Category Archives: Human Reproduction

Since the birth of the first test tube baby in the United Kingdom in 1978, more than eight million babies conceived through in vitro fertilizationfertilizing human eggs in a laboratory and then implanting them into a womans uterushave been born, the vast majority of them in Europe and North America. Between 1 and 2 percent of all children born in the United States each year are conceived through in vitro fertilization. For many couples who struggle to conceive naturally, IVF allows them to become parents in a way unimaginable only two generations ago.

Who could find fault with that?

In reality,the methods by which children are conceived through IVF can be problematic for anyone who believes that human life begins at conception and should occur through natural means. That is the teaching of the Catholic Church,which also teaches that the removal of the conception of a child from the sexual relationship between spouses is a problematic notion.Many other many religious traditions worldwide accept IVF technology, with varying definitions of what processes should be allowed.

Over the last four decades, bioethicists and church leaders have tried to reconcile church teaching on these issues with the fact that, for many couples, technological assistance is necessary to conceive. We are not anti-science, the church has argued, but we are against treatments and procedures that violate the dignity of human life and discard a central reason for marriage.

The church objects to IVF on two separate grounds, the first being that fertilizing an egg in a laboratory removes the conception of the child from the marriage act. In a 1998 article for the U.S. Conference of Catholic Bishops, Begotten Not Made: A Catholic View of Reproductive Technology, John Haas, then the president of the National Catholic Bioethics Center and a consultant to the N.C.C.B. Committee for Pro-Life Activities, stated the rationale behind this objection:

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The Vatican made a similar argument in a 1987 clarification issued by the Congregation for the Doctrine of the Faith and signed by Cardinal Joseph Ratzinger, then the prefect of the C.D.F., titled Donum Vitae (The Gift of Life). Implanting a fertilized egg into the uterus in the hopes of a pregnancy, the document stated, objectively effects an analogous separation between the goods and the meanings of marriage because it is seeking a procreation which is not the fruit of a specific act of conjugal union. In other words, sex between married persons is meant not just to be unitive, bonding the couple in love, but also procreative, meant for the conception of children. A parallel understanding of sexunderpins the churchs teaching in Humanae Vitae (On Human Life), the 1968 papal encyclical affirming the churchs ban on artificial birth control.

Donum Vitae further stated, citing Canon 1061 of the Catholic Churchs code of canon law, that fertilization is licitly sought when it is the result of a conjugal act which is per se suitable for the generation of children to which marriage is ordered by its nature and by which the spouses become one flesh. But from the moral point of view procreation is deprived of its proper perfection when it is not desired as the fruit of the conjugal act, that is to say of the specific act of the spouses union.

Similarly, a 2008 document from the C.D.F., Instruction Dignitas Personae on Certain Bioethical Questions, signed by its prefect at the time, Cardinal William Levada, argued that any medical techniques used for the treatment of infertility must respect three fundamental goods: a) the right to life and to physical integrity of every human being from conception to natural death; b) the unity of marriage, which means reciprocal respect for the right within marriage to become a father or mother only together with the other spouse; c) the specifically human values of sexuality which require that the procreation of a human person be brought about as the fruit of the conjugal act specific to the love between spouses.

Medical efforts that assist procreation, the document states, are not to be rejected on the grounds that they are artificial. As such, they bear witness to the possibilities of the art of medicine. But they must be given a moral evaluation in reference to the dignity of the human person, who is called to realize his vocation from God to the gift of love and the gift of life.

Dr. Haas noted that Donum Vitae was not meant to be seen as a negative reaction to the use of medical technology to assist couples trying to conceive; rather, it teaches that if a given medical intervention helps or assists the marriage act to achieve pregnancy, it may be considered moral; if the intervention replaces the marriage act in order to engender life, it is not moral. For example, the church accepts NaProTechnology, a form of natural family planning that incorporates scientific research and advanced medical techniques for predicting ovulation and levels of fertility, as a valid method for assisting couples trying to conceive.

