Infertility is a growing problem in India and factors causing infertility are not just clinical. Rapid urbanization has brought about significant changes in lifestyle, which has also contributed to the rising infertility rates. Factors such as increasing alcohol and tobacco consumption, obesity, stress including a hectic lifestyle are leading to infertility. Today more women are choosing careers over marriage and/or motherhood. Consequent to this, the increasing marital age as well as increasing maternal age due to women delaying motherhood are also factors that have further added to the infertility burden. Modern medicine offers a solution for this.

Women can now hormonal drugs to boost ovulation to enhance fertility or they can opt for assisted reproductive technology. But, there are greater chances of multiple pregnancies with IVF or ovulatory drugs. A recent study jointly conducted by ICMR and Indian Society for Assisted Reproduction (ISAR) in Mumbai has revealed that 45% of couples who opted for ART had twins or triplets. The practice of multiple embryo transfers in IVF to increase the chances of conception has increased the likelihood of multiple births and also preterm births. Twins born out of assisted pregnancies are usually non-identical (fraternal) twins.

ICMR, at present, recommends not more than three embryo transfers at one sitting and the remaining embryos can be cryopreserved to be used later. However, many European countries, Australia and New Zealand have adopted elective single-embryo transfer as a practice in IVF.

Infertility has been known since the Vedic era. Our traditional customs and rituals are not simply traditions that should be followed, they have been designed in such a manner so as to prevent lifestyle disorders. Worshiping sun in the months of Magh, Vaishakh and Kartik and eating calcium-rich foods like sesame and urad dal has long been a ritual for Indians. The three Shahi Snans mentioned in our Vedic literature are undertaken in the months of Magh, Vaishakh and Kartik (Vikram calendar). Shahi snan signifies exposure to sunlight to get vitamin D. infertility is associated with vitamin D deficiency. Therefore, both vitamin D and calcium are necessary to increase fertility.

The main marriage season starts from Devuthan Ekadashi, Tulsi Vivah followed by Amala Navami. The seeds of Shyama Tulsi are known to increase the viscosity of semen and in women they help the release of eggs, a clomiphene-like action. Amla also increases sperm concentration.

IVF should not be opted for as first-line option for infertility without trying out all other options. Given that many countries are now adopting elective single-embryo transfer, ICMR should also consider revising its policy on embryo transfers.

Dr KK Aggarwal

Padma Shri Awardee

Vice President CMAAO

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA