Few insights into infertility incidence in India

Dr Sulbha Arora

In a country where traditions, family values, and societal norms play a prime role in shaping lives, infertile women often face severe social stigma. Many women believe that they bear a higher responsibility for infertility than men, which puts them under greater psychological stress and more prone to suffering severe social consequences. The stigma of not giving birth to children affects approximately 53 per cent to 64 per cent of female infertility patients worldwide. This stigma not only causes harm to the mental health of these women, but also affects their quality of life, making them bear the adverse social consequences such as domestic violence, marriage breakdown, or even delay in receiving the treatment.

According to a WHO report, the prevalence of primary infertility in India was 3.9 per cent (age-standardised to 25–49 years) and 16.8 per cent  (age-standardised to 15–49 years) using the “age but no birth” definition. Therefore, it is crucial to have a deep understanding of the patients’ stigma and effective intervention in alleviating it.

In India, the discussion of infertility as a circumstance in both men and women—has just recently gained recognition. A double-digit increase in infertility has made it a personal and societal health concern in India. Infertility negatively affects couples socially and financially, in addition to emotionally. India has a population of as many as 27.5 million infertile people, including men and women, according to the Indian Society of Assisted Reproduction.

Several lifestyle factors contribute to infertility, with low sperm count, lifestyle choices, alcohol consumption, insufficient sleep, delayed marriage, and the dilemma between pursuing a career or getting married being among the key influencers. These elements collectively play a significant role in affecting reproductive health and fertility. It’s essential to recognize the complex nature of infertility, as addressing these factors can enhance the chances of achieving successful conception.

When a couple has regular, unprotected sexual encounters yet is unable to conceive, the couple is said to be infertile. Around 30 per cent of known cases of infertility contain defective sperm, while 40–50 per cent are primarily caused by abnormalities of the female reproductive system. One of the biggest risk factors that can impact someone’s fertility is their age. A man’s fertility begins to fall after the age of 50, whereas a woman begins to decline after the age of 30 and continues to do so after that.

Low sperm count, influenced by various environmental and genetic factors, is a critical aspect of male infertility. Additionally, individuals’ lifestyles, characterized by stress, poor dietary habits, and lack of exercise, can contribute to reproductive challenges. Excessive alcohol consumption is known to impact fertility adversely, as it can disrupt hormonal balance and impair reproductive function. Inadequate sleep, often overlooked, can also be a contributing factor, as it affects the overall well-being of individuals, including reproductive health. Delayed marriage may pose challenges, as age can impact fertility in both men and women.

Furthermore, the modern dilemma of choosing between career aspirations and marriage can add another layer of complexity to the fertility equation, as individuals may face difficulties in finding the right balance. Addressing these factors through lifestyle modifications, timely medical interventions, and open communication about reproductive health can significantly contribute to improving fertility outcomes.

Infertility stigma can bring heavy mental pressure and psychological burden to female infertility patients and affect their quality of life. Therefore, effective and targeted psychological interventions should be developed to reduce the patients’ stigma and improve their quality of life.

As India continues to evolve, breaking free from deep-rooted stigmas surrounding infertility is crucial for the well-being of individuals and couples facing these challenges. Society must prioritize awareness and education, dispelling misconceptions through targeted campaigns and educational programs. Access to affordable infertility treatments is paramount, requiring improvements in healthcare infrastructure and financial support systems. By initiating open conversations, encouraging empathy, and challenging traditional norms, society can play a pivotal role in creating a more supportive and understanding environment for those dealing with infertility.

Psychological interventions and counseling services must be developed to help individuals and couples cope with the emotional toll of infertility. Advocacy for policy reforms, workplace sensitivity, community support, responsible media representation, and legal protections are essential components of a multifaceted strategy. By collectively implementing these measures, societies can build an environment that supports and understands those dealing with infertility, ultimately dismantling the social stigma associated with it.

Dr Sulbha Arora, MD, DNB, Clinical Director, Nova IVF Fertility, Mumbai