Catholics in the pews have a reputation for being somewhat cavalier regarding the churchs teachings on human sexuality and reproduction. While the church obviously does not determine the morality of an action or trend by the percentage of Catholics who perform it, one study, released in 2011 by the Guttmacher Institute, suggested that 98 percent of sexually active Catholic women in the United States between the ages of 17 and 44 had used artificial contraception at some point, in direct contravention of church teaching.

IVF, however, may cause other ethical dilemmas for the faithful. Many attempts to implant an egg into a womans uterus involve fertilizing a number of eggs and implanting a number of embryos in the uterus at once, then reducing the number of viable fetuses through abortion surgeries before the full number come to term. In many other cases, excess embryos are frozen and stored. Church teaching is that life begins at conception, and that from the moment of conception the fertilized egg is a person. For anyone who accepts this premise, the conclusion is inescapable: The selective elimination of implanted embryos is the killing of innocent human beings, and the storage of embryos in a frozen state is a violation of their human dignity.

Most studies suggest that over 90 percent of embryos conceived through IVF will dieand not just from selective abortions, as the medical process has an extremely high failure rate. To be fair, natural conception also does not always offer great odds of success: The U.S.C.C.B. estimates that 15 percent of known pregnancies end in miscarriage, while the Centers for Disease Control estimate that half of all pregnancies in the United States end in miscarriage or stillbirth, and many millions of women never know that they suffered a miscarriage.

The pastoral response to this is difficult for parish ministers and health professionals. Most couples marry with the expectation of a family. When infertility becomes an obstacle, it is not just an issue of the procreative nature of marriage but its unitive nature as wellif people marry with the assumption that children will follow, and that proves impossible, the unitive element of marriage can be badly hurt. The theologian Lisa Cahill hasargued that the church's ban on IVF even when it does not include donors or surrogates "fails to foreground its teachings about sex, love and parenthood in the actual experiences of married parents or of infertile would-be parents" (America, March 28, 1987). Many pastoral ministers know of couples who have suffered as they parsed out what it meant that one or both spouses could not conceive naturally.

As reproductive technologies improve and proliferate, the ethical dilemmas will affect more and more couples. Most American Catholics now know adults, themselves now sometimes parents, who were once upon a time called test tube babies. Their witness enters the conversation as well.

And now we move to the most difficult ethical question: What about the embryos that were frozen? The teaching of the church is that each and every one is a unique human being who deserves to be born and to flourish. So should the church allow infertile couples to become pregnant through IVF using embryos currently in storage? It might violate the principle that a child should be conceived through sex, but it could also be seen as a mercy to the embryos themselvesand a grace to childless couples seeking to live out the procreative nature of their marriage.

One problem? There are at least 400,000 frozen embryos in the United States alone. Other estimates suggest the number might approach a million.

What to do with those 400,000 or more embryos, the castoffs of a well-funded industry that carefully euphemizes what is required and lost to implant a viable embryo in a healthy uterus? Couples who choose IVF face cruel choices yearly because they are typically asked to pay $600 or more a year to keep their embryos frozen rather thanhave them discarded. But what if they could offer those embryos to parents who are struggling with conception? What if childless couples could adopt such embryos and raise them as their own?

It would require some clarification of the teachings of the Catholic Church on the issue, or at least a nuance added to existing doctrine, because Donum Vitae states that the notion that embryos could be put at the disposal of infertile couples as a treatment for infertility is not ethically acceptable and would also lead to other problems of a medical, psychological and legal nature. But with the teachings already applied to vaccinesthat what has already been created is licit to use, even if its origins were not necessarily licitmight it be possible to give childless couples the chance to bear the forgotten?

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Why does the Catholic Church object to IVF? It's more complicated than you think. - America Magazine

Today marks the end of the official 16 Days of Activism against Gender-Based Violence, which falls on International Human Rights Day. This years theme was Orange the World: Fund, Respond, Prevent, Collect! We spoke to some of our Members of the Human Rights, Refugees and Violence Against Women Committee about the activities they carried out to ensure that awareness around the theme of the 16 Days was increased and to increase commitment to the elimination of this tragedy.

