In today’s fast-paced world, people are busy in their career commitments and fulfilling their day-to-day priorities. Many couples believe that it would be easy to start their families whenever they want. The fact is that after a certain age, men and women both start to lose their fertility potential. There are many contributing factors due to which modern urban couples are struggling to conceive. Late marriages, stress of work, different work shifts, weight issues, painful sex, menstrual cycle confusion, decreased libido are just the tip of the iceberg.
Bringing technology to bedrooms is also killing the time couples need for being together. Long working hours and the need to be always updated is enough to shift one’s emotions in a downward spiral. As a result of all these young couples are spending less and less time with each other. The pressure on couples is so immense that it is not uncommon to see them juggling to find their ovulation time through various means so they can schedule sex around it. Medically we advise couples to have sex every alternate day when they are planning to conceive.
Whatever be the sexual scenario, an average healthy couple may take one to two years of regular unprotected intercourse to conceive. However, if after one year of trying to conceive if one is unsuccessful, it is time to visit a gynecologist for baseline tests and examination. One can even see a doctor earlier if there is a medical history like irregular periods or infections etc. that can reduce the fertility potential.
Many couples believe that it would be easy to start their families whenever they want. The fact is that after a certain age, men and women both start to lose their fertility potential. There are many contributing factors due to which modern urban couples are struggling to conceive.
Men and women both contribute equally to fertility problems. But one has to realise that even in cases where the male is the cause of infertility, the woman is the one bearing the brunt of the medical treatments in the form of ultrasounds, injections etc. and many people automatically assume that it is the woman’s “fault” anyway. Regardless of which partner has the problem — and often it’s both — it’s important to face infertility together as a couple, to think in terms of having a family and support each other fully.
IVF AND SURROGACY AS SAVIOURS
For couples having issues with fertility surrogacy and IVF (In Vitro Fertilisation) treatments can be a boon. IVF is the most common and most effective type of assisted reproductive technology (ART) to help women become pregnant. The IVF procedure involves making multiple eggs with medicines, removing them from the ovaries with the help of a small operation and then fertilising these eggs outside the body, in a laboratory dish. Once the babies start to grow in the lab, they are then transferred back and implanted into the womb. It is also known as test tube baby in day-to-day usage.
Young women with top chances of IVF success have per-cycle success rates of 40% or higher, while the majority of women have per-cycle success rates of 20-35%. Age of the woman plays a very important role in determining the success of the cycle. IVF can be performed with a woman’s own eggs, or with donor eggs in case of any problems with eggs. Other commonly used options are intracytoplasmic sperm injection (ICSI), transfer of cryopreserved (e.g. frozen) embryos, and IVF with the use of a gestational carrier (surrogate).
The success of an IVF treatment is affected by many factors in addition to parental age, such as the woman’s height, weight, (BMI), ovarian reserve, sperm count and motility, reproductive history (e.g. the number of pregnancies, miscarriages, etc.), and clinical diagnoses.
Surrogacy, an issue that’s at the centre of a nationwide debate these days, is another commonly utilised option for couples struggling to have a baby. Surrogacy means when another woman carries and gives birth to a baby for the couple who want to have a child. Surrogacy is applicable if the woman has a medical condition that makes it impossible or dangerous to get pregnant and to give birth. More prevalent medical conditions that might make surrogacy utilizable are absence or malformation of the womb, advanced tuberculosis or infections of the womb, recurrent early pregnancy losses or repeated IVF implantation failures.
Various types of surrogates are available depending upon the medical needs of the couple. It could only be limited to renting only the womb where the sperms and the egg are from the couple themselves or the surrogate may also donate her egg and use the sperm from prospective father.
Risks associated with surrogacy
Generally, the surrogate mother is fully checked before the procedure for major medical illnesses like HIV or hepatitis. But the risk of lesser known medical or genetic syndromes remain as they are for any normal couple. Also despite the legal paperwork, the risk of surrogate getting emotionally involved may be there especially if she is a known person or distant family member. This makes a lot of surrogacy arrangements unenforceable. There have been cases where the infertile couple have filed for divorce or one partner dies while a surrogate was carrying their baby and now none of the partners want to claim the baby leaving the surrogate in a very precarious position.
Thus while science has opened up more avenues for an infertile couple to have their own babies, these options should be weighed carefully and opted for only if the scales are tilted heavily in favor of and not only as a shortcut or as a matter of convenience.
The writer is a Delhi-based gynecologist working with Srishti: The Gynae Clinic