Fertility segment in India has grown at a 20 percent CAGR in the last five years. The country, reportedly, sees about 2-2.5 lakh IVF cycles in a year and has the potential to do about 5-6 lakh IVF cycles. 

In an interview with Dr Nisha Bhatnagar senior IVF specialist from Aveya IVF & Fertility Centre, She talks about the sector, technologies involved, and how men and women have taken to IVF, over the past few years. Excerpts:

What are the issues pertaining to infertility in India?

In my career of 25 years, I have seen a steep rise in the cases of infertility in India especially in the last 10 years where cases of infertility rose to 30% to 35% of the total population. The reasons for such sharp rise in infertility being:

  • Lifestyle changes from the very beginning of one’s lives. Children being virtually active rather than being physically active. People are bound to their chairs and desks. This sedentary lifestyle is one of the reasons for the increment in the cases of infertility in India.
  • Young fertile people are now more career oriented than ever which usually reflects in the newly observed pattern of delayed marriages.
  • The food and environment one exposes themselves is also a major cause in the rising case of infertility amongst the population. The rise in the consumption of nutrition-less foods like packaged, canned or junk foods etc.; being constantly exposed to harmful radiations from mobile phones, laptops or microwaves etc. are affecting the fertility of the masses. 

Infertility is not only attributable to one’s age but it is acquired over a period of time or majorly since childhood.

Is age a limitation in IVF treatment?

Nature has defined a life cycle for every living being; there’s infancy, maturity and decline; a human being also starts as an infant, grows to adulthood and then declines to death due to old age. Similarly, fertility also follows the same life cycle wherein a female body is not developed enough before the age of 18 to carry the pregnancy; this age marks the start of adulthood. Since the number of eggs is limited in a female body and the best eggs are used first by the body, the number and quality of eggs start to decline after a certain age. In Dr. Nisha’s opinion, age has no bar for IVF treatment but beyond 35 years of age, fertility declines very sharply. Furthering 40 years of age, it is very difficult to conceive with a female’s own eggs’ so conception with donor eggs is considered as an alternative. According to ICMR guidelines, pregnancy after 50 years of age should be avoided.

What is the current scenario of male infertility?

People are now more aware and accepting of the fact that male infertility is also a reason for unsuccessful conception. Male infertility is also on the rise since males and females both are exposed to the same unfavourable environment. The limited number of eggs in a female was ever evident but the decline in the male sperm count was not as evident since the numbers were high; ranging in hundreds of millions. Looking at the W.H.O. The classified average sperm count declined from 140 million or 150 million to 30 million or 40 million in the last 10 to 15 years. It is clear that the male infertility is also on the rise.

How has Covid-19 impacted the industry?

The whole world was affected by this pandemic negatively but I have also observed few positives too. I would talk about the positive observation first; with all the fuss around health and immunity, people actually started to take care of their health which they had been neglecting for a long time. They adopted a healthier lifestyle by eating healthy and exercising. Also the stress was in control to some extent which helped a lot of them to conceive naturally at home. The couples who were successful in conceiving represented only a small percentage of the population, most of the couples or people in general were not coming out of their houses, they were refusing to visit hospitals for scanning or check ups etc. which impacted the industry to a great extent but looking at the current decline in the number of covid-19 cases, and the vaccination drive, there is a possibility that there might not be another wave. Following all the precautions and guidelines and with the development of herd immunity along with being vaccinated we may never face another wave. 

What are the most prominent reasons for infertility ?

Most prominent reasons for infertility in females are mainly:

  • Blocked tubes
  • PCOS
  • Endometriosis
  • Low ovarian reserves
  • Male Factor Infertility

Apart from these reasons, there still are few cases of unexplained infertility in some couples where she thinks stress has a major role to play. One more reason for unsuccessful conception in couples is lack of intercourse; usually both the partners are working which restricts their time together and they are unable to have intercourse properly. 

What is the success rate of Artificial Reproductive Technologies?

Success rate actually depends on the reason for infertility, whether the reason is egg or sperm or tubes or any other , we need to investigate and treat accordingly. We may not be able to point out what’s not working for you but once we get hold of the reason for unsuccessful conception, we can treat it. I would encourage  people to not think of IVF as the last resort but to think of it as a diagnosis. Once we find the reason for not conceiving successfully, we can suggest treatments accordingly since every individual is differently built, their problems related to not getting pregnant are also different and subsequently the line of treatment would also differ. 

What is minimum Stimulation IVF?

Minimal Stimulation IVF is a gentle controlled ovarian stimulation that aims to produce a maximum of 4.5 oocytes. Minimal Stimulation IVF focuses on combination of oral  tablets and GnRH agonist triggers for Oocyte maturation. Stimulation IVF It is re-emerging as a solution for Ovarian Hyperstimulation syndrome, cost, and patient discomfort.   

About Dr. Nisha Bhatnagar

Dr. Nisha Bhatnagar is an experienced Senior IVF specialist with over 20 years of experience in the discipline. She specialises in low and no-drug infertility solutions that help women conceive with minimal invasiveness and unparalleled success. She offers holistic approaches to IVF, including innovative treatments like Natural Cycle IVF, Minimal Stimulation IVF and Injection-Free IVF.

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