At a recent conference in Visakhapatnam, experts have said that infertility in men is more widespread than the condition is in women in India – and warned that it too often goes overlooked.
Between ten and fourteen percent of Indians are affected by infertility according to the Indian Society of Assisted Reproduction, with 27.5 million couples attempting to conceive in 2015 affected by the condition. At the Visakhapatnam conference, organised by the Oasis Fertility Centre for Reproductive Medicine, experts said that infertility in men is 1.5 percent more common than infertility in women with the age of onset lowering from 35 to those aged over thirty. Despite this, cultural norms surrounding infertility mean that treatment is disproportionately female-focused.
“Male infertility is completely ignored,” said clinical embryologist Dr Krishna Chaitanya at the conference. “But nearly fifty percent [of] infertility among couples is related to reproductive anomalies or disorders in the male. Hence, it is important that male infertility is evaluated properly.”
Experts have notified this trend for some time. “For [too] long, infertility was a cross that women had to bear,” said Dr Sama Bhargava, an expert in in-vitro fertilisation at Fortis Hospital in Noida. “But we’ve found that less than thirty percent of Indian men have normal semen characteristics leading to conception problems for women.” Bhargava goes on to note the far-reaching impacts of infertility, describing it as “an under-researched condition that is wrecking marriages and even people’s lives.”
For women, infertility leads to much stigma no matter the source within the relationship. “Childbearing is considered an essential role in life and a yardstick by which women’s worth is measured,” Bhargava says. “So infertility invites social stigma. It is time we recognise it as a perilous personal and public health issue.”
“We have observed that male infertility factor is the primary reason for inability to conceive [especially] between the [ages] of 29 to 35,” observes infertility specialist Dr Jyoti Bali. “They either have a combination of low sperm concentration or poor sperm motility, or abnormal morphology. However, due to social stigma, male fertility problems are considered secondary and most often go undiagnosed and untreated.” Sperm count is declining in the country. The average sperm count of an Indian male stood at sixty million per millilitre three decades ago, but has since declined to twenty million per millilitre.
Of signs and symptoms, Dr Bali notes that “there are a few signs and symptoms related to male infertility that includes difficulty with ejaculation, volumes of ejaculated fluid being very less, erectile dysfunction and no or very [little] sexual desire. Men with infertility problems may also have recurrent respiratory infections, inability to smell or minimal growth of hair on body and face.”
The causes of male infertility, according to Oasis Fertility Centre for Reproductive Medicine clinical head and fertility specialist Dr Radhika Potluri, include “pollution, stress, obesity, irregular sleep patterns and smoking. All of these affect sperm count. Moreover, in rural areas, exposure to pesticides is also adding to the problem.”
Such issues are relatively widespread among men in India, where 83,144,300 males aged fifteen and above and 429,500 boys aged ten to fourteen smoke cigarettes daily; many Indians miss out on the recommended hours of sleep a night; and pollution is a public health blight throughout the country’s cities and rural environments, causing manifold health problems. As the conference reminds us, these conditions are manifesting in infertility in men – causing untold suffering for couples throughout the country.