Infertility and IVF treatments aren’t only a ‘woman’s problem’
Experts on the importance of partnership in fertility treatments
In many schools, we’re introduced to the concept of human reproduction through the activity of germination. We’re made to plant a seed in the soil and track its growth. We’re told that new life will be brought into the world with the right amount of water, rich soil and the warmth of sunlight. From a tiny seed grows a big, tall and strong tree. But as every plant owner knows, there are times when even the most polished green thumb needs some help. We easily reach out for nutrient-rich fertilisers to create a nurturing environment for the seed to settle down and soak up all the goodness it’s being fed. So, why are we still apprehensive when talking about issues of people needing assisted reproductive technologies (ART) like IVF treatments?
According to a CNBC report, an average of 2-2.5 lakh IVF cycles are conducted in India annually, with projections indicating a rise to 5-6 lakh cycles annually.
It’s still a hushed matter, left for women to discuss behind closed doors with other female relatives—their problem to deal with through rounds of injections, medications and hormonal side effects. But Mumbai-based doctor Sheetal Sawankar, fertility specialist and founder of Avisa IVF & Fertility Center and Dr Arveen Vohra, of Anaahita Fertility Clinic, Bengaluru, say that both partners need to be on board for fertility treatments. It’s not a ‘women’s issue’, but a journey a couple embarks on together.
The word infertility itself holds so much weight – the alternative, ‘barren’, is no better. Infertility affects both men and women – physically and mentally. Sawankar says that when women are under the age of 35, and after a year of regular unprotected sex, they are still unable to conceive, that is when they should consider consulting a fertility specialist and looking into IVF treatments. “For women who are over the age of 35, if you’re having regular, unprotected intercourse for six months and aren’t able to conceive, that is when we claim that the couple is infertile and start digging into what could be the cause,” she adds.
Vohra doesn’t believe in the waiting-a-year philosophy. “Age doesn’t matter. If you are thinking about having children at any point – it could be before your engagement, right after marriage, or even as you finish college and planning for the future, if you know motherhood is something you want – get a preconception check done, even if you don’t go with any IVF treatments in the end.”
Then, the sonograms, blood tests, semen analysis and more get lined up to check various aspects of your reproductive and overall physical health. But before any of the testing for IVF, there’s extensive couple’s counselling, say Sawankar and Vohra, that dives into medical histories and relationship dynamics to give the couple the most in-depth analysis of what they would need. While the woman may have to stick to a very strict medication routine, sonograms and injections, it’s not like the man is let off the hook with just a semen sample.
All experts emphasise couples’ need for open communication, empathy and support for their partners in this bumpy journey.
“The IVF treatments can’t be left to the woman to deal with. She’s already going through a lot”
Imagine living every waking moment by a strict schedule. You’re eating and exercising based on specific requirements, and your diet is limited. Sex is no longer about intimacy and connection but an exercise you perform on a doctor-created routine. Add to that medication and daily injections in your stomach. As much as people side-eye IVF treatments, no woman does this for fun.
Fertility issues in women can range from hormonal imbalances like PCOS, age, environmental and lifestyle factors, fibroids and endometriosis, and structural problems with the uterus; the list seems endless. So, it’s no surprise that the finger often points towards women when couples aren’t able to conceive naturally.
Fertility treatments can be emotionally, financially and physically draining experiences. There’s an urgency for women to reproduce. Vohra says that in the current “instant generation where we literally Swiggy or Zomato anything we want and get it that instant, when it comes to having a baby, and you are unable to, it’s very difficult for women to comprehend why it is not happening.”
Add to that the physical and emotional stress that half of first-time IVF cycles fail. “Fertility treatments are also a major life experience. Most people don’t treat it that way, nor allow women to act like it is,” says Vohra. IVF treatments require time, energy and as stress-free an environment as we can possibly create. Imagine taking a jab in your stomach in the morning, trying to curb your hormones while trying to talk to a non-communicative partner, then rushing around the house doing chores, meeting family responsibilities and ensuring that your manager at work hasn’t caught on that your project is running slightly behind.
“When people come in for fertility-related consultations, we advise them not to jump straight into it (of course, this also depends on every individual case). These things need proper planning after looking over both partners’ schedules.” You can’t start IVF treatment and then jet off to Sri Lanka because you agreed to plan your favourite cousin’s 7-day-long wedding ceremonies.
“You can’t decide the nature of infertility based on only one semen analysis”
The popular myth is that infertility is caused by a ‘deficiency’ in the woman, but Sawankar quickly corrects that myth. Medical ailments, injuries, genetic disorders, lifestyle habits and environmental stressors impact male fertility as much as it affects women.
The most common test to diagnose infertility in men is a semen analysis, which Sawankar says gives them a rough idea about the sperm count and motility – two important factors when it comes to doing IVF.
Sawankar says there are techniques, such as intracytoplasmic sperm injection (ICSI), for when motility and sperm count are issues. The expert with sperm injects each egg.
The common perception is that the role of men is limited to ejaculating into a jar and handing it off to the nurse. Ejaculation is not a guarantee of a job well done, explains Sawankar. Azoospermia is one of the leading causes of male infertility, where ejaculation is successful but has zero sperm. After determining if it’s obstructive or non-obstructive azoospermia, surgical sperm retrieval might be needed.
Sawankar has observed in many cases where couples haven’t “consummated the marriage before coming for fertility treatments. While taking the detailed history you come to realise that they aren’t having proper intercourse for reproduction, or the man is dealing with erectile dysfunction or premature ejaculation where implantation of sperm is unsuccessful.”
Add growing pollution, environmental stressors, occupational hazards and poor physical and mental health to the scene, and male fertility takes a major hit.
“Smoking is a major contributor to infertility. Small blood vessels supply the testes with blood, and alcohol and smoking restrict the blood supply and majorly affect motility and count. If someone works in hazardous environments, such as lots of construction sites and painters, this can impact sperm health,” adds Sawankar. A history of diabetes and metabolic conditions like hypertension, poor diets, very hot showers (where the temperature is higher than the body temperature) and high-stress levels are all things that Sawankar says experts help the couple tackle before any ‘real treatment’ is started.
Getting a bad semen analysis report can feel like a wily coyote dropped an anvil on your chest. But Sawankar assures that one test result isn’t enough to decide what’s happening in your body. “If there is low sperm in your semen, you have to repeat it after a period of three months. You may need to repeat the count after a few days if the count is zero. Many external factors like stress or illnesses like dengue or malaria can temporarily hamper sperm count.”
Technology has come a long way to assist reproduction, as long as men start their journey with honesty and willingness to make the necessary lifestyle changes.
It takes two
This is a mutual partnership between both partners to handle the ups and downs together. Think about it: the stress, the hope, the disappointment – it’s a lot to go through alone.
It’s a real whirlwind for the partner going through the physical procedures. Hormones doing their cha-cha, doctor visits becoming a part-time job, and the uncertainty of it all – it’s an emotional minefield.
Then there’s the other partner, taking on the role of the support system, the cheerleader, the shoulder to cry on. Watching your loved one go through this is like being on the sideline, feeling limited in ways you can help yet trying to be strong.
When both partners are in sync, it’s like having a secret superpower. You can tag-team the emotional hurdles, make tough decisions together, and be there for each other in ways you never knew you could.
But when one’s on board, and the other’s not, you row a boat with just one paddle. It gets messy and frustrating and can strain your relationship seriously.
In the end, it’s about facing this crazy ride hand-in-hand. Understanding each other’s emotional rollercoaster, supporting one another, and being a solid team, no matter the outcome.
