper quantities. Irregular or absent periods are the primary indications of obstacles in the ovulation process.

PCOS: Polycystic ovarian syndrome (PCOS) affects approximately 10 per cent of reproductive-aged women worldwide. This condition results in a hormonal imbalance that prompts the body to produce excess testosterone, leading to potential difficulties with ovulation. Women with PCOS may exhibit symptoms such as irregular or absent periods, excess body weight, excessive hair growth on the body or face, and acne.

Uterus Problems: When an egg is unable to attach to the uterine wall properly, it cannot develop into a viable fetus. Issues with the uterus can arise from factors such as fibroids or polyps, which are non-cancerous growths originating from the uterine wall. Depending on their size and location, these growths may have an impact on fertility. Additionally, scar tissue within the uterus resulting from infection, miscarriage, or abortion could also be a contributing factor. Unexplained lower abdominal pain or bloating could be indicative of uterine problems that may affect fertility.

STIs and AutoImmune Diseases: STIs such as chlamydia and gonorrhoea, and diseases such as lupus, diabetes, thyroid disease, and rheumatoid arthritis can interfere with one’s ability to conceive.

Underlying Health Conditions: Other potential causes of infertility in women may involve conditions such as uterine fibroids, immune system disorders, kidney disease, and diabetes, as well as premature menopause, among others.

Male Infertility

Some common male infertility conditions include:

Sperm Mobility Problems: The quantity of sperm released during ejaculation, known as sperm count, greatly influences the likelihood of conception. Men with a sperm count of 10 million or less per millilitre of semen may face more fertility challenges compared to those with a normal sperm count of 20 million or more per millilitre of semen.

A low sperm count is referred to as oligospermia, while the absence of sperm production is known as azoospermia. Issues with sperm mobility can arise due to various factors, including hormonal imbalances involving testosterone or other hormones, abnormalities within the testicles, exposure to specific environmental toxins or chemicals, certain medications such as steroids, genetic conditions, infections like chlamydia and gonorrhoea, or cancer.

Sperm Production Problems: It may seem obvious, but for sperm to reach the egg, it must be expelled from the penis. Male infertility can occur when there are issues or obstructions preventing this process. The causes of such issues include sexual problems like premature ejaculation or erectile dysfunction, retrograde ejaculation (when semen flows back into the bladder instead of being ejaculated through the penis), and blockages in the testicles or the tubes responsible for carrying sperm.

Heat Exposures: Regular use of saunas, steam rooms, hot tubs, whirlpools, and hot baths can temporarily hinder sperm production and diminish sperm count.

Underlying Health Conditions: Men with a medical history of genital infections, mumps occurring after puberty, hernia surgery, undescended testicles, or scrotal varicose veins (varicocele) may also encounter a reduction in fertility.

(Inputs byDr Vandna Narula, Senior Consultant -Fertility & IVF, Motherhood Fertility & IVF, Chandigarh)

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