Statistics show that one in five couples in the UAE face fertility issues, a figure that is higher than in other parts of the world. As per the Dubai Health Authority’s (DHA) latest findings, around 50 per cent of women in the UAE face issues pertaining to infertility. This is in large part caused by a shifting demographic trend coupled with late marriages, and consequently, late attempts to start a family.
At the recent inauguration of the Aster IVF & Women Clinic, it was observed that fertility treatments in the UAE need to become easily accessible and affordable to tackle the growing infertility numbers among couples.
Dr. Gautam Allahabadia, Medical Director of Aster IVF and Women Clinic delves into the various aspects of infertility in the UAE.
Is infertility still a subject that women shy away from or is there a growing awareness about the treatments available to resolve this?
Today women recognise infertility as a medical issue and are much more open to consulting Infertility Specialists. Infertility is defined as the inability to conceive or carry a pregnancy to term after 12 months of trying to conceive. If you are over the age of 35, the time of trying to conceive is reduced to 6 months. It is important to see a Fertility specialist, or a Reproductive Endocrinologist, or in some cases your Obstetrician and Gynaecologist or Urologist for a complete fertility check-up and diagnosis.
What are the common causes for infertility?
Painful or irregular periods, unable to pinpoint ovulation days, partner having a history of sexually transmitted disease for which he has undergone treatment, unhealthy BMI, more than one miscarriage are some of the common causes. Other reasons are Endometriosis, a disorder of the female reproductive system in which the endometrial tissue (the normal lining of the uterus) is found outside the uterine cavity. Luteal Phase Defect (LPD) when the endometrium is inadequately prepared, either because the secretion of progesterone by the ovary is below normal or because the endometrium isn’t responding to the normal stimulation by progesterone. Polycystic Ovary Syndrome is a very common hormone disorder in women, a leading cause of infertility, and one of the most under diagnosed diseases in the UAE. Infertility of about 30 per cent is also due to a male problem such as structural abnormalities, sperm production disorders, ejaculatory disturbances and immunologic disorders.
What are the other known types of infertility?
There is a condition called Secondary Infertility which is defined as the inability to become pregnant, or to carry a pregnancy to term, following the birth of one or more biological children. Unexplained Infertility is experienced by one in five couples despite completing a full infertility work-up. The emotional response to hearing, “there is no apparent reason for your infertility” can be frustrating. Fortunately, there are many options available for the couple diagnosed with unexplained infertility. Besides, abnormalities of the uterus can have a significant impact on the ability of a woman to conceive and to carry a pregnancy successfully. Some women have an abnormally developed uterus from birth (congenital) while others may develop a uterine problem due to infection or surgery (acquired).
What are the unhealthy lifestyle choices leading to infertility?
There is an increasing body of evidence that lifestyle factors can impact reproductive performance. For example, studies have demonstrated that smoking in women significantly decreases the chance of conception. In males, smoking negatively affects sperm production, motility and morphology and is associated with an increased risk of DNA damage. In the female, the constituents of cigarette smoke may affect the follicular microenvironment and alter hormone levels in the luteal phase. Obesity and low body weight can impact reproductive function by causing hormone imbalances and ovulatory dysfunction. Alcohol is a known teratogen and its consumption has been reported to decrease fertility.
Fertility treatments as a broad rule are considered expensive…
This is because the equipment, fertility injections and consumables that go into making babies in the laboratory are very expensive with a short expiry. At Aster IVF, we have introduced treatments like IVF Lite which decrease the total amount of fertility injections and hormones that go into a patient with lesser harmful effects and better pregnancy rates in most groups of patients. With decreasing costs and increasing patient compliance, treatments such as IVF Lite are the future of Assisted Conception.
How important is counselling and explaining the various options that are available to a patient, as a good starting point before a treatment is suggested?
A person suffering from infertility will face complex issues, which span biological, psychological, social and ethical domains. Discussion of these issues in a counselling context is often beneficial for patients. The aim of counselling is to explore, understand and resolve issues arising from infertility and infertility treatment and to clarify ways of dealing with the problem more effectively.
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