Infertility

Delhi has the lowest fertility rate among Indian states, with a Total Fertility Rate of 1.5, which is significantly lower than the national average (2.2). The growing problem of low egg reserve is one of the most significant factors contributing to lower fertility rates in urban women. Stress, pollution, pesticide exposure, and smoking and alcohol addiction are all major causes of this condition. A recent study found that one in every two women who were unable to conceive had a low egg reserve. Previously, it was a problem that arose with increasing age; however, this has changed. Low egg reserve is a common concern among today's young girls, with women as young as 27 years old experiencing infertility as a result. Consider the story of Kajol (name changed), a young woman who had given up hope of ever becoming a mother after two failed IVF blastocyst transfers (implantation of the embryo in the uterus). She had been dealing with primary infertility for eight years and had been diagnosed with a low Anti-Mullerian Hormone (AMH) concentration, which indicates how many viable egg cells a woman still has. Donor eggs are almost always required in these situations because the woman's body does not produce enough eggs for retrieval. During an ultrasound, Kajol was also diagnosed with a very low Antral Follicle Count (AFC), which dashed her hopes even further. Ovarian Rejuvenation Therapy, also known as ovarian PRP, was used to allow Kajol to become a biological mother of a daughter, effectively ending their wait. Ovarian PRP is a quick and easy procedure that improves the organ's ability to generate eggs. This is critical for women with low AMH, because the typical stimulation of the ovaries during IVF may not produce the optimum results. Preparing the ovaries and then stimulating them boosts the odds of retrieving high-quality eggs and, as a result, higher-quality embryos. To generate platelet-rich plasma (PRP), we drew around 5ml of blood, spun it, and added reagents - the entire procedure took about 20 minutes. The PRP was then injected into the ovaries at least twice during the menstrual cycle's first 14 days. In the following cycle, we stimulated her ovaries for eggs and discovered that ovarian PRP worked for her. Intracytoplasmic sperm injection (ICSI) produced two grade-1 blastocysts, and frozen embryo transfer was performed the following cycle, with the implant successful on the first try. During antenatal screening, the nuchal translucency scan, dual marker, and non-invasive prenatal testing were all normal. Kajol is one of many women who have struggled for years to conceive due to a low egg reserve. With fertility rates declining, egg freezing is more important than ever for women. This procedure enables a woman to plan her pregnancy without fear of becoming infertile in her 30s. As a result of increased awareness, an increasing number of young women are choosing to freeze their eggs. We have seen an increase in the number of women under the age of 35 who have chosen to freeze their eggs in the last year. This is a safe and reliable option for any woman, married, single, or in a relationship. The eggs can be stored for up to ten years before being thawed and fertilised whenever she wants. (Dr. Gauri Agarwal, Founder & Director, Seeds of Innocence and Genestrings Diagnostics) Read More► How to Maintain A Healthy Liver

New Delhi, June 25 (IANS) The Union Ministry of Health and Family Welfare on Friday dispelled rumours that Covid vaccines cause infertility, saying that most of the people who receive the shots do not face any side-effects post inoculation, but it does not mean that the jabs are not effective.Covid vaccines do not cause infertility, the ministry said in a statement."At least six different types of Covid-19 vaccines will be available in India soon. We expect to procure 30-35 crore doses in a month to be able to vaccinate 1 crore persons in a day," the ministry said.N.K. Arora, Chairman, National Technical Advisory Group on Immunisation in India (NTAGI), said: "When the polio vaccine came and was being administered in India and other parts of the world, this sort of a rumour had spread at that time too. At that time, a misinformation was created that children who are getting polio vaccine may face infertility in the future."This sort of wrong information is spread by the anti-vaccine lobby. We should know that all vaccines go through intense scientific researches.""None of the vaccines has this sort of a side-effect. I would like to fully assure everyone that this sort of propaganda only misguides people. Our main intention is to save ourselves, our families and the society from coronavirus," he added.Arora further said that if the efficacy of a vaccine is 80 per cent, 20 per cent of the vaccinated people may contract mild Covid. The vaccines available in India are capable of reducing the spread of the virus. If 60-70 per cent people are vaccinated, the spread of the virus can be checked, Arora said.He said that as far as side-effects are concerned, all vaccines have mild side-effects. This includes mild fever, fatigue, pain in the injection site, for a day or two. It does not cause any serious problems.Most people do not face any side-effect after Covid vaccination, but it does not mean that vaccines are not efficient. Only 20-30 per cent people are going to experience fever after vaccination. Some people may get fever after the first dose and not have any fever after the second dose and vice-versa. It varies from person to person and it is highly unpredictable, experts said..--IANSmiz/sdr

