ISSN: 2642-6250
Authors: Suresh K*
Fertility has been one of man’s desired attributes since the beginning of recorded history and remains a driving need for young couples to prove their fertility as soon as possible after marriage. Though this trend is changing a bit over a decade, due to some people with higher education, getting married late, working couple and some who are intentionally delaying parenthood. In India, pregnancy is usually viewed as a normal physiologic phenomenon, that does not require any intervention by professionals, unless there is some problem in conceiving, or pregnancy going to full term or in birthing. Most Indian families believe that they have little or no control over their pregnancies or outcomes. The importance of motherhood in traditional patriarchal cultures is rooted in the teachings of all the religions. The World Health Organisation (WHO) has recognised infertility as a public health issue. Although biological factors are the primary cause, factors like social, health, and lifestyle factors do have an adverse effect on a couple’s ability to reproduce. The current fertility rate for India in 2024 is 2.122 births per woman, in 2023 it was 2.139 births per woman, in 2022 it was 2.159, in 2021 = 2.179 births per woman, and 2.159 in 2020, witnessing a reduction of 0.95% each year. Replacement level fertility needed to maintain a stable population size, is estimated to be 2.1. below which the population starts declining as we see in China (1.705 in 2023) today. High levels of infertility will generate low desire for contraception. Fertility and infertility are social conditions which are intricately connected. Where fertility is highly valued, infertility will conversely be devalued. Infertile across Indian women in 2019-21 (NFHS-5) by duration of marriage varied from i) women married for ≥1 year = 42.9%, ii) married for ≥2 years =30.7% Married for ≥3 years =24.1%, married duration ≥4 years =20.7% and married for ≥5 years = 18.7%. Age at marriage, biological factors, and lifestyle factors are strongly linked to infertility. People with higher education levels, late marriages, working couple and those intentionally delaying parenthood are more likely to experience primary infertility. Materials and Methods: This article is based on authors experience of guiding four cases of primary sterility in last 5 years. For different reasons first case has succeeded, second is progressing towards success, third is 30% hopeful as the cause is not necessarily associated with infertility and in the fourth all efforts have failed except IVF which the couple could not afford. The case studies suggest that Infertility in India needs to be Public Health Concern!
Keywords: Fertility Rate; Infertility; Transvaginal Scan (TSV); Obstetric First Trimester Scan (OFTS); Septate Uterus; Semen Analysis; Oligospermia; Hormone Therapy
