Apart from 40 per cent of infertile cases due to males, as many as 2 per cent of all men will exhibit suboptimal sperm parameters.
By Dr Isha Khurana
The birth of a child is a life-changing event as in one miraculous moment the entire pattern of life of a couple changes. Infertility and problems of impaired fecundity have been a concern through ages and is also a significant clinical problem today, which affects eight to 12 per cent of couples worldwide.
Men account for 40 per cent of infertility cases
However, due to the patriarchal nature of our society the burden of infertility primarily falls upon the female. However, it has been reported that 40 per cent of infertility cases were related to men, 40 per cent to women and 20 per cent to both sexes. Even in times of the Ramayana and Mahabharata, the male factor infertility has been known but societal pressures have always been directed towards the female partner. Recent studies report that apart from 40 per cent of infertile cases due to males, as many as 2 per cent of all men will exhibit suboptimal sperm parameters. It may be one or a combination of low sperm concentration, poor sperm motility, or abnormal morphology.
Calculating regionally-based male infertility rates is challenging for a number of reasons and even the WHO does not have defined statistics. First, population surveys generally interview couples or female partners of a couple who have unprotected intercourse and wish to have children. This is a very specific population. As such, data from a significant number of infertile individuals is never included, which may prejudice the data.
Men, and families, may be in denial of their infertility
Second, unlike female infertility, male infertility is not well reported in general but especially in countries where cultural differences and patriarchal societies may prevent accurate statistics from being collected and compiled, the female partner is often blamed for infertility. Men, therefore, do not usually agree to undergo fertility evaluation, resulting in underreporting of male infertility.
A third challenge stems from the fact that male infertility has never been defined as a disease, which has resulted in sparse statistics. Most men fail to accept treatment for their sub-fertility, even to the extent of being in denial of their problem.
The female partner, thus, cannot alone be held responsible for infertility, but unfortunately the society continues to put undue expectations on women, often leading to anxiety and depression. In a couple battling infertility, the women often seems to become the target of comments of society.
Need for openness in families
Even in cases where the male causes have been identified, the in-laws or husband often demand that such facts not be disclosed, leading to more stress and marital discordance. In rural India, superstitious practices are witnessed, which may endanger a woman’s life. Many episodes have been reported of religious heads exploiting women to get them pregnant, cases of polygamy for the purpose of childbearing are also known and it is high time that society awakens to the importance of male factors contributing to infertility and timely and adequate treatment of the same.
Workplace stress contributes to infertility
Another major problem in developing countries like India, is the growing MNC culture, where both partners are working with erratic timing of work and workplace stresses, which sometimes take their toll on interpersonal relationships and intimacy.
Couples tend to marry late and then plan pregnancy even later, which further worsen the chances of pregnancy. A woman’s reproductive age spans between 15-45 years. When such a couple starts planning pregnancy, the clock is already ticking and they have a limited time for a favourable outcome.
It has been found that workplace stress also increases the chances of sub-fertility or infertility in a couple, leading to an inability to have relations during the fertile period.
Another important contributory factor to the growing problem of infertility is lifestyle changes, with most corporate couples leading a sedentary lifestyle, mostly working on computers and laptops. Obesity, due to unhealthy food habits, also leads to male or female sub-fertility. The growing incidence of alcohol and smoking especially in females has worsened fertility issues.
It’s time to rethink mindsets and bring stress under control, so that chances of fertility can improve. It’s only when science meets hope that beautiful things can happen.
(The writer is a gynecologist and IVF specialist at Apollo Fertility, Delhi.)