Infertility and advanced ART techniques

On the occasion of World Fertility Day (November 02), more and more Indians should apprise themselves of the impact of changing lifestyle practices on their reproductive health and undertake measures to ensure a healthy life

Today, infertility is a growing health concern in India. Though fertility health has been in conversation for a long time in the society, many Indians are still unaware about infertility, its causes and treatments. Creating awareness about this important health aspect and the available treatment options is crucial in helping break the social taboo associated with the subject, along with providing a ray of hope for several childless couples. On the occasion of World Fertility Day (2nd November 2, 2018), we aim to educate, communicate and empower those experiencing challenges in terms of fertility health and natural conception.

Infertility currently affects about 10 to 14 percent of the Indian population, with higher rates in urban areas where one out of six couples get impacted.An increasing number of couples are suffering from infertility and related conditions, owing to a hectic lifestyle, evolving eating habits and the growing incidence of other medical issues like obesity, diabetes, cancer, etc. Infertility today is an increasingly prevalent health concern and is no longer considered an urban phenomenon or a condition that is believed to be confined only to women.

Infertility has today become a lifestyle disease in India. With several couples seeking medical assistance to conceive, infertility treatments are today a widely sought after medical solution. Though there is a significant increase in the number of patients opting for infertility treatments in India, the numbers are still abysmally low compared to the couples actually requiring medical treatment, due to lack of awareness amongst the public regarding infertility. In fact, of the 10-15 per cent infertile couples who are actively seeking children in India – only 1 per cent have sought IVF treatment so far. However, there is a slow but steady change of perception underway and the IVF market in India is projected to grow at a 21 per cent CAGR. The demand for IVF is higher than it has ever been which has also led to the development of advanced infertility treatment options.
in-vitro fertilisation (IVF) and Intra Cytoplasmic Sperm Injection [ICSI] have long been the most commonly used Assisted Reproductive Technology (ART) techniques. However, IVF-ICSI does not lead to 100 per cent results owing to various factors like implantation failure, advanced maternal age, poor quality of eggs or sperms, low grade embryos, impaired endometrial functionality etc. With the increasing trend in personalised medicine and healthcare services, IVF has witnessed a growing need for individualised protocols such as personalised embryo transfer (pET) and individualised ovarian stimulation to optimise treatment. Technologies like blastocyst culture, Magnetic Activated Cell Sorting (MACS) and reproductive genetics like Preimplantation Genetic Screening (PGS), Preimplantation Genetic Diagnosis (PGD), and Endometrial Receptivity Array (ERA) have helped to increase the success rate of IVF treatments by a significant percentage.

MACS: This is a semen preparation technique that involves the magnetic separation of healthy sperms from the apoptotic ones, which have lower fertility potential. Apoptosis (programmed cell death) is a regulation process of the cell cycle which may occur during spermatogenesis (the process of development of sperm cells), thereby causing cell damages such as sperm DNA fragmentation and is known to be an effective method to treat male infertility.

PGS: Abnormalities in chromosomes is one of the commonest causes of recurrent abortions or failures. Embryos with an incorrect number of chromosomes either fail to implant or miscarry during the first trimester of pregnancy. Reproductive genetics helps in screening the embryos and select the normal embryos for implantation.PGS allows screening for chromosomal abnormalities in embryos during an IVF cycle. All 23 chromosomes are analysed using PGS in order to detect aneuploidies (alterations in the number of chromosomes), which are the leading cause of miscarriages and recurrent implantation failure.

PGD: It helps couples who have a history of certain hereditary genetic conditions in their families [e.g. Thalassemia major]. The technology helps in screening the embryos for specific genetic diseases to prevent the transmission to the child.

ERA is a test to determine whether the uterus is properly receptive to accept the embryos. It also gives the exact time period during which an embryo needs to be transferred into the woman’s uterus to achieve a successful pregnancy.

These latest developments in IVF-ICSI technologies stand tall as a huge relief for many couples as well as fertility experts. Given the steady increase in the number of infertility cases reported in India, such advanced ART techniques come as a boon to several childless couples in the nation. With more number of cases being reported, this also indicates a positive trend of an increase in awareness about subject of infertility and its related causes. In today’s fast paced life, it is essential that individuals understand the importance of fertility health and take care of themselves for a fertile future. Taking up a healthy and active lifestyle with regular health checkups not only provides a healthy body and mind but also helps to make for a safe future.