Dr Diana M. Galimberti from Argentina, tells us how, alongside colleagues, they committed to addressing violence against women in Latin America.

Dr. Miguel Gutirrez Ramos and I committed to address the topic of sexual abuse and violence throughout Latin America when in Istanbul.Although in El Salvador, Guatemala and Argentina we received immediate support for our activities, the worldwide quarantine impeded continuation of this project until mid- 2021.However, Dr. Gutirrez has actively participated in several meetings that were nevertheless held: at the University of Santa Fe in October of this year, where I acted as coordinator;once at a nation-wide course for obstetricians in Peru, and he will be a speaker at a meeting on sexual and reproductive rights in Arequipa, Per shortly.He habitually represents the topic of GBV from FIGO perspective at the professional meetings he attends.

During times of war, general disruption of the normal way of life conduces to higher levels of violence in society.

Argentinais one of the most advanced countries in facing GBV against women and girls.Social programmes, judicial backing and general campaigns are forwarded by the Ministry of Health and also the Ministry of Justice and Human Rights. A federal survey for all health workers has recently been launched and, based on its results, training programs on GBV will beinstituted in all public hospitals of the country.

Dr Chiara Benedetto, Chair of the FIGO Subcommittee for Refugees, explains the current situation in Italy and what they are doing to advocate for an end to violence against women.

Winning rights for girls and women is about more than giving opportunities, it is also about changing how countries and communities work, and how the fabric of society evolves. It means investing in a fairer, more equal society, free from violence. Indeed, we are living through a trying time where Gender Based Violence (GBV) is ever more behind locked doors as the waves of the COVID Pandemic confine victims with perpetrators. In Italy, there were 91 feminicides in the first 10 months of 2020, i.e., 1 every 3 days and a 73% increase in requests for help to the various associations (Istat -TheItalian National Institute of Statistics).

In line with FIGOs declarations on Violence Against Women, we recognisethat violence against women and against girls is highly prevalent and may be exacerbated in situations of crises such as conflict, displacement and among refugees. Indeed, we are in constant contact with our migrant focus group members, also through emergency numbers and assistance. Despite the COVID Pandemic and the heavy restrictions on meetings/congresses in person, numerous initiatives have been, and will be taken in Italy to raise awareness as to GBV, including a webinar, video appeals, and a number of online meetings and initiatives.

Dr Colleen McNicholas from the United States comments on their situation and what we need to do to centre the most vulnerable.

The United States continues to provide example after example of why the work of addressing and eliminating human rights violations, especially acts committed against minority communities, is so important. The devastating revelation of forced hysterectomies and sterilisation on migrant detainees reawakened an awareness of the shameful history this country has of prioritising the fertility and reproduction of some while decimating others. When I think of the most impacted by violence against women, I cant help but acknowledge the horrific rates of murder amongst transgender women, particularly women of colour. If raising awareness about gender-based violence is to have a meaningful impact, we must centre the most vulnerable.

From Mexico, Dr Atziri Ramirez tells us about online support groups for victims of violence.

I have committed myself to an online facebookgroup called "Feminist Doctors" where we touch upon several topics one of them regarding "how to educate and disseminate the Violentometer" which is a scale where a woman can realise that she is being a subject of violence. We have concluded that a good way is by posting this information in groups and offering access to public resources (such as public telephone numbers of agencies that are supporting women who are victims of violence in their homes). Following the line of online content I also became part of a group called "Trueka Feminist" which supports victims of violence by online trade. I have disseminated this information among my peers,undergraduatestudents and trainees.

Finally, Dr Taghreed Alhaidari shared posters that were created by the Iraq Member Society which were published on social media, highlighting facts and figures on the rates of GBV.

We hope these examples inspireyou to continue to carry out this important advocacy work and help to eliminate violence against women, beyond the 16 Days of Activism. For more resources on GBV and the 16 Days, visit the UN website.

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16 Days of Activism What have our Members been up to? - International Federation of Gynecology and Obstetrics

A sad fact remains this Christmas 60% of children in LGBT+ families have zero legal rights to one of their parents five years on from the Marriage Equality Act of 2015.