Covid-19 can cause male infertility by harming the testicular cells which produces sperms thereby making it difficult to make the female pregnant, says a new study done by the scientists of Israel. The study, published in the journal of Fertility and Sterility, claims that the studied men had a reduction of around 50 percent on average of the number of sperm per milliliter, total volume of ejaculate, and motility of sperm. Nobody knows yet how severe this problem is and these effects are reversible or not. Infection is accepted as a possible underlying cause of male infertility. For example mumps may have a long term effect on fertility of male patients and can cause azoospermia, so we know viruses can have such an impact. Dr Shobha Gupta, Medical Director and IVF Specialist from Mother's Lap IVF Centre says: "I wouldn't be surprised if this virus causes a temporary down in sperm production. People who get corona virus are probably quite unwell, they are having low immunity even influenza will cause a decline in sperm count temporarily. The question is how long it will last and whether it is recoverable." "Every time there is a new thing coming up with this virus, we are still learning and if the person has low immunity and is prone to catch the infection in any way the sperm count is affected and can cause male infertility" she added. Dr Shweta Goswami, Sr. Consultant IVF from Jaypee Hospital Noida and IVF Consultant from Zeeva Clinic explains: "Any viral infection but just Covid-19 can lead to high grade fever and decrease in sperm count and motility at least temporarily. It's too early to suggest anything for Covid-19 as semen changes can take up to 3-4 months post infection and numbers are too low at present but it could potentially cause harm and any sort of illness fever can reduce sperm count and motility and this may hold for corona virus as well." Mask-wearing can help to protect their fertility during the pandemic, even if one ultimately becomes infected. "Men who have moderate or serious Covid-19 infections could find their fertility impaired for an unknown amount of time. Because mild cases don't seem to affect fertility, I would advise men to wear facemasks. This way, even if they get sick, their immune systems will be dealing with a smaller viral load and consequently they'll have a milder form of the disease and there has to be more studies to confirm how severe this problem is, once the patient recovers semen parameters may improve" said Dr. Anubha Singh, another city based Gynecologist and IVF Specialist from Shantah Fertility Centre. "If people are protected by a mask, and the smaller the load of catching the infection, the better the immune system's chances of beating the virus while still in the mild stage and having minimal impact on sperm" added Dr. Anubha Singh. Choose a healthy life and take precautions, as this virus is very new and nobody knows how to recover from it or how not to catch the infection. So we have to be our on guard till the vaccine comes. Follow these advices as precautions to protect fertility: Wear Masks and do proper sanitizing Avoid being overweight Do not smoke and refrain yourself as much as you can from consuming alcohol Do not wear tight underwear as it can affect the circulation of blood in the genital region and raise the temperature of the testicles which further decreases the sperm count Avoid keeping mobile phones near genital area as it causes radiation also do not place laptops on your lap as it can raise the scrotum temperature Eat nutritious food and exercise regularly to maintain healthy immunity (Puja Gupta)

There have been two major changes in our societal fabric in the past decade or so. First is the shift from joint families to nuclear families which translates into a lack of help from family members in raising our children and demands sacrificing at least one person's career, in most cases the woman, to take care of the baby. So the couple keeps postponing pregnancy and hence the rise in the number of DINKs (double income no kids) couples. Lifestyle ailments are increasingly playing villain, especially obesity and diabetes. Over 40 per cent of young men and women are either overweight or obese. Sexually transmitted infections and polycystic ovarian syndrome (PCOS) are other new areas of concern among women. A rise in unprotected sex has led to sexually transmitted infections (STIs) and widespread use of both emergency contraception and surgical abortions, which can trigger serious infections that may cause irreversible infertility, Dr Kaur points out. "Second, is the advent of social media and with it among other things, the pressure to live a certain kind of lifestyle. There is a constant pressure to earn more, achieve more to be seen and talked about more. It has changed our priorities and so getting married or having babies doesn't seem as important." The expert lists down few important points related to infertility and pregnancy: The right age to conceive: It is very important to bust this myth about age and IVF and to educate young couples that every female is born with a finite number of eggs in her ovary which depletes with every passing year. This decline is very rapid from 35 years of age and the success rates with any fertility treatments including IVF decrease with each passing year beyond the age of 32. Also conception - It is not a female problem. And a man can equally be responsible for fertility issues, just like the woman. Female factors are responsible for infertility in about 40-50 per cent cases and male factors are directly responsible in about 30 percent cases and contributing indirectly in nearly 50 per cent . Job pressure: Women and men have made it their lives' goal to work and earn and in turn have lost all connectivity with their own selves. A lot of people are found to look after their physical health by exercising, trying to eat right. However, they have been made to believe that work is life and hence looking after their mental health is avoided by many people altogether. No elder family member to guide : People believe in living in a nuclear family these days and they prefer to live in cities with high paying jobs. The joint-family system is completely broken, also there's been a decline in the Interpersonal relationship of couples and hence there are hardly family members to guide a couple regarding conception. Women are under a lot of work pressure at offices, adding to that is the pressure of looking after their homes and men work twice as hard to keep up their lifestyles. Amidst all of this, couples almost end up not having the confidence to take the responsibility of children and hence wait too long to conceive. Obesity in men as well women: Obesity is a poison from both men and women trying to conceive. It leads to decline in the number, motility and overall quality of sperms in men and causes poor quality egg production in women. All this may lead to lack of ability of the sperm to fertilize the egg and lack of ability for the fertilized egg to be implant in the uterus. Smoking, alcohol, drug and substance abuse: Couples should start taking such concerns seriously, alcohol, smoking, drug and substance abuse is as bad as it sounds. The damage done is permanent and can't be recovered. No amount of intoxication is alright for the body. Way forward: Infertility is a complicated issue and many things are involved in it as stated above. Women shouldn't wait till they are above 30 years of age to conceive. The best thing to do is to seek a doctor's guidance early in life. A doctor can do a number of tests to find the cause at the beginning itself and if needed a useful treatment plan can be developed to increase the chances of conception, says Dr Kaur. "Women who are advancing in age and have late marriages should be made aware egg preservation methods. Women are born with a finite set of eggs that get depleted through the course of their lives hence it is important that working women in their late twenties learn more about egg cryopreservation in case they want to have children later in their lives. It is very important for couples to understand that - IVF has its limitations. The increasing access to IVF (InVitroFertilization)/test tube baby and other advances in the field of reproductive medicine has also made couples more complacent as they think pregnancy can be achieved at any age with these technologies. However, the more a woman ages, the less are her chances of conceiving even through IVF," she concludes. (Puja Gupta can be contacted at [email protected])