World Health Day: Lifting the curtain off stigmas associated to reproductive health

On World Health Day, Dr Kshitiz Murdia, CEO & Co-founder, Indira IVF talks about current challenges and need of the hour in reproductive health

Health is a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity. All current definitions of health define health as more than the absence of sickness, suggesting an individual’s greatest capacity for self-realisation and fulfillment. As a result of the interaction of individuals with the social environment, social medicine and public health approaches to health suggest that we should not only examine the health of individuals, but also the health of groups and communities.

During the pandemic, by remaining confined in homes and following lax routine activities such as sleeping, unplanned eating, and almost negligible physical activity; the disease has certainly impacted our body in many ways and its impact on sexual and reproductive health have also been observed widely. A study published in BMJ Open says that many young adults have sexual and reproductive health problems due to COVID-19 pandemic and related containment measures.

Even today, due to the lack of awareness certain vital elements of our health like mental health and sexual and reproductive health are taboo topics not openly discussed about in the society. In India, the conversation about infertility too has found acceptance remotely only in the recent past.

Infertility is described as a couple’s failure to conceive after one year of unprotected intercourse or owing to a medical condition that prevents it. According to published data from the World Health Organization, infertility affects roughly 48 million couples and 186 million people worldwide. Fertility rates in India have been steadily dropping for the past two decades.

The national Total Fertility Rate (TFR) was determined to be 2.2 in the National Family Health Study (NFHS) 2015-16 survey, down from 2.7 in the NFHS 2005-06 survey. India’s fertility rate has been declining, according to the most current numbers from the National Family Health Study, with the 2019-21 survey putting it at an all-time low of two children per woman. Even when we look at matters beyond fertility like Maternal mortality rate (MMR), it till date remains one of the leading causes of demise for women after conception. According to latest data published in March 14, 2022 India’s maternal mortality ratio (MMR) has improved to 103 per 100,000 live births in 2017-19, from 113 in 2016-18 per 100,000 live births. However, the United Nations has set in its Sustainable Development Goals (SDGs) this rate as less than 70 per 100,000 live births. MMR in India has decreased significantly over the years, but we are yet to go a long way to achieve the UN SDG.

It is a harsh truth that for ages women in this country have been at the receiving end of much blame in cases where a couple is unable to conceive due to their role throughout the process. The term mother is associated with both pregnancy and childbearing in several cultures across the world, whereas father or paternity is associated with ownership of these children. The foundation for this is society’s assumption that women’s conventional norm or ‘destiny’ is to marry and produce children in order to continue on the family’s genetic lineage. As a result, instead of seeking scientifically supported guidance, individuals turn to superstitious beliefs and religious leaders for correctional measures. 

Research has found that of all cases of infertility, women are accountable for 40 per cent, men for another 40 per cent, and both men and women for the remaining 20 per cent.¹ Sadly, men’s infertility has only recently been brought to light as a result of studies in the last few decades.

In India, access to the right diagnosis and treatment is a huge challenge that leaves couples overwhelmed at times. It has to be appreciated that with the advancement of fertility treatment across the world most conditions relating to infertility are curable. Besides other reason age could be the single most important factor affecting live birth.

At the same time, while it’s a popular misconception that individuals in their late thirties seek counsel on assisted reproductive technologies, we’ve seen an increase in the number of younger couples seeking treatment alternatives from infertility experts. Indians are rapidly adopting ART and its treatments to fulfil their dreams of childbirth. One of the most popular methods IVF service is estimated to grow at a CAGR of 14.7 per cent by 2026². A major share of India’s medical tourism is credited to assisted reproduction.

Infertility remains a hidden topic, even after undergoing infertility treatment and having a healthy baby through IVF, many are reluctant to share their experiences with friends and family. The lack of knowledge about the process involved may be due to the fact that infertility is personal, often viewed as a curse or taboo in India and hence not publicly announced. Knowledge of infertility treatment, allows people to make decisions about family planning for years to come.