Q&A with Dr Rahul Manchanda: Decoding Infertility in young couples

Why is it there an increasing trend of infertility among couples today? What are the causes?

Infertility is increasing or rising mostly due to couples delaying pregnancy. Fertility declines with age especially after the age of 35yrs. Hence more cases of infertility are cropping up. This, along with a hurry/impatience to have children when they decide to, leads to perceived infertility which in itself is a cause of infertility.

Unhealthy practices like – Undergoing abortion through easily available Over the Counter pills and indiscriminate use of such pills lead to secondary infertility, which again is on the rise.

How can infertility be avoided? What preparations/ precautions that could make when they are planning conception? In terms of food, lifestyle, exercises or anything else?

Infertility can be avoided by leading a healthy lifestyle, and planning babies at what is considered the peak reproductive age around 22-30 years (Peak being 24-26 years).

For men, it is important not to smoke or drink excessively.

Also visit your gynaecologist/doctor for pre-counselling once you have decided to start a family. In case of any infections (bacterial, fungal) or, sexually transmitted diseases, treatment should be undertaken without any delay.

It is important to lead an active lifestyle and exercise regularly, this keeps one physically fit for the “rigors” of pregnancy and also mentally fit which is equally important. Outdoor exercise helps us in getting exposure to sunlight which is important and sadly lacking today.

A high protein diet with lots of cottage cheese, soya, chicken eggs, lentils and milk is good. Intake of green leafy veggies helps in increasing haemoglobin levels. Folic acid must be started in the pre-conception stage, at least 3 months before one is planning to conceive. A dosage of 5 mg daily serves good. If not taken in the pre-conception phase, it could be started as soon as you learn about your pregnancy – to avoid congenital abnormalities. Fruits like apples, pomegranate, banana are also good for health.

One should try and avoid putting on weight before getting pregnant and be within the recommended weight for the given height bracket. Once pregnancy occurs then of course it is necessary to put on weight but not excessive even then.

What are the basic tests that a couple must undertake (separate for man and woman) to check if everything is fine?

Tests are typically advised only if the couple has regular, unprotected intercourse for atleast a year. If the woman’s age is higher than 30 years and has irregular menstrual cycles or any other gynaec issues, or if the couple has been trying for more than a year, certain tests could be done to diagnose the bottlenecks. To start with, a simple semen analysis is advised for the man as one of the first tests, which can eliminate a host of other possibilities. Generally, if the woman is healthy and is menstruating regularly and has no other problem she does not require anything to be done.

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