Q: What is infertility?
If the couple has regular intercourse, does not use any contraception and still does not conceive within one year, they are said to be infertile. 80-85% of the couples conceive within one year of unprotected intercourse i.e. without the use of any contraceptive. However, the rest 15-20 % who are unable to conceive naturally are said to be infertile and these would require proper evaluation and help for getting pregnant.
Q: After how many years of marriage, should a couple get concerned about their fertility and seek medical help?
Younger couples could wait for 1-2 years before starting any treatment, but elderly couples especially when the woman is 35+ needs to seek medical help within 6 months of their marriage.
Q: Does fertility depend on age?
Yes, in a woman fertility does depend on her age. A young woman is naturally more fertile as she has more number of good quality eggs than a woman who is 35 +. Hence a woman who is 35 + should not wait for a long period for a natural conception and should seek help from a proper fertility expert. Also the chance of genetic abnormalities and medical complications like Hypertension and Diabetes increases with age.
Q: What are the reasons for the increase in incidence of Infertility?
In recent years, there has been an increase in the number of couples seeking medical assistance for infertility. The incidence of male factor is also increasing. The reasons for this is increase in the number of women delaying conception, rise in the incidence of sexually transmitted infections, environmental hazards giving rise to low sperm count and the general trend of postponement of parenthood amongst career oriented individuals.
Q: What are the factors on which conception depends?
It depends on:
- Age of the woman.
- Period for which they have been trying for a pregnancy.
- Frequency of intercourse - Infrequent sexual intercourse, for example having sex once or twice in a month decreases the chance of pregnancy. Having sexual intercourse 3-4 times a week, during the fertile period would improve the chance of conception.
- Presence of fertility problems - Existing fertility problems in either of the partners reduces the chances of conception.
Q: When should a couple seek medical help for infertility?
If the woman is below 35 years and has normal menstrual periods, and the couple has tried for a conception for a year with a frequency of sexual intercourse 3-4 times a week during the fertile period and has yet not conceive, then they need to consult an Infertility expert.
Q: In what circumstances should the couple visit the doctor still earlier?
The following could be the considerations:
- The woman is older than 35 years of age and the couple has been trying for a pregnancy for more than 6 months.
- The woman does not menstruate regularly i.e. her menstrual cycle is either less than 21 days or more than 45 days.
- The couple has difficulty or inability to have normal sexual intercourse / frequency of sexual intercourse is less.
- The woman has medical illness like diabetes , epilepsy or hypertension.
- History of pelvic infection in the woman in the past.
- History of medical termination of pregnancy (MTP) / 2-3 spontaneous abortions in the woman.
- History of surgery in the pelvis or in the lower abdomen in the woman.
- Men with history of surgery in the external genital area.
- Men with prostate problems.
- Men with undescended testes.
Q: How does body weight, diet & exercise affect fertility?
For increasing the chance of pregnancy, balanced body weight of the woman would be beneficial. Being obese or grossly underweight affects the maturation of eggs in the woman and hence may affect her fertility. Also, a grossly obese woman would have mechanical difficulty in having normal sexual relations.
Regular, moderate exercise especially in the form of yogasanas, walking, swimming, or jogging prove beneficial for fertility. It has been observed that strenuous form of exercises for example jogging over 3 miles a day can hamper ovulation and hence may lead to decrease in fertility in the woman.
Balanced and nutritious diet help increase the chances of conception and ensure proper growth of the fetus.
Q: Does smoking / alcohol / Recreation drugs / mobile phones / laptops affect fertility?
In men, smoking can cause a decrease in the sperm count and sperm motility. In women, chronic smoking affects the maturation of eggs (ovulation), and causes growth retardation in the growing fetus.
Alcohol when taken on a regular basis affects both the sperm count and its motility. An intoxicated man is also unable to have sexual intercourse. In a woman, chronic intake of alcohol affects the liver functions, causing hormonal imbalance and affects egg maturation. Chronic consumption of alcohol during pregnancy causes growth retardation and increases the chances of congenital anomalies in the fetus.
Use of Recreation drugs like Marijuana and Anabolic Steroids decreases the sperm count. It could also affect the performance of sexual intercourse.
Excessive uses of cell phones and laptops have been associated with a decrease in the count and motility of the sperms.
Q: Is stress a major factor in infertility?
Chronic stress may interfere with the ovulation, may decrease the sexual desire and hence affect the frequency of sexual intercourse in the couple.
Q: How would one know the cause of infertility?
A detailed history of both partners is very helpful in giving a clue to the cause of infertility. For e.g. anovulation is the cause of infertility in a woman who has irregular periods and who is also obese, blocked fallopian tubes in a woman with previous history of pelvic infection, low sperm count in a man with past history of mumps. Examination of both the partners, and getting the required investigations would give a complete picture.