It’s common for young men and women to be publicly questioned about their marriage plans by the elders of the family after a certain age — roughly mid-twenties for women and definitely late-twenties for men. Turns out those questions have a solid base in science, as not just the naanis and masis but now many doctors believe that late marriages and the laptop-based urban lifestyle do affect the fertility of a couple.
Lower fertility has led to the rise in number of in-vitro fertilisation (IVF) clinics. IVF is a procedure used to help a woman get pregnant. "During IVF, mature eggs are collected from ovaries and fertilised by sperm in a lab. Then the fertilized egg (embryo) or eggs (embryos) are transferred to a uterus. One full cycle of IVF takes about three weeks," Mayo Clinic explains.
Around 15-20% population is infertile
Right now, in India, around 15-20 percent of the population is struggling with infertility and experts say late marriages and delay in family planning are among the reasons. "The infertility is also on the rising trend — both in males and females," Dr Reena Gupta said.
Dr Meenu Vashisht Ahuja, a consultant at Birla Fertility and IVF told CNBC-TV18.com that the fertility potential of a couple drops with growing age. This is because women's eggs have very short half lives.
She said: "10-15 percent is not a small number if you look at the Indian population base," she said.
Meanwhile, Dr Kaberi Bakshi said, "The infertility index of the general population is 10-15 percent of the couple in the reproductive age group. In metropolitan cities, that may even go as high as 20 percent."
When asked about the right age to plan pregnancy, Dr Reena Gupta said, "Ideally by (the age of) 35, you should complete your family,” meaning have at least one child.
"After that, the egg quality and quantity go down and the success rate of fertility treatment also declines after the age of 35," she said.
Other reasons for infertility
Besides age, environmental factors, sleeping late, drinking alcohols, smoking hookahs, putting on weight, no exercise and even using of laptops play a role in affecting the fertility of couples in big cities.
The increase use of laptops — when you keep on laps — heats the testicles which destroys sperms, experts said.
Also, Rita Bakshi notes, "(With women working now), it's difficult to have intercourse exactly on the (fertile) days."
In rural areas, infertility is mainly due to infections and "tuberculosis affecting ovaries."
IVF market expanding
Experts said that over a decade, there has been a significant rise in the number of IVF clinics. There's a need, so the market is expanding, they said.
While increasing infertility is one reason, awareness is another. "The taboo associated with infertility is slowly reducing," Dr Bakshi said.
Besides this, more young people are getting trained for the IVF treatment. "Training courses and fellowships started and so, people started setting up mechanisms in their own hospitals and didn't want to refer to the specialised centre. Therefore, fellows are increasing and youngsters are taking up the course," said Dr Ila Gupta.
Dr K.D. Nayar was more sceptical. He said these clinic are an easy source of making money. Dr Reena Gupta seconded him, saying that people feel they milk revenue as it's a costly treatment. The cost of IVF ranges between Rs 1.5-3 lakh.
But, Dr Ahuja said there's huge gap between demand and supply; therefore, to meet that rising demand, more IVF clinics are cropping up. "As many as 2,50,000 to 3,50,000 cycles of IVF are currently being done in the country, whereas the need is about 6,00,000 cycles... we have to do 50 percent more than we have been doing," she said.
How good it is to normalise infertility treatments?
At a time when technologies have advanced, should you be content thinking that late marriages or continuous drinking and smoking are fine when you have an IVF treatment as an option to solve your problems?
Dr Nayar said while it is boon for people who are not able to conceive naturally, "it is no substitute to natural conception."
IVF does not even guarantee 100 percent success and is also an expensive procedure. While Dr Rita Bakshi said the success rate of IVF is 35-50 percent, Dr Sandeep Talwar said it is around 50 percent and Dr Reena Gupta said it is 55-60 percent.
Dr Ahuja said if a couple can conceive on their own, then they should do that. "Even we don't push a person to IVF straightaway. We always try to give them a very mild treatments to start with." She added that one must be aware of their fertility potential even before they enter into a stage of wanting to become a parent.
Patients who may not need IVF are often prescribed medicines and asked to have timely intercourse. The other treatments are ovulation induction and intrauterine insemination (IUI), a type of artificial insemination.
