Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

Breaking the taboo around men’s reproductive health  

Note4Students

From UPSC perspective, the following things are important :

Prelims level: World Health Organization (WHO)

Mains level: Data related to infertility and What are the actual causes of infertility?

Why in the news? 

Following World Population Day (July 11), amidst discussions on global population dynamics, it is essential to highlight a topic often overlooked in conversations about reproductive health: male infertility.

World Health Organization (WHO) Global Perspective on infertility:

  • Prevalence: WHO estimates that 60 million to 80 million couples worldwide experience infertility.
  • Male vs. Female Infertility: Globally, male infertility accounts for approximately 50% of all infertility cases.

Issues Specific to India:

  • Data Deficiency: Unlike global estimates, specific prevalence data for infertility in India are outdated (from ICMR guidelines in 2005) and not comprehensive.
  • Male Infertility: In India, male infertility constitutes a significant portion of all infertility cases, estimated to be around 50%, mirroring global trends.
  • Contributing Factors: Unique challenges in India include environmental pollution, pesticide exposure in agriculture, lifestyle changes including late marriages and stress, which contribute to rising infertility rates.
  • Access to Treatment: Disparities in access to advanced infertility treatments exist, with urban areas having better access compared to rural regions.
  • Cultural and Social Stigma: Infertility remains stigmatized in Indian society, affecting mental health and social well-being of affected couples, and hindering open discussions and seeking timely medical help.

What are the actual causes of infertility?   

  • Male Factors: Low sperm count (oligospermia) or poor sperm motility (asthenozoospermia). Anatomical issues such as blocked sperm ducts or varicocele. Hormonal imbalances, genetic factors, and environmental influences like exposure to toxins.
  • Female Factors: Ovulation disorders, including hormonal imbalances like PCOS. Structural issues like blocked fallopian tubes or uterine abnormalities. Endometriosis, is a condition where tissue similar to the lining of the uterus grows outside the uterus.
  • Shared Factors: Age-related decline in fertility. Lifestyle factors such as smoking, excessive alcohol consumption, and obesity. Medical conditions like cancer and its treatments, autoimmune disorders, and certain medications affecting fertility.

Treatment options

  • Semen Analysis: Essential for diagnosing male infertility, conducted after a period of sexual abstinence.
  • Medical Consultation: Vital to identify underlying causes, whether physical (e.g., blocked sperm flow, anatomical issues) or genetic.
  • Corrective Surgeries: Address issues like blocked sperm ducts, undescended testicles, or anatomical abnormalities affecting sperm production and flow.

Assisted Reproductive Technologies (ART):

  • Intra Cytoplasmic Sperm Injection (ICSI): Effective for cases of severe male infertility where sperm count is extremely low.
  • Intrauterine Insemination (IUI): Suitable when sperm motility is good but count is low, facilitating fertilization within the uterus.
  • In vitro Fertilisation (IVF): Used when both sperm count and motility are low, involving fertilization outside the body before implantation.
  • Donor Sperm Insemination or Adoption: Options for couples where male infertility is irreparable, providing alternative paths to parenthood.

Way forward: 

  • Enhanced Data Collection and Research: Update and expand prevalence data on infertility in India through national surveys and research initiatives. This should include both urban and rural populations to understand regional disparities.
  • Public Awareness and Support Programs: Launch nationwide campaigns to raise awareness about infertility as a medical condition, debunk myths, and reduce stigma.

Mains PYQ: 

Q In order to enhance the prospects of social development, sound and adequate health care policies are needed particularly in the fields of geriatric and maternal health care. Discuss. (UPSC IAS/2020)

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