This week, ahead of Christmas, Equality for Children have renewed their pledge to ensure that progress is made to achieve equality for all children of LGBT+ families. By Christmas 2021, the grassroots group hopes to achieve 100% parental rights for all LGBT+ families.

Sadly, this is not the case today.

This Christmas we think of all the children of LGBT+ families who have been left behindAs it stands today, only one parent can be a legal parent, which of course is perilous in the event of bereavement, illness and more, Ranae Von Meding, Equality for Children.

Currently, ONLY 40% of LGBT+ families have the same rights as heterosexual couples, leaving behind 60% of children as not having access to full legal parental rights and this is five years on from the passing of the Marriage Equality Act of 2015

For most Irish families, this is the happiest time of the year. It should be a time of joy and celebration. Yet for those who are still not considered a legal family, it can be a really difficult time full of uncertainty and pain, says Ranae von Meding, CEO of Equality for Children.

It is important to acknowledge that some LGBT+ parents in Ireland now have the same rights as heterosexual parents. This is a huge step in the right direction. However, many families still fall outside of any legal framework and in these cases only one person in an LGBT+ family can be a legal parent leaving an unknown outcome for families in the event of bereavement, illness and more.

Despite the progress being made, LGBT+ children are #stillnotequal.

The protections promised in 2015 by the government under the Children and Family and Relationships Act, dictate a very particular LGBT+ family makeup. They finally came to fruition earlier this year and the first parental orders were issued early in the summer. This has been a source of enormous relief for hundreds of families. However, it is not enough. Around 40% of children of LGBT+ families benefit from this bill. That leaves the other 60% with no legal connection to one of their parents. And that simply is not good enough.

Equality for Children recognises that progress has been made with the Assisted Human Reproduction Bill at Oireachtas Committee stage, as well as the ongoing work from the Special Rapporteur on Child Protection, Dr. Conor O Mahony, to investigate parental rights for LGBT+ families using assisted human reproduction. These are significant developments and have the potential to provide pathways to legal recognition for hundreds of more families.

Equality for Children is a grassroots campaign which was launched in October 2019 campaigning for equality for all children of LGBT+ families in Ireland. It was started by a collective of concerned parents and allies, who were tired of waiting for their families to be given the recognition they deserve.

The campaign has garnered support from people who are willing to help across social media, fundraising, lobbying, design and more, but the task group is asking people to support them through volunteering to join them in the fight for full equality.

The reason why this campaign is so important is because many children of LGBT+ parents are still on the dangerous sidelines of grey legislation. We are #StillNotEqual, and our children ultimately suffer the most, until something changes. We look forward to working with government departments in the coming months to progress these crucial issues. she commented.

To find out more or see how you can help visit their website at http://www.equalityforchildren.ie.

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Only 40% of LGBT+ families have the same rights as heterosexual couples - SHEmazing

The presence of the Babinski sign has already been reported for some Renaissance paintings, and the first observations date from the beginning of the 20th century.23 More recently, several articles have highlighted paintings by Botticelli containing the Babinski sign.789 However, some other paintings with the toe phenomenon have scarcely been written about,810 and, until now, no systematic study of the Babinski sign in paintings of the Christ Child from the Renaissance period (1400-1550 CE) has been reported. We did such a study using a specific and strict method, and we observed that 30% (90/302) of the corpus of paintings portrayed the Babinski sign, with a stimulating factor in 53% (48/90) of cases.

