India is a country that has seen drastic lifestyle changes in the recent years especially among the young population. From smoking cigarettes to excessive use of contraceptives there is a steady increase in the poor lifestyle choices which have adverse effects on all aspects of health. The effects on fertility however are often overlooked. The increase in lifestyle risk factors is found to be one of the key drivers for the high occurrence of infertility among Indian men and women.
The major lifestyle factors that have contributed to infertility are increased use of tobacco, high alcohol consumption, increasing prevalence of contraceptive use, rising levels of obesity, stress, career oriented women postponing marriage, couples opting to plan a child at a later age, late working hours, etc. Apart from those, certain medical conditions such as Poly-Cystic Ovarian Syndrome (PCOS), endometriosis, premature ovarian failure, congenital problems related to hormones (like LH/FSH) or organs (like uterus, tubes & ovaries) etc. also cause early onset of infertility. While clinical solutions can help overcome the medical factors, there is a dire need to create awareness on the lifestyle risk factors for infertility to avoid those and to combat difficulties in seeking early fertility care.
The evidence based review of lifestyle factors addresses the adverse impact of potentially modifiable, non-communicable lifestyle factors like age, weight, smoking, psychological stress, alcohol consumption, exposure to environmental pollutants on the reproductive outcome in the general populations. Evidence also suggests that modifications in the lifestyle factors can assist couples to conceive spontaneously and optimize the chances of conception in those undergoing ART treatment. Young population is aware that the negative lifestyle factors reduce fertility but falsely believe in fertility myths. Hence regular public education campaigns are necessary to avoid erroneous beliefs about pseudo-protective factors like diet, benefits of rural living, misperception of impact of age on fertility.
Routine well-women visits offer an excellent opportunity to begin to address the impact of selected risk factors for infertility. Clinicians can optimally utilize these visits to target appropriate interventions for initiating, repeating and reinforcing messages on fertility risks.
Let us understand how some of the major lifestyle factors affect fertility.
Certainly there are many other factors, including ethnicity, that lead to infertility apart from the above, and the given lifestyle risk factors result in assorted health problems apart from impaired fertility. Nonetheless, we need to understand that the problem of infertility is growing by leaps and bounds in the modern world, with an estimated 22-33 million Indian couples impacting the health of Indians. Hence, we need to spread more awareness on infertility and its causes, appropriate behaviours to prevent it and available treatments for infertility.
It is important for young women to lead a healthy lifestyle, ensuring a balanced diet and regular exercise. A doctor consultation is recommended in case of prolonged or irregular menstrual cycle for early evaluation. Couples who fail to conceive after one year of marriage and women who plan to start a family after 35 years of age are advised to get fertility check done. Today various advanced infertility treatments are made available in India, however 70% of all cases require only minimum treatment.