Last Updated on April 24, 2023 by Neelam Singh
The World Health Organization (WHO) states that if a couple fails to conceive a child even after engaging in unprotected intercourse for 12 months or more, it is considered as a case of infertility. There are two types of infertility: primary and secondary. Primary infertility is when a couple has never conceived, while the secondary infertility means the inability to carry a pregnancy to full term after having given birth previously.
Both men and women can experience infertility, yet society tends to place greater responsibility on women for this. In India, the male infertility has gone up in the recent years, with 30 to 50 per cent of men having semen quality below the defined standard according to a WHO report. Certain factors like being overweight, lack of regular exercise, stress, and addiction to tobacco, nicotine, and alcohol can affect a man’s fertility adversely. Unfortunately, people often tend to overlook the problem of male infertility in India. This is despite the fact that recognising and treating male infertility problems can lead to a happier life for couples.
Dr Manju, a reputed consultant gynaecologist and infertility specialist from Gopalganj, Bihar, said, “According to our narrow mindset, women are held responsible even if the men have any biological defect. It has been seen in cases of infertility where men’s responsibility varies between 30-40 per cent, while for women, it is 40-55 per cent. Ten per cent fault lies with both. Another 10 per cent is still not known scientifically. Doctors thus talk to both partners in cases of infertility and counsel them about the problem before treating them.”
Understanding the problem through examples
Citing a case of male infertility, Dr Manju said, “Supriya and Ashish (names changed) did not have a child even after three years of their marriage. Supriya came to meet me at the family’s insistence and was accompanied by her mother-in-law on the first day. She was made to undergo some tests and I advised her to bring her husband along the next time she came to the clinic since he also had to do some tests. Hearing this, her mother-in-law said it is Supriya who would conceive the child so what was the need for Ashish to come for tests. I tried to explain it to her but she did not like it. A few days later, Supriya came to me with her husband but one could clearly make out that he was not comfortable. I talked to both. In cases of infertility, counselling plays a major role as proper treatment could be started only after that”.
“We have seen cases where the husband, who stays away from home, and even when he comes home for a day or two, his wife fails to conceive and the family then brings her to me asking for her treatment. We tell them the same thing: Send the couple together. We also try to make them understand that a man’s sperm remains active for 72 hours while the woman’s egg for 24 hours. If the man and woman stay together for even 20-25 days in a month but not in time of ovulation, then it is impossible to become pregnant. If the couple feels comfortable, we also advise them to stay together around the ovulation period”, said Dr Manju.
Men feel hesitant
Speaking of male infertility, Dr Manju said, “Infertility in men is caused by pre-testicular, testicular, and post-testicular factors. Production of inadequate sperm in the testicles, abnormality in functioning of sperm or other irregularities can lead to male infertility. Also, men who work in hot places or remain exposed to radiation can develop such problems. So, while examining male fertility, it is his semen that is tested first. In this test, the health of the sperm is analysed – its texture, shape, mobility, etc. Generally, one millilitre of semen contains 20 million sperm. More than 50 per cent of the sperm should have a forward progressive motion which means they have the right mobility. This is called active motile sperm.”
She also said that male infertility can be caused if sperm count is less than 15 million or below 39 million in total ejaculation. If sperm count is less than 15 million, then the condition is called oligospermia. If the count is not measurable, then it is a case of azoospermia. If the shape of sperm is abnormal, it is called teratospermia. If a male has both reduced sperm count and low sperm mobility, it is called oligoteratozoospermia. According to Dr Manju, infection in the testes can also adversely affect the quality of sperm.
Other reasons
According to statistics, inferior quality and low count of sperm are the reasons for infertility in more than 90 per cent of males. In these cases, doctors suggest hormone therapy to increase the sperm count. But there are also men who succeed in becoming a father despite having a low count due to their extra sperm mobility.
In cases of azoospermia, the affected couple can seek help from ‘donor semen’ to become parents. Like blood banks, semen banks are also available in many places. There are cases where men suffer from testicular abnormality because of genetic reasons and there, donor semen proves to be effective for their wives to carry pregnancy.
There are also problems such as erectile dysfunction, semen ejaculation failure or premature ejaculation that can hinder pregnancy. Doctors advise medication and counselling to deal with many of these problems.
Emergence of new techniques
With changing times, new ways of dealing with infertility have also emerged. One of the most popular among them is IVF or In vitro Fertilisation. Apart from that, intracytoplasmic sperm injection can also be tried by couples to achieve parenthood.
Doctors suggest that to avoid infertility, men should take proper care of their health and diet. They should also do physical exercise daily so that a balanced weight can be maintained. Only a healthy couple can give birth to a healthy child and thus, instead of blaming only the women, we should encourage the men also to go for regular health check-ups.
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