The impotency to conceive children in females and the inability to impregnate in males is called infertility. When a couple fails to achieve the clinical pregnancy after 12 months or more of regular unprotected sex, then, the condition is characterized by infertility.
Infertility can occur both in males and females.In our country infertility is stigmatized with women considering it to be prevalent only among women. Data suggests that among the overall 13 to 15 percent of infertility in our country, 40% are due to male factors and 40% are due to female factors. Rest of the 10% are the undiagnosed cases.
Infertility in females
Female infertility can occur due to various reasons like:
- Damage in the fallopian tubes leading to failure in the transportation of eggs from ovaries to the uterus.
- Hormonal imbalances that prevent the release of an egg from the ovary and thickens the lining of the uterus.
- Uterine and cervical conditions including polyps and fibroids.
Female infertility can be diagnosed through the following tests:
- Hysterosalpingography (HSG)
- Transvaginal Ultrasonography
Among the cases of male factor infertility worldwide, more than 90% of the cases are due to reduced sperm number, low-quality sperms or both. Rest of the cases includes the conditions arising from anatomical problems, hormonal disorder or genetic defects.
Male infertility can be diagnosed through the following tests:
- Semen and Sperm analysis
- Hormone evaluation
- Testes biopsy and genetic tests
Treatment of Infertility
Infertility treatments include
- Laparoscopy which reconstructs reproductive organs by getting rid of scar tissues, opening the blocked tubes and removing ovarian cysts by laparoscope inserted through a small cut near the belly button
- Hysteroscopy which removes polyps and fibroid tumors, divide scar tissue, open up blocked tubes through hysteroscope entered into the uterus through the cervix.
- Intrauterine insemination
- In Vitro Fertilization (IVF)
- Intra Cytoplasmic sperm injection (ICSI)
- Gamete Infra fallopian tube transfer (GIFT)
- Zygote Intrafallopian tube transfer (ZIFT)
Social aspects associated with infertility in our country
While infertility of various types can be equally prevalent among both men and women, women face the unjust of being blamed and cursed to be the failure of women. Majority of people cannot afford the expensive tests and treatments of it and are also not well aware of those facilities. They rather choose polygamy as an option. Even if the infertility is due to the malefactor they might continue to remarry for some couple of times without being aware that they could be incapable to impregnate.
In such cases, females are also seen to stigmatize themselves as sinful and support their husband (unwillingly from the heart) to remarry since the childbearing is considered as the central achievement of life in our society. In most of the cases, their consent to remarry is also not deemed necessary. The torture for women who are recognized as infertile (irrespective of who is responsible) is not limited to her stigmatizing as sinful. She will have to bear the disrespect and abuse (verbal and physical) from her husband, family, and society. She might also have to bear the face the situation of a boycott of social functions and different rituals. And once the husband remarries her status in the family and the society becomes worse than ever. Aware of all the consequences, a woman expects to give children in order to win affection from husband and family and to establish her position in the society.
Even among the people who are aware and can afford the tests and treatments (sometimes tests only), males refuse to go for tests, at least before the spouse goes and confirms the negative infertility tests. Be it due to the fear of being questioned in masculinity or the confidence in the masculinity, females are blamed and looked down upon.
While the majority of male infertility can be diagnosed through the sperm analysis only, it could be economical if males go through the tests first and let the women after their negative test is confirmed as compared to go through all the tests of females and switch to male in case of negative tests.
In a country like ours where maternal and child health is still a huge challenge to cope up with, infertility is not a subject that has got enough attention. Couples who are unable to conceive and cannot afford the huge sum for its treatment could adopt the children as many are waiting to be adopted.