Family & Children Health The Pregnancy Seeking conception: Experiences of urban Indian women with in vitro fertilisation.

   In Indian society fertility defines womanhood and motherhood, and infertility is stigmatised. Women faced a lot of pressures to produce a biological child, and go through all kinds of treatments, including the advanced reproductive technologies like IVF,ART, GIFT, ZIFT, TET, ICSI,IMSI,donor egg,surrogacy services to have a child.

   Infertility is considered a curse for women, especially in India where the female partner is blamed in almost all cases.

   Urban lifestyle has left its mark in all the aspects of health, but none has been as overlooked as Fertility Issues.Perhaps this is because fertility is the last thing on the minds of an average working couple juggling family life, demanding workplace deadlines and ever tight finances. Between managing the professional & personal commitments, reproductive health is left unattended, especially as the effects of a poor reproductive health are not alarming or incapacitating. More and more cases are diagnosed at a stage when fertility becomes a pressing issue due to social or family pressures.

   In India, it is estimated that approximately between 15-20% of all couples of fertile age suffer from infertility. This figure is on the increase because of increased urbanization and pollution, stress, a competitive work environment and a hectic and fast paced lifestyle. The World Health Organization (WHO) estimates that approximately 8-10% of couples experience some form of infertility problem. On a worldwide scale, this means that 50-80 million people suffer from infertility.
However, the incidence of infertility may vary from region to region.

   Due to the professional commitments and the cut throat competition in the dwindling job market most of the men and especially women are delaying their marriage and the reproductive events. It does not affect the men so much, as the sperm production is an ongoing process and continues well in old age though in decreased quantity and quality. For a woman, its an age related event as they are born with a finite number of eggs which are lost at regular interval every month, beginning at puberty. The plateau is reached at the approximate age of 35 years and it has been shown that around 37 years of age theres a sharp decline in the number of eggs, finally reaching a point where fertility potentials are exhausted. This is when the menopause is achieved. The other factors which adversely affect a womans fertility are the increase in incidence of miscarriage, deteriorating egg quality and complications of pregnancy in an advanced age. Medical wisdom dictates that women should finish having babies by the time they are in early thirties, after which fertility levels begin to drop. After 35 years she is on the wrong side of the biological clock and she is faced with difficulties as well as complications. This age groups response to fertility treatments is also sub- optimal. The ovarian response is poor and they sometime have problems carrying the pregnancy to term.

   Many of these urban men and women, who face fertility impairment, are from the group of highly motivated go-getters. Its a classic case of mouse replacing the spouse. There are couples who request for insemination, simply because they have no time to plan a natural conception, what with long work hours, night shifts and frequent out- station travel. The employees working in nocturnal shifts also suffer from hormonal disturbances caused by changing sleep rhythms and bio-cycles. Hormonal disturbances in women lead to disturbed egg release and ovulation. Similarly, lifestyle of men is affected by, late hours, unhealthy eating habits, routine consumption of alcohol and smoking and finally high stressed life.

   The problem originates as early as in childhood when eating habits are developed. The concept of healthy eating is impressed upon few kids in schools or at homes. As a result the incidence of obesity is on the rise in urban Indian population. These unhealthy eating practices of fried food, oily meals overcooked vegetables and little or no physical exercise is carried on to adolescent and adulthood, where it rears its ugly head in the form of health problems, which later translate to impaired fertility. The weight gain, along with genetic factors, leads to disturbed hormonal milieu which leads to irregular periods and anovulation. This can present as Polycystic Ovarian Syndrome. Generally this can be improved to help the woman conceive by lifestyle modification, diet planning and weight reduction. We definitely do not advocate a size zero, but as less as 5% weight loss, achieved scientifically, help to improve the response of the ovaries.

