Why in the news?
Following World Population Day (July 11), amidst discussions on global population dynamics, it is essential to highlight a topic often overlooked in conversations about reproductive health: male infertility.
World Health Organization (WHO) Global Perspective on infertility:
- Prevalence: WHO estimates that 60 million to 80 million couples worldwide experience infertility.
- Male vs. Female Infertility: Globally, male infertility accounts for approximately 50% of all infertility cases.
Issues Specific to India:
- Data Deficiency: Unlike global estimates, specific prevalence data for infertility in India are outdated (from ICMR guidelines in 2005) and not comprehensive.
- Male Infertility: In India, male infertility constitutes a significant portion of all infertility cases, estimated to be around 50%, mirroring global trends.
- Contributing Factors: Unique challenges in India include environmental pollution, pesticide exposure in agriculture, lifestyle changes including late marriages and stress, which contribute to rising infertility rates.
- Access to Treatment: Disparities in access to advanced infertility treatments exist, with urban areas having better access compared to rural regions.
- Cultural and Social Stigma: Infertility remains stigmatized in Indian society, affecting mental health and social well-being of affected couples, and hindering open discussions and seeking timely medical help.
What are the actual causes of infertility?
- Male Factors: Low sperm count (oligospermia) or poor sperm motility (asthenozoospermia). Anatomical issues such as blocked sperm ducts or varicocele. Hormonal imbalances, genetic factors, and environmental influences like exposure to toxins.
- Female Factors: Ovulation disorders, including hormonal imbalances like PCOS. Structural issues like blocked fallopian tubes or uterine abnormalities. Endometriosis, is a condition where tissue similar to the lining of the uterus grows outside the uterus.
- Shared Factors: Age-related decline in fertility. Lifestyle factors such as smoking, excessive alcohol consumption, and obesity. Medical conditions like cancer and its treatments, autoimmune disorders, and certain medications affecting fertility.
Treatment options
- Semen Analysis: Essential for diagnosing male infertility, conducted after a period of sexual abstinence.
- Medical Consultation: Vital to identify underlying causes, whether physical (e.g., blocked sperm flow, anatomical issues) or genetic.
- Corrective Surgeries: Address issues like blocked sperm ducts, undescended testicles, or anatomical abnormalities affecting sperm production and flow.
Assisted Reproductive Technologies (ART):
- Intra Cytoplasmic Sperm Injection (ICSI): Effective for cases of severe male infertility where sperm count is extremely low.
- Intrauterine Insemination (IUI): Suitable when sperm motility is good but count is low, facilitating fertilization within the uterus.
- In vitro Fertilisation (IVF): Used when both sperm count and motility are low, involving fertilization outside the body before implantation.
- Donor Sperm Insemination or Adoption: Options for couples where male infertility is irreparable, providing alternative paths to parenthood.
Way forward:
- Enhanced Data Collection and Research: Update and expand prevalence data on infertility in India through national surveys and research initiatives. This should include both urban and rural populations to understand regional disparities.
- Public Awareness and Support Programs: Launch nationwide campaigns to raise awareness about infertility as a medical condition, debunk myths, and reduce stigma.
Mains PYQ:
Q In order to enhance the prospects of social development, sound and adequate health care policies are needed particularly in the fields of geriatric and maternal health care. Discuss. (UPSC IAS/2020)