This frequency mainly results from the artistic revolution of the 15th century. In the Middle Ages, when trying to illustrate Jesus Christ, painters often represented him as a small man, with a childs height but the body and the face of an adult. Even though this way of depicting the Christ Child is still used in some Orthodox traditions, it might be regarded as an incongruity, as highlighted by Huysmans: To make the inexpressible childhood of a God () they created a hybrid being, who is no longer a child, and who is not a God, some kind of monster.11 During the Renaissance, artists began to represent the nudity of the Christ Child to demonstrate the incarnation of Christ, who was subsequently portrayed in a very realistic form. Modern art historians postulate that the imagery of the overtly sexed Christ was an affirmation of kinship with the human condition.12

As a consequence of a growing desire for realism, most Renaissance painters no longer depicted the Christ Child as a small man but as a real infant. If they had live infants as models, they were more likely to involuntarily reproduce the Babinski sign. This realism was not merely the consequence of the Italian Renaissance revolution, as it is much more the hallmark of Flemish and Rhenish painters (particularly van der Weyden, Memling, Schongauer, and Grnewald), known for their tendency to paint precise, sometimes trivial, realistic details from everyday life. This trend towards realistic depictions is also shown by the fact that in these paintings, the infants, clothes, and general surroundings belong to the Western world contemporary to the painters and are not representative of the Middle East in the first century CE. This tendency may also explain the painters frequent reproduction of the Babinski sign as soon as representation of the infants nudity became acceptable, examples of which are given in figure 2 (A-C and E). By contrast, Italian painters tended to depict idealised human bodies, with a quest for perfect beauty, as seen in the models of antiquity. Therefore, some painters, such as Fra Angelico, Masaccio, or Tiziano, failed to reproduce the Babinski sign in paintings of the Christ Child.

The stimulating atmosphere of the Renaissance period and the need for a scientific approach and precise observation of live infants to improve likenesses has been proposed as a possible explanation of the representation of the Babinski sign in paintings of the Christ Child. The particular influence of the Renaissance led to accurate depiction of natural phenomena, especially in painting. Botticelli was an example of this new focus; 40% (12/30) of his paintings in this study depict a Babinski sign. Nevertheless, many great painters such as Raphael, known to have an eye for the finest details of their subjects, almost never depicted the Christ Child with an upgoing toe. Many Renaissance painters were aware of medical and anatomical realities; neurological abnormalities such as ulnar claw or facial dystonia appear in Renaissance paintings,1314 and some painters, such as Michelangelo and da Vinci, did anatomical dissections. However, this pursuit of anatomical knowledge seems not to have been a determining factor for the depiction of the Babinski sign in painting; da Vinci, who was an anatomist and contributed to the study of the nervous system,15 depicted the Babinski sign in only 22% (2/9) of his paintings of the Christ Child. Similarly, no Tiziano paintings portray the toe phenomenon. However, Tiziano, with his student Jan van Calcar (c1499-1545), certainly participated in the illustrations for the anatomical masterpiece De Corporis Fabrica by Andreas Vesalius (1514-64).16

To explain about 30% of the paintings displaying a Babinski sign in our study, two other mechanisms can be discussed: the master-student effect, and the copying effect. In our corpus, a master-student effect could be suspected regarding Leonardo da Vinci and his master Andrea del Verrochio. It is interesting to note that the three paintings of the Christ Child with a bilateral Babinski sign were produced by Andrea del Verrochio (The Virgin and Child with Two Angels, c1470) (fig 2, D) and Leonardo da Vinci (Madonna of the Carnation, c1479, and Madonna Benois, c1480). This hypothesis of artistic filiation is supported by the bilateral Babinski sign that was recently observed on a sculpture attributed to da Vinci (Virgin with the Laughing Child).17

The practice of copying works of art was frequent during the Renaissance, particularly for Virgin and Christ Child paintings. The painting Saint Luke Drawing the Virgin, of which many copies exist, is a clear example of this.18 However, examples of serial paintings, such as Madonna and Child with the Milk Soup by Grard David, which was reproduced in at least three versions, are rare. The Babinski sign is not present in the version of this painting exhibited in the Palazzo Bianco in Genoa, whereas it is present in the other two versions. Cranach the Elder frequently produced serial paintings of the Madonna and Child, reproducing the Babinski sign each time, but this phenomenon cannot explain the occurrence of the sign in other paintings by the same artist, such as The Virgin and Child with a Bunch of Grapes (Fig 2, E).

