The Institute of Reproductive Medicine (IRM), Kolkata is the brainchild of world-renowned Gynaecologist and ART expert, Late Dr. Baidyanath Chakravarty, who delivered the 3^rd Test Tube baby in India. Established in 1986, more than 7600 babies have been delivered till date via IVF. Dr. Meenakshi Karan, IVF specialist, has been attached with IRM for more than 6 years and has treated innumerable infertile couples.

Infertility is a growing global concern. According to the World Health Organization (WHO) 1 in 6 people worldwide experience infertility during their lifetime. It affects both men and women almost equally. Countries with aging populations and low birth rates (e.g., Japan, South Korea, Italy) are deeply concerned. People are starting to realize the deep impact of infertility which can create serious issues in the long run like population decline leading to shortage of labour.

Infertility is a complex issue which has more than health-related concerns. In many countries there is a social stigma associated with it. In many cultures, childbearing defines a person's social identity and worth. Infertile individuals, particularly women, may be viewed as "incomplete," "broken," or a "bad omen," which can lead to devaluation and public humiliation.

In communities with limited education about reproductive health, infertility is often blamed on the woman, even when it is caused by male-factor infertility. In-laws and community members may openly speculate about the cause, contributing to a constant state of shame and anxiety. Infertile couples may be excluded from family gatherings, religious ceremonies, and community events, which can cause deep isolation. The fear of being pitied or questioned often leads individuals to withdraw from social interactions voluntarily.

Infertility can lead to detrimental effects on relationships. Intense social pressure and the stress of infertility can be a major source of marital conflict. This can lead to resentment, arguments, and communication breakdowns. Studies indicate that couples who do not conceive after fertility treatments are at a higher risk of divorce. In patriarchal societies, an infertile woman may face threats of divorce or be pressured to accept that her husband takes another wife to have children. Her social status within the family becomes unstable and insecure.

There are many reasons which are increasing the chances of infertility. In many countries, people are choosing to have children later in life due to career goals, financial insecurity, and higher education pursuits, among other reasons. It is a proven fact that fertility decreases with age. Peak fertility is typically in the early to mid-20s. Fertility begins to decline gradually in the late 20s to early 30s, and more significantly after age 35. By age 40, the chances of natural conception drop sharply. The decline is due to both quantity and quality of eggs decreasing with age. There's also a higher risk of miscarriage and chromosomal abnormalities (like Down syndrome) with increasing maternal age. For men however the effect is not as severe as in women. Male fertility declines more gradually, often starting around age 40–45. Sperm quality (motility, volume, morphology) and testosterone levels may decrease. Advanced paternal age is linked to increased risks of autism, schizophrenia, and other conditions in offspring. 

Environmental and Lifestyle Factors also play a crucial role. Air pollution, exposure to endocrine-disrupting chemicals, and toxins are linked to declining fertility. Lifestyle factors like poor diet, obesity, smoking and alcohol and stress and sedentary habits are detrimental to fertility.

Consulting an expert for infertility is important because infertility is often a complex medical condition with a wide range of potential causes, and timely, specialized care can significantly improve chances of conceiving. An expert can recommend and interpret appropriate tests (e.g., hormone panels, ultrasound, semen analysis) to pinpoint the root cause, which is crucial for selecting the right treatment. A personalized treatment plan is integral to a successful treatment. A Fertility specialist tailors treatment based on:

• Diagnosis
• Age
• Duration of infertility
• Medical history
• Financial considerations

Common treatments include:

• Ovulation induction
• Intrauterine insemination (IUI)
• In vitro fertilization (IVF)
• ICSI for male infertility
• Donor egg/sperm options or surrogacy

Without expert input, patients might waste time and money on ineffective treatments or miss better alternatives. Timely intervention improves success rates. Early diagnosis and appropriate treatment can increase the success rates of natural or assisted conception. Delaying expert consultation may reduce the treatment options and success probabilities.

A fertility expert can identify and manage contributing factors like:

• Thyroid dysfunction
• Obesity or underweight
• Insulin resistance
• Stress, alcohol, or smoking
• Sexual health or timing of intercourse

They may also uncover other conditions (e.g., fibroids, autoimmune diseases) that could be silently affecting fertility or pregnancy outcomes. Hence, they can provide guidance on lifestyle and underlying health conditions.

Reproductive endocrinologists and fertility clinics offer:

• High-resolution imaging
• Embryo freezing
• Genetic screening (PGT)
• Surgical correction (e.g., laparoscopy)

These services are often not available in general medical practices. Thus, consulting experts can help patients access advanced technology.

Infertility can be emotionally draining, as already seen. Experts are the best ones to provide psychological and emotional support by providing targeted counselling. They can refer patients to support groups and help them cope with the ups and downs of treatment. A multidisciplinary team ensures that mental and emotional health is cared for alongside physical treatment.

Therefore, expert help aids in understanding:

• Success rates
• Risks and side effects
• Financial implications
• Alternative options (e.g., adoption, donor conception)

This empowers the patients to make clear, confident and informed decisions.   

By Dr Meenakshi Karan, MD (Obs and Gyn) DNB (Obs and Gyn), FNB (Reproductive medicine): Consultant and IVF Specialist, Institute of Reproductive Medicine , Kolkata, West Bengal, India

Contact no - +919319325225, Email id – irmkol.intl@gmail.com URL – www.irmkolkata.org