   On the other end of the spectrum is the newer phenomenon of crash dieting and distorted body image in teenagers. This is definitely an influence from the west, more common especially in the metropolitan cities. The incidence of anorexia nervosa is more common now than we would imagine. This is due to unreasonable expectations from ones body and an unhealthy competition amongst the peer groups. The effects of this type of life style can cause a serious imbalance in the fertility hormones in the body, especially girls, leading to absence of menses, severe anemia and renal disorders. The condition needs medical as well as psychological attention. Obsession with the body image has to be improved upon gradually, by boosting the confidence levels and family support systems.

   Excess of anything can be bad. So while we do advice exercise to keep the body healthy, too much of athletics can have its effects. Over enthusiastic athletic activity can also send signal to the brain and decrease the outflow of fertility hormones. This is very commonly seen in female athletes and affects their future fertility. The new fad of body building that has caught the imagination of Indian youth has been fuelled by the recent attempts of the movie personalities to build a perfect body, in the shortest of time possible. While on this pursuit, they get into the consumption of protein and health shakes and hormone supplements. Some of the constituents of these supposedly health supplements actually signal the brain to reduce the production of male & female hormones and in turn lead to fertility problems.

   Environmental toxins, finally recognized as health hazards, are an offshoot of urbanization. Adulteration, pollutants, additives and dyes used in the food stuff as well as toys are another factor which has become an important variant in the health care of developing countries. Lot of the coastal areas have been identified as having a high mercury level in their sea food. This in turn has been related to the high incidence of sperm abnormalities and ovulation problems. People working in the chemical industry, in contact with paints fumes, dyes etc have also been found to have a lower sperm count.
Endometriosis is another condition which till a couple of decades back was supposedly a western problem. Now with urbanization, and adaptation of western lifestyles, we have also inherited their diseases. Endometriosis is seen quite commonly in young women today. It is a condition where the lining of the uterus is present in other places outside the uterus usually on the ovaries, fallopian tubes, and ligaments that support the uterus; the area between the vagina and the rectum; the outer surface of the uterus; the lining of the pelvic cavity; the bladder, bowel, vagina, cervix, vulva, and in abdominal surgical scars. In sync with the menstrual cycle, this tissue builds up, breaks down, and sheds each month; but unfortunately, it has no way of leaving the body. As a result it causes internal bleeding, breakdown of blood and tissue from the lesions, and most often inflammation which can cause pain, infertility, scar tissue formation, ovarian cysts, adhesions and bowel problems. There is no way to cure it completely, though GnRH agonist injections can suppress the growth to an extent and then surgical removal can be attempted if required. On a brighter note, pregnancy seems to dissuade this growth of tissue in aberrant places.

   Lifestyle modification to tackle obesity, tobacco smoking and alcohol consumption, have been proposed as crucial in influencing the outcome of both natural and assisted conceptions.

1]Occasional relaxing get-away for the couple
2]Cut down on alcohol intake
3]Stop tobacco smoking and alcohol consumption
4]Avoid processed food, preservatives etc.
5]Organic food, sea food judicious selection
6]Stop diet/ binge cycle
7]Make space for some form of physical exercise in the week
8]Regular health checks
9]Plan family before 35 years of age
10]Pre- natal vitamins/ anti-oxidants
11]Weight loss if high BMI
12]Ovulation induction for anovulatory women with patent tubes
13]IUI to counter some of the cervical, semen and Ovulatory factors
14]IVF/ICSI for damaged /blocked tubes, asthenozoospermia/azoospermia, unexplained infertility
15]Minimally Invasive Fertility surgery for fibroids, polyps, ovarian cysts etc.

   Lifestyle modification should be the preferred initial treatment of infertility.

   If you are still having problems after applying these fertility tips for women, and want more detailed information that can help then contact for knowing more about IVF Fertility infertility specialist,fertility centres that can provide the best affordable quality infertility,fertility treatments with advanced reproductive technologies like IVF,ART, GIFT, ZIFT, TET, ICSI,IMSI,donor egg,surrogacy services at Morpheus ART Fertility Centers.

Contact Us For More details:

Morpheus Life Sciences Pvt. Ltd.
Tel: 91 22 42030900
Fax: 91 22 42030901

Article By: Morpheus Art

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