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India’s fertility rate plummets, doctors seek solutions

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Updated on: 28 March,2024 09:00 AM IST  |  Mumbai
Aakanksha Ahire | [email protected]

A recent study makes concerning revelations about the drastic decline in India’s fertility rate. It hails careers, delayed childbearing, stress and climate change as key factors driving the decline. We spoke to health experts who explore various solutions and remedies to ensure healthy fertility

India’s fertility rate plummets, doctors seek solutions

India could face a significant decline in population in the years to come due to the drop in fertility rates. Photo Courtesy: iStock

Key Highlights

  1. Delayed childbearing in women raises risk of infertility
  2. Infertility in men can occur due to low sperm count or poor sperm motility
  3. Exposure to pollutants disrupts hormone balance leading to reproductive issues

A recent study in the medical journal The Lancet revealed a substantial decline in India’s fertility rate, from nearly 6.2 in 1950 to just under two in 2021. The report further projects a continued decrease to 1.29 in 2050 and 1.04 in 2100. This decline aligns with global trends, with the total fertility rate (TFR) witnessing a similar decrease. 
 
From over 4.8 children per woman in 1950, the TFR has dropped to 2.2 children per woman in 2021. Globally, it is expected to decline to 1.8 in 2050 and further to 1.6 in 2100.
 
Experts caution that if the findings of the Lancet study are accurate, India could face a significant decline in population in the years to come. 
 
So what is the cause behind the low fertility rate in both men and women? We asked health experts to dig deep into the details published in the study. They dissect the causes, health impacts of infertility and solutions.  
 
Dr Surabhi Siddhartha, consultant obstetrician and gynaecologist, Motherhood Hospital, Kharghar, “Several factors contribute to the rising infertility rates in both men and women. These include delayed childbearing due to various reasons like pursuing education, career goals, or financial stability. Environmental factors such as pollution, exposure to toxins, and climate change can also impact fertility. Stress, unhealthy lifestyle habits, obesity, and chronic medical conditions like diabetes can further exacerbate infertility issues.” 
 
Further, Dr Ritu Hinduja, fertility consultant, at Nova IVF Fertility, Mumbai, says, “Delayed childbearing, especially in women, increases the risk of infertility due to declining fertility with age. Further, lifestyle factors like poor diet, lack of exercise, smoking, excessive alcohol consumption, and drug use can also impact fertility in both men and women.” 
 
Infertility in men can occur due to factors such as low sperm count, poor sperm motility, or abnormal sperm morphology. This can be caused by conditions like hormonal imbalances, genetic factors, infections, or lifestyle choices such as smoking, excessive alcohol consumption, or drug use. 
 
In women, infertility may result from ovulatory disorders, fallopian tube blockages, endometriosis, polycystic ovary syndrome (PCOS), uterine abnormalities, or age-related factors. 
 
Other medical conditions such as endometriosis, sexually transmitted infections (STIs), and obesity can also cause infertility.

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How can climate change impact fertility rates? 
Siddhartha: Climate change can indirectly affect fertility by influencing environmental factors like air and water quality, temperature fluctuations, and food supply. Exposure to environmental pollutants and toxins can disrupt hormone balance in both men and women, leading to reproductive issues. Additionally, extreme weather events and natural disasters associated with climate change can cause physical and psychological stress, which may affect fertility.
 
Does infertility have adverse health impacts: 
Siddhartha: Infertility can have significant emotional, psychological, and physical implications for both men and women. It can lead to stress, anxiety, depression, and strain on relationships. Moreover, underlying medical conditions contributing to infertility may also impact overall health and well-being. 
 
Hinduja: In men, infertility may be associated with hormonal imbalances and increased risk of conditions like testicular cancer. In women, infertility can impact hormonal balance, and menstrual regularity, and may exacerbate conditions like PCOS or endometriosis, potentially leading to long-term health consequences.
 
What role does a diet play in one’s fertility? 
Siddhartha: Diet plays a crucial role in fertility for both men and women. A balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats provides essential nutrients like vitamins, minerals, antioxidants, and omega-3 fatty acids, which support reproductive health.
 
Hinduja: An unhealthy diet high in processed foods, saturated fats, sugar, and excessive caffeine or alcohol intake can negatively impact fertility by contributing to obesity, hormonal imbalances, inflammation, and oxidative stress.
 
What foods expose one to the risk of developing infertility? 
Siddhartha: Certain foods and dietary habits can increase the risk of infertility. These include processed foods, sugary beverages, trans fats, excessive caffeine consumption, and alcohol. These foods can disrupt hormone levels, promote inflammation, and impair reproductive function in both men and women.
 
What foods can contribute to a healthy fertility rate?
Hinduja: A fertility-friendly diet includes foods rich in antioxidants (fruits, vegetables, nuts), omega-3 fatty acids (fatty fish, flaxseeds), and folate (leafy greens, legumes) which support reproductive health. Additionally, foods high in zinc (oysters, poultry, beans) and vitamin D (fatty fish, fortified foods) benefit fertility. Consuming a variety of nutrient-dense foods, staying hydrated, and maintaining a healthy weight are key to promoting fertility in both men and women.
 
How can men and women ensure a healthy fertility rate? 
Siddhartha: To ensure healthy fertility, couples should adopt lifestyle practices that support reproductive health, such as maintaining a balanced diet, engaging in regular physical activity, managing stress levels, avoiding exposure to environmental toxins, and practising safe sex to prevent sexually transmitted infections. 
 
Hinduja: Seeking regular medical check-ups and addressing any underlying health conditions promptly is also essential for optimising fertility. 

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Can infertility be treated? 
According to both experts, infertility can be treated effectively, depending on the underlying cause. Treatment options for men and women may include:
 
Treatment for men: 
Medications: Hormonal therapy or medications to improve sperm production and quality.

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