Infertility in Kashmir: Not Just a Woman's Concern

In Kashmir, there is often a prevalent concern within a few months of a marriage if the bride has not conceived. However, it’s important to emphasise that, in the majority of cases, there is no immediate cause for worry.

In many instances, a delay in conception is entirely normal and may be due to various factors, including stress, lifestyle, or even purely a matter of timing. The human reproductive process is complex, and it can take some time for a couple to achieve pregnancy, even when both partners are healthy.

When to seek medical help for infertility:

l  Infertility is typically evaluated when a couple has been trying to conceive at least one year without success.

l  For couples where the female partner is 35 years or older, it’s recommended to seek medical evaluation for infertility after six months of trying without success. This is because fertility tends to decline with age, and earlier evaluation can be beneficial.

l  If there are known or suspected issues that may affect fertility, such as irregular menstrual cycles, a history of certain medical conditions like hypothyroidism, or previous fertility problems, couples may choose to seek evaluation earlier.

l  In cases where there are clear signs of infertility or underlying health issues, such as irregular periods or a history of conditions like polycystic ovary syndrome (PCOS) or endometriosis, it’s advisable to consult a fertility specialist sooner.

With whom to start evaluation:

Often, we tend to focus initial infertility investigations on the bride. However, it’s essential to remember that infertility is a shared concern. Studies suggest around 50% of infertility cases stem from a female factor, 20-30% from a male factor, and 20-30% from a combination of both. Therefore, it’s crucial to evaluate both partners to gain a comprehensive understanding of potential causes and improve the chances of successful conception.

l  Male Partner: If there is reason to suspect male factor infertility, the male partner may be evaluated first. This may involve a semen analysis to assess sperm count, motility, and morphology.

l  Female Partner: In many cases, the female partner may undergo initial evaluation, especially if she has a known history of reproductive health issues, such as irregular menstrual cycles, polycystic ovary syndrome (PCOS), or endometriosis. Her evaluation may include a pelvic exam, hormone testing, and an assessment of her ovarian reserve.

l  Both Partners: It’s common for both the male and female partners to undergo initial evaluations simultaneously. This approach allows healthcare providers to comprehensively assess potential factors contributing to infertility from both sides.

l   Known Medical History: If one partner has a known history of health issues that could impact fertility, they may be the first to undergo evaluation.

Preventing infertility:

In addition to knowing your menstrual cycle and fertile days, maintaining a healthy lifestyle, managing chronic conditions, and avoiding habits like smoking, alcohol consumption, and drug use, it’s important to highlight the significance of avoiding late marriages, especially in the context of Kashmir.

Late marriages can indeed have an impact on fertility and the ability to conceive. Delaying marriage can result in a shorter window for starting a family, which can be a contributing factor to infertility concerns.

Treatment for infertility: 

l  Lifestyle Modifications: In some cases, adopting a healthier lifestyle can address infertility. This includes maintaining a balanced diet, regular exercise, and stress management.

l  Medications: Fertility drugs may be prescribed to stimulate ovulation in women or enhance sperm production in men.

l  Surgery: Surgical procedures can correct anatomical issues, such as blocked fallopian tubes or varicoceles (enlarged veins in the testicles).

l  Intrauterine Insemination (IUI): This involves placing specially prepared sperm into the uterus at the time of ovulation to increase the chances of fertilisation.

l  In Vitro Fertilisation (IVF): IVF is a widely used technique that involves fertilising an egg with sperm outside the body and then implanting the embryo in the uterus.

l  Intracytoplasmic Sperm Injection (ICSI): This is a form of IVF where a single sperm is   directly injected into an egg.

l  Counselling and Support: Emotional and psychological support through counselling or support groups can be essential during fertility treatments.

l  Assisted Reproductive Technologies (ART): ART includes a range of advanced techniques to address infertility, such as intracytoplasmic sperm injection (ICSI) and gamete intrafallopian transfer (GIFT).

It’s essential to maintain open communication and support within a marriage, recognizing that the timeline for starting a family can vary for different couples. Patience, understanding, and, when necessary, medical advice, can go a long way in addressing concerns and ensuring a healthy and fulfilling family life. It’s crucial to recognize that infertility issues are not exclusive to the female partner, and both the male and female partners need to undergo evaluation.

Dr Shakeel ur Rehman is Chairman and Founder Kashmir Clinics Group