An alternative hypothesis is that the dorsiflexion of the toes in some of Botticellis or Cranachs infants is a Mannerist stylistic choice, as shown also by the formalised placements of the fingers.9 However, this cannot be the correct explanation, as Mannerism is an artistic style that emerged only in the later years of the Italian High Renaissance (around 1520), breaking all the codes of anatomical accuracy, proportion, and balance.19 Mannerism is clearly absent in paintings by Flemish painters such as Rogier van der Weyden or Grard David or Rhenish painters such as Martin Schongauer, who frequently depicted the Babinski sign. Examples of works containing the Babinski sign by these artists are in figure 2 (A, B, and C).

Many studies of the plantar reflex in infants have been published. These have sometimes reported contradictory findings about the flexion or extension response (Babinski sign) of this reflex. One reason for these heterogeneous results may be the interference of the grasp reflex of the toes, which is generally present during the first year of life. Taking the grasp reflex into account, the physiological response of the plantar reflex until the age of 6 months is hallux extension. The main factor in eliciting the hallux extension in infants seems to be the intensity of the stimulus.420 In our corpus, we observed stimulation of the foot in 53% (48/90) of the paintings. We obviously could not evaluate the intensity of this stimulus. Nevertheless, as already noted, in some cases the stimulus was directly applied to the lateral part of the sole, the site known to elicit the Babinski sign.7

At the age of 6 months, hallux extension usually ceases to be the manifestation of the plantar reflex.420 Nativity, Adoration of the Magi, and Presentation at the Temple paintings are supposed to be set during the first week of Jesuss life, and Madonna and Child paintings during the first year. Evidently, the age of the Christ Child as depicted in paintings does not correspond to the chronological reality of these events. We therefore cannot show a relation between the frequency of the Babinski sign and the subject matter of the paintings in our series. Even if a preoccupation with realism dominated in this artistic period, the painted Christ Child usually appears older than the reality. As determining the precise age of the model is difficult, we are not able to establish a correlation with the myelinisation of the nervous system. The use of older children as models might therefore explain the low frequency of the depiction of the Babinski sign by some painters.

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The Babinski sign in Renaissance paintingsa reappraisal of the toe phenomenon in representations of the Christ Child: observational analysis - The BMJ

The uni says the money will fund three major research projects, which includes studies on fertility and tackling climate change.

The University of East Anglia has secured over 5-point-1 million pounds in funding.

The grants from the European Research Council will be used to pay for three major research projects.

Dr Charlie Wilson, from UEAs School of Environmental Sciences has been awarded 1,598,465 to study the digitisation of daily life and its impact on climate change.

Digitalisation is a major trend that has reshaped our lives from streaming music and TV to using smart meters to reduce energy use in our homes. Dr Wilsons project will involve 80 living lab households to investigate how these changes impact carbon emissions and climate change.

Dr Simone Immler from UEAs School of Biology has been awarded 2,122,476 to research fertility.

Her project will investigate the role of selection on sperm and eggs based on their genetic make-up in determining the fitness of the resulting offspring in zebrafish. And the team hope this will one day help us understand more about human reproduction and fertility.

Dr Alexander Suh, from UEAs School of Biological Sciences, has been awarded 1,994,180 to explore the evolutionary origin and impact of germline-restricted chromosomes.

The funding is part of the EUs current research and innovation programme, Horizon 2020. With this support, the project leaders will be able to consolidate their teams and have far-reaching impact.

Prof Fiona Lettice, Pro-Vice-Chancellor for Research and Innovation at UEA, said: ERC Consolidator Grants are awarded to the most talented researchers and innovators, so I would like congratulate Simone, Charlie and Alexander for this great achievement. Their projects will improve our understanding of these important topics and will deliver significant impact and real change.

ERC President Prof Jean-Pierre Bourguignon said: This funding not only empowers bright minds from across Europe to pursue their most ambitious ideas at a critical stage of their careers, but also helps train the youngest generation of researchers as members of their ERC teams.

