IVF need not be first choice for fertility issues; healthy lifestyle and sexual intimacy are crucial

Hyderabad: Medical experts are noticing a continuous rise in fertility issues among couples, stemming from physiological and psychological factors. On a macro level, for the world’s most populated country, it won’t make much of a demographic difference if some couples do not opt for parenthood by choice or due to medical reasons. But on an individual level, it becomes a cause of concern as most couples aspire to embrace parenthood someday.

More and more young couples are seeking medical help or turning to IVF methods to conceive due to fertility issues and lack of sexual intimacy. Let’s see what health experts have to say on this issue.

Men and women can have fertility issues

In order to successfully conceive, both eggs and sperms need to be healthy. Elaborating on the fertility issues in couples nowadays, Dr Anitha Kunnaiah, senior gynaecologist and fertility specialist at Yashoda Hospital said, “Instead of calling it by the derogatory term ‘infertility,’ I would rather say, sub-fertility is caused by any structural or functional disturbance in the path of production of eggs, sperms and reproductive organs of the male and the female. It can be genetic defects or certain anomalies in the organs or infections, which disrupt the formation of the embryo normally. We find both men and women equally having these problems. However, usually, the male partner does not volunteer for a check-up and assumes that the fault is with the female partner, which may not be true in 50 per cent of the cases.”

Causes of conception-related problems

The causes affecting the quality of reproductive life can be related to lifestyle as well as the external environment. “These include pollution, fertilisers in food grains, faulty food habits that include smoking, drinking alcohol, eating processed and junk food, especially processed meat and dairy products, disturbed sleep pattern, excessive work stress and lack of quality time for intimacy with partners, obesity, diabetes, hormonal issues, PCOD, and overexposure to electronic gadgets that cause hormonal disturbance. Wearing excessively tight jeans also affects blood circulation and sperm count in males. Also, eating food or drinking water in plastic containers can act as endocrine disruptors as plastics release toxic chemicals,” said the gynaecologist.

Male fertility issues

Dr Chandramohan Vaddi, urologist and director of Preethi Urology and Kidney Hospital, Hyderabad said, “Increasingly, fertility issues like erectile dysfunction and low sperm count are noted in men, especially those into white collar jobs i.e. IT professionals.”

“Various factors such as late marriages, opting for parenthood in the late 30s and 40s, excessive work stress, lack of family time and intimacy among couples, prolonged exposure to electromagnetic radiation from laptops, can adversely impact sperm count,” the urologist said.

Case study: Woman battling Vaginismus opts for fertility treatment

A 30-year-old woman, married for five years, visited a fertility centre with the complaint of being unable to achieve vaginal penetration and was extremely fearful of the pain related to penetration. Her medical examination revealed no physical abnormalities. As their relationship progressed, she withdrew from any kind of sexual contact. She reported that her partner was supportive and he was present throughout her initial medical examination.

She was a homemaker and her husband was a photographer, whose work demanded travelling at night. That was also one of the issues the couple had. They lived in a joint family and lacked adequate privacy. Even though she was educated about sexual aspects, she didn’t have much exposure. Rather, interaction with her friends made her believe that sexual intercourse would be painful and there will be chances of bleeding. They had come for treatment because of family pressure, hoping that IVF can help them in conceiving.

“She hyperventilated during the initial exam and was diagnosed with primary vaginitis (inflammation of the vagina). We initiated our vaginitis protocol. Although the patient was extremely anxious, she was cooperative when the catheter was inserted during the dilation process. As a part of psychological counselling, the couple were counselled individually and later together. In the process of counselling, we got to know that the husband and wife have a healthy relationship. We have recommended sexual intercourse for a few months to conceive naturally,” said the doctor treating the woman.

Vaginismus – a treatable problem

Dr Pallavi Prasad, fertility consultant at Nova IVF Fertility, Bengaluru explained, “Vaginismus is a disorder characterised by involuntary pelvic muscle spasms that make vaginal penetration painful or difficult, it even includes sexual intercourse and gynaecological exams. It may cause infertility and have an impact on a woman’s ability to become a mother. Moreover, since women with vaginismus may not feel sexually satisfied, it can cause physical and emotional pain.”

“The predominant symptom of vaginismus is severe fear and anxiety towards any attempt at penetration, which leads to avoidance of sexual interaction. Past trauma, a lack of sex education, cultural views, anxiety, and interpersonal troubles are some of the causes. Medical treatment, counselling including cognitive-behavioural therapy, and physical therapy, as well as partner support, are vital in treating vaginismus in order to overcome emotional barriers and restore sexual health and intimacy,” the doctor said.

Remedies

To counter fertility-related issues, medical experts advise the partners to consult doctors and get themselves evaluated. Conceiving should be tried naturally first and IVF should be the last option if everything else fails. Apart from treatment and counselling, they also recommend eating home-cooked healthy food, an hour of physical exercise daily, seven to eight hours of undisturbed night sleep, de-stressing oneself with deep breathing exercises, yoga and meditation and spending quality time with partners without electronic gadgets around.

Statistics

The fertility rate in India since independence: Average live births per woman

(2021 to 2023) 2.1

2020 – 2.2

2015 – 2.3

2010 – 2.6

2005 – 3.0

2000 – 3.3

1995 – 3.6

1990 – 4.0

1980 – 4.8

1970 – 5.5

1960 – 5.8

1950 – 5.9