Improving mental health and leading a well-balanced lifestyle can help battle infertility issues, say experts. Photograph used for representational purposes only
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Infertility is on the rise in India: now the statistics are also showing it. A 2023 research paper, ‘Surging trends of infertility and its behavioural determinants in India’ published in Plos One, found that the rates of infertility in couples in India was 22.4% in 1992-93, surged to 25.3% in 2005-06 and then further spiked to 30.7% in 2015-16. And unlike what is commonly believed, men contribute to infertility issues about 40 to 50% of the time. What is behind these rising rates? Doctors point to changing lifestyles, obesity and unhealthy diet choices are some major factors.
Understanding infertility
Infertility is generally termed as the inability to conceive a child through a normal conjugal relationship between a couple for over a year.
Doctors say that globally, the quality of sperm has been decreasing, which is one of the major contributing factors to the rise in infertility. Another major factor is the fact that couples now, in general, start planning their families later than they did in earlier generations, which potentially decreases their chances of conception as the sperm quality declines in the male partner with age, while the egg reserve reduces in the female partner.
Runa Bal, professor at Nil Ratan Sircar Medical College and Hospital, who has worked with infertility issues for a long time, says addiction to various substances as well as sedentary lifestyles are also contributing factors. “Be it addiction to tobacco, alcohol, drugs, or sitting in one position for long hours inside the office – all of these add to the problem of infertility. Working in a heated area can also reduce sperm quality in men,” Dr. Bal further added. That is why she says that a semen sample test is the first step in understanding infertility issues in couples, because it is a non-invasive test, unlike the ones performed in women.
Experts also noted that rising lifestyle issues, such as Polycystic Ovary Syndrome (PCOS) and endometriosis, can also decrease the chances of pregnancy in a couple. Sujay Das Gupta, director of clinical service, Genome – The Fertility Centre, a private fertility clinic in Kolkata, said that rising awareness among people may also be a factor behind the rising number of cases. “Couples are now open to the idea of visiting an infertility clinic and speaking to an expert. Five years ago, this was still a hush-hush topic, and so, we are also seeing and diagnosing more people now,” Dr. Das Gupta added. He underscored the need for couples to not be misinformed, and to consult an expert if they were unable to conceive through normal sexual intercourse after one year.
Infertility facts and figures
Infertility affects millions of people – and has an impact on their families and communities. Estimates suggest that approximately 17.5% of the adult population — roughly one in every six people of reproductive age worldwide experience infertility in their lifetime.
In the male reproductive system, infertility is most commonly caused by problems in the ejection of semen, absence or low levels of sperm, or abnormal shape (morphology) and movement (motility) of the sperm.
In the female reproductive system, infertility may be caused by a range of abnormalities of the ovaries, uterus, fallopian tubes, and the endocrine system, among others.
Equal and equitable access to fertility care remains a challenge in most countries; particularly in low and middle-income countries. Fertility care is rarely prioritized in national universal health coverage benefit packages.
Source: World Health Organization
Combating the blame factor
There are many instances, even now, Dr. Das Gupta said, where relatives and families ask whose “fault” it is for the couple being unable to get pregnant. He pointed out that counselling in these cases was important, in order to explain to families that there was no “fault”: often, it was merely a medical condition in one partner, much like common medical disorders such as hypertension or diabetes.
It is the women who most often bear the burden of not being able to conceive, say doctors who have extensively handled infertility issues. “This adds to anxiety and depression among women, making conception harder. In our experience, we have seen that when a couple adopts a child and gets rid of the anxiety, within a year or two, they also become biological parents because their mental health becomes better,” Dr. Bal added.
In many cases women are the first to approach doctors, because the load of ‘starting a family’ and bearing a child remains on their shoulders due to societal mores. Doctors said that many couples also insist that their family remain in the dark if the pregnancy was achieved through IVF.
Lack of work-life balance
Experts highlighted that with hectic work lives, a lot of couples do not find time to have a regular conjugal life, which makes conception difficult. Clinics have also reported that many couples go through several rounds of infertility tests only to later reveal that they have not had sexual intercourse in over five years or more.
Atreyee Chatterjee, chief embryologist, Genome – The Fertility Centre says that with changing social structures, better education and awareness, men have become open to the idea that even a male partner can have issues and can be a contributing factor in infertility.
“Couples, especially women start to become reclusive when they cannot conceive, and relatives keep asking them about it. We constantly urge family members to not do this because we never know the trauma couples have already survived and how many rounds of IVF they have failed. It can add to their trauma,” Ms. Chatterjee added. She noted that in her years of experience she has observed a consistent decline in the sperm quality, which also affects conception even through IVF.
As a solution, experts said that better mental health, reducing work pressure, balanced diets, increased physical activity, and a focus on a better lifestyle can play a major role in battling infertility issues and help in natural pregnancy through conjugal relationship between couples.
Published – May 11, 2025 12:37 pm IST