Infertility is rising rapidly, driven by lifestyle, stress and age, and is emerging as a major public health concern worldwide, including in Guwahati
Infertility is no longer a silent struggle affecting only a few couples, it is now emerging as a significant public health concern across the world. The World Health Organisation (WHO) has recognised infertility as a major reproductive health issue, affecting millions of couples globally. While biological causes remain one of the primary reasons, experts say changing lifestyles, stress, delayed marriages, unhealthy food habits, and environmental factors are increasingly contributing to the growing infertility rate.
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Despite its rising prevalence, infertility often remains a topic surrounded by stigma and silence, especially in countries like India where parenthood is deeply associated with social expectations and family life. Medical experts believe that lack of awareness and social pressure often prevent couples from seeking timely medical help.
According to WHO estimates, around 8 to 12 per cent of couples worldwide suffer from infertility. In India too, studies indicate a steady rise in infertility among reproductive-age couples over the decades.
As mentioned in a report by the National Institute of Health, Census data from India showed that infertility among ever-married women increased from 13 per cent in 1981 to 16 per cent in 2001. Another Indian study found that nearly eight per cent of currently married women experienced primary or secondary infertility, with secondary infertility accounting for a major portion of the cases.
To understand the reasons behind the increasing infertility rate, GPlus spoke to Dr Rasna Hiloidari, MBBS, MD from Assam.
Speaking about the major causes behind the growing infertility cases, Dr Rasna said delayed marriage and late pregnancy planning are among the biggest reasons.
“Nowadays many people prioritise education, career and financial stability before planning a family. As pregnancy gets delayed, natural fertility gradually declines,” she said.
She further explained that modern lifestyles are also playing a major role in reproductive health problems. Chronic stress, anxiety, lack of physical activity, sedentary routines leading to obesity, unhealthy eating habits, processed food consumption, smoking, alcohol intake, and inadequate sleep are all contributing factors.
Connecting these lifestyle changes to fertility issues, Dr Rasna pointed out that stress has a direct impact on reproductive hormones.
“Stress increases cortisol levels and decreases Gonadotropin-Releasing Hormone (GnRH), which is responsible for regulating reproductive hormones such as LH and FSH,” she explained.
According to her, inadequate sleep also affects fertility by disrupting melatonin levels and increasing oxidative stress, ultimately causing hormonal imbalance.
Dr Rasna added that unhealthy habits such as smoking and alcohol consumption have become increasingly common, especially among young people, and these habits negatively impact fertility in both men and women.
“In women, smoking and alcohol can damage eggs, reduce ovarian reserve, disturb ovulation, and increase the risk of miscarriage. In men, it lowers sperm count, affects sperm quality, and can even cause testicular atrophy,” she said.
She also highlighted how unhealthy food habits and obesity are linked to hormonal disorders such as insulin resistance, PCOD, and anovulation in women, while in men they may lead to reduced testosterone levels and lower sperm count.
According to WHO estimates, nearly 30 to 40 per cent of infertility cases are linked to such lifestyle-related factors.
Apart from lifestyle issues, environmental exposure is also becoming a growing concern. Dr Rasna stated that exposure to pesticides, harmful chemicals, radiation, and excessive heat from electronic devices like mobile phones and laptops can negatively affect reproductive health, particularly male fertility.
“Rising rates of sexually transmitted diseases are another factor contributing to infertility,” she added.
Explaining the role of age in fertility, Dr Rasna said many people underestimate how rapidly fertility declines over time, especially in women.
“At the age of 20, women have nearly 90 per cent normal-quality eggs. By 35 years, it drops to around 50 per cent, and after 40 years, only around 10 to 15 per cent normal eggs remain,” she said.
She further explained that women are born with a fixed number of eggs, and both the quality and quantity reduce with age.
“Egg count decreases from nearly one to two million at birth to around 25,000 by the age of 37,” she added.
In men too, fertility declines with age. According to Dr Rasna, sperm count and sperm motility decrease after the age of 40, while DNA fragmentation in sperm also increases.
While infertility affects both men and women, society often places the burden solely on women. However, medical data suggests otherwise.
“Infertility increases almost equally in both men and women. Male factors account for around 30 to 40 per cent of cases, female factors contribute another 40 per cent, while the remaining cases involve both partners or remain unexplained,” Dr Rasna said.
The social impact of infertility is equally concerning. WHO and several studies have highlighted how infertile couples often face stigma, isolation, emotional distress, and even domestic violence.
Studies from India have shown that infertility can severely affect mental health and social relationships, especially for women who continue to face societal pressure regarding childbirth.
As infertility cases rise, fertility treatments are also becoming increasingly common. Data from Guwahati Medical College and Hospital (GMCH) recorded 1,376 IVF-related cases between January and May 2024 alone, nearly equal to the total number recorded during the previous year.
However, fertility treatments remain financially challenging for many couples. In Guwahati, a single IVF cycle may cost anywhere between Rs 80,000 and Rs 1.5 lakh or even higher, depending on medication and the clinic.
Speaking about the increasing demand for fertility treatment, Dr Rasna said greater awareness and improving medical technology are encouraging more couples to seek help.
“Today people are more aware about infertility and available treatment options like IUI and IVF. Success rates have improved compared to earlier decades, and there is also better insurance and corporate support in some cases,” she said.
At the same time, she stressed that there are still many misconceptions surrounding infertility in society.
“One of the biggest myths is that infertility is only a woman’s problem. In reality, male infertility and combined factors contribute significantly,” she explained.
Another common misconception, according to her, is that age does not affect fertility.
“People often think they can delay pregnancy without consequences, but both egg and sperm quality decline with age, especially after 40,” she added.
She also addressed myths surrounding breastfeeding, miscarriage, IVF, and birth control methods.
“Many believe pregnancy cannot occur during breastfeeding, but breastfeeding only lowers fertility temporarily and is not a reliable contraceptive method,” she said.
Similarly, one or two miscarriages do not necessarily mean infertility, although repeated miscarriages may require medical investigation.
Dr Rasna further clarified that IVF does not guarantee pregnancy in a single attempt, and some couples may require multiple cycles. She also said that adoption is not the only option after failed IVF, as several other treatments and alternatives are available depending on the underlying cause.
Another widespread misconception is that people who already have one child can never face infertility again.
“Secondary infertility is actually very common,” she said.
She also dismissed the belief that contraceptive methods cause permanent infertility, explaining that fertility generally returns within a few months after stopping birth control measures.
As infertility continues to rise globally and in India as well as in Guwahati, experts emphasise the importance of early awareness, healthy lifestyle choices, and timely medical consultation. While medical advancements have made treatments more accessible than before, addressing the social stigma around infertility remains equally important. Doctors say open conversations, education, and emotional support can help couples seek help without fear, shame, or isolation.