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Today we live life on the fast track, controlled and manipulated like robots, by the hands of the clock. Life is one mad rush to compete, excel, amass wealth and often spend it in ‘riotous’ living.
The human body is comfort-loving. Food, sleep, recreation, sex are requirements that keep a person healthy. An imbalance in any of these essentials is bound to create physiological and psychological upheavals. Nowhere is it so explicitly evident as in the field of Reproduction and Fertility. In the last forty years, Fertility has shown a decline especially in affluent countries or where the level of education is high. Rapidity of social change is another factor.
Either the woman, the man or the couple jointly, may be the cause of declining fertility.
Women
o Changing roles of women have been cited as the foremost reason. About 64% of all working women are married. In some families they are the sole bread winners. It is this empowerment that has given women a lot of attitude both in their behaviour and fashion statements. Many working women claim that they have no domestic skills at all.
o Changing Lifestyles: Smoking, drugs and alcohol consumption can have an adverse effect on fertility. Someone described a child born to an alcoholic mother as a “pathetic little creature, starved, shriveled and imperfect.”
o Risky behaviour: De-linking sex from marriage has led to cohabitation before marriage and extra marital liaisons. Promiscuousness is a significant trend of this millennium. Women are therefore exposed to sexually transmitted disease, HIV, AIDs and other bacterial infections, which can cause blockage of the tubes. Frequent termination of unwanted pregnancies can also leave residual infection in the fallopian tubes or cause incompetence of the cervix. The latter can cause recurrent abortions when the woman eventually decides on keeping her pregnancy.
o Late Marriages and Late pregnancies: The ill effects of postponing pregnancy till very late cannot be ignored. The most fertile period in a woman’s life is between 22-30 years. Fertility decreases after forty. Though many women like Cherry Blair and Susan Sarandon have delivered in their late forties, this is certainly not an ideal age. As one grows older, the likelihood of spontaneous abortions and abnormal fetuses increase. Medical complications like pregnancy induced hypertension, Eclampsia, or Diabetes can occur. Labours too can be difficult, and the incidence of operative deliveries shoots up.
Hypertension, Diabetes, Coronary heart disease are problems of middle age. When these already exist, pregnancy puts them in a ‘high risk’ category. The growth of the fetus may be affected or there may be chromosomal abnormalities. Children born to such mothers may also be genetically programmed to suffer from similar diseases in their adult life.
o Identity Crisis: Because of the dual roles of home maker and wage earner, long working hours, lack of sleep, women suffer from anxiety and tension. Stress acts on the adrenal glands which become over active, and even produce small quantities of male hormone. Many career women are aware of it. Some choose to ignore it but others quit their high powered jobs and opt for motherhood.
Cortisol leads to higher waist:hip ratio. Sometime ago the BMJ carried an interesting article about the way body fat distribution can influence fertility more than age or obesity. Researchers in Netherlands reported that 0.1 unit in waist:hip ratio led to 30% decrease in conception rates, irrespective of age or weight.
Men.
Studies from US show that 25-30 million men have suffered from a decline of sperm count over the years. Another study by the Mumbai Institute of Research for Reproduction shows that the quality and quantity of sperm have declined over the last couple of decades. Tests were done on 1500 men between 1986-95, which showed a reduction in sperm count by 30% and reduction in motility by 10%. Similar trends were noticed in England, France, Denmark Scotland and Finland. In the West, this was attributed to an increase in testicular cancer, and in India, due to pollution with pesticides containing a high percentage of lead.
o Behaviour changes: “Metrosexuals” are learning to be more feminine, more accommodating and more emotional. They like to preen themselves like women. Male beauty products have gone up by 30%, and those asking for plastic surgery have increased by 20%. According to New York Times, male models look “chicken chested, hollow cheeked and undernourished.”
With wives who are economically independent, many feel disempowered. They are confused about their status within the family, and even categorize themselves as the “newly oppressed minority.”
o Lifestyles: Lucrative and competitive jobs are not without their share of stress. Erratic
mealtimes, fast food, processed food, lack of exercise, constant preoccupation with TV or the Internet make both male and female bodies resistant to Insulin. As a result, more insulin is produced, and there is more accumulation of fat, leading to obesity, which diminishes fertility.
Alcohol, though it increases desire, decreases performance. Drugs such as marijuana reduce testosterone levels by up to 41%. Narcotics, tranquillizers, and certain medicinal drugs are known to reduce fertility.
Similarly, infections like TB, Gonorrhea cause epididymal obstruction.
o Fashion: The normal sperm count is between 60-200million/ml. Studies show that counts have dropped by 1/3 in men between 30-40 years. This may be due to groin hugging jeans that are popular with the young. Tight jeans push back the testicles into the body, where the temperature of 98.6 degrees is 3 degrees higher than in the scrotum. Similarly men using laptops also increase the temperature in the scrotum, as laptops operate at 70 degrees C. Those who keep their cell phones in their pockets or clipped on to belts while using a ear piece to chat may also be compromising their sperms.
o Age: Men may be able to retain their virility up till the seventh decade, but the belief that they could father normal children is debated. Advanced paternal age can cause autism or schizophrenia in their offspring. Harry Fischer in his book “The Male Biological Clock” says fertility reduces with age, and the risk of genetic abnormality in their progeny is high.
o Andropause or male menopause may happen between 50-60 years. Males suffer from loss of libido in addition to other symptoms like fatigue, loss of muscle volume, enlarged prostate and emotional problems.
Couples:
As income and social status increase, sexual activity reduces. Sometimes couples try to outdo each other in job status or earning capacity. This creates a “no win” situation in the bed room. A number of double income couples say they have no time for sex. 50% of these suffer from infertility because of infrequent sexual activity. When it does happen, it is a mechanical ritual.
Many men find it difficult to adjust to the demands of living with modern wives. With changing sexual equations, women not only flaunt their sexuality but demand fulfillment. When disappointed, they openly express dissatisfaction with their spouses. This can cause psychological infertility and impotence in men.
When husbands work in other cities or countries, or are frequently away from home, like pilots or traveling salesmen, there is less opportunity for marital sex. The ‘Absentee Husband Syndrome’ is responsible for falling sperm counts.
Voluntary Childless Couples are on the rise. This may be by mutual consent. Fear of what children can do to such career oriented people makes them deprive themselves of sexual gratification. Sex becomes an enemy to be avoided at all costs. Because natural urges are suppressed, instability in marriage relations may set in. Sexual anorexia expresses itself in psychosomatic symptoms including infertility.
On the other hand, it could also lead to extra-marital escapades or create an addiction to clandestine sex.
Some couples consider the high cost of nurturing and educating children, and prefer not to have any.
It is time for couples to re-assess their life styles and working patterns. Sorting out power balances in a marriage partnership will facilitate ‘togetherness’ and ‘intimacy’. Families are important building blocks of society, and children are a ‘godly heritage.’