To prepare for the challenges of tomorrow, Europe must stick to the vision of investing in frontier research, which has proved time and again its crucial added value. That is why so many count on Europes leaders to endow the Excellent Science pillar of Horizon Europe with the resources essential to strengthen Europe as a whole.

Hear all the latest news from across the UK on the hour, every hour, on Greatest Hits Radio on DAB, at greatesthitsradio.co.uk, and on the Greatest Hits Radio app.

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UEA given millions for research funding | News - Greatest Hits Radio (Norfolk and North Suffolk) - Free Radio

By: Parenting Desk | New Delhi | December 4, 2020 4:36:51 pmIt is important to speak to your doctor/fertility expert first for any queries and advice on difficulty in conceiving and fertility options possible and available. (Source:: Pixabay)

By Dr Abha Majumdar

Often, couples and doctors use the words subfertility and infertility interchangeably, but it is imperative to realise that both the terms are quite different. In fact, the prognosis and treatment for both these conditions also differ. This is an important aspect to consider when couples seek infertility counselling. The fertility counsellor analyses the health condition of the couple, their conception issues and investigate whether it is subfertility or infertility.

What does each term describe?

When the conception takes longer than the average, but the woman and the man can conceive a child, is best described as subfertility. In this condition, couples have reduced fertility or experience delay in fertility, but the possibility of conceiving naturally still exists, even though they may take longer time to conceive than what their expectations may be.

On the other hand, infertility deals with inability to conceive naturally. There are various types and causes of infertility in both men and women. In some cases of infertility, a woman may not produce eggs at all either due to hormonal imbalance or absence of eggs in the ovary. Similarly, infertility among men deals with either complete lack of sperm creation or the absence of the entire delivery system or route for sperms to pass into semen, even though sperm production is sufficient.

ALSO READ |Early birth linked to higher risk of hospital visits: BMJ study

Factors that affect fertility negatively:

Various factors in women like hormonal problems affecting ovulation, or functional issues like obstruction in the fallopian tube or in the cavity of uterus which are severe enough and do not let pregnancy happen naturally, lead to infertility. Similarly, in men complete absence or severe deficiency of sperms in semen leads to infertility. However, if these problems are mild and only require more time or minimal assistance in the form of lifestyle modification and good sexual practices for a pregnancy to happen, then these are categorised as subfertility. For example, Polycystic Ovary Syndrome (PCOS) is quite common among women affecting ovulation and may cause irregular ovulation among women leading to subfertility. On the other hand, conditions like reduced ovarian reserve and premature menopause due to aging or pre-existing medical conditions can also affect fertility leading to infertility among women.

However, in most of the couples, the factors remain the same that lead to subfertility or infertility. It is the severity of the cause which defines the conditions. Subfertility and infertility affect both men and women and sometimes even both together.

ALSO READ |Delayed vaccination: How it may impact your child

How treatment differs

The treatment for both, subfertility and infertility, will depend on the cause found after examination and investigations, for the couples inability to conceive. The fertility evaluation will involve tests for both the man and woman.

After a thorough analysis, the fertility expert will advise treatment options for them, depending on the results of the analysis. The expert might suggest simple treatment options like lifestyle changes for example, reducing alcohol and caffeine consumption, maintaining healthy weight and adequate physical and sexual activity for most sub-fertile couples. On the other hand, one may need to resort to medical or surgical treatment or even advanced treatment options such as use of assisted reproduction techniques like IVF depending on the severity of the problem found.

Therefore, to summarise, some of the medical treatment options for men include surgery for opening the blockage in the sperm delivery system or medications for sufficient sperm production in the ejaculate. For women, some of the treatment options would include fertility enhancing drugs comprising ovulation inducing agents, surgery to restore tubal patency or In-Vitro Fertilisation (IVF).

ALSO READ |Why women with perinatal depression experience full-blown depression during pregnancy

It is important to speak to your doctor/fertility expert first for any queries and advice on difficulty in conceiving and fertility options possible and available.

(The writer is Director, Centre of Human Reproduction & IVF, Sir Gangaram Hospital)

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Subfertility and Infertility: Are these different? - The Indian Express