The document discusses fertility and infertility. It defines fertility as the ability to conceive children, noting factors that influence high fertility rates like early marriage, education level, economic status, nutrition, and availability of family planning. Infertility is defined as the inability to conceive after regular unprotected sex for over two years. Causes of infertility include age, smoking, obesity, STDs, hormonal issues, fallopian tube problems, and abnormal sperm count or mobility. Treatments may include at-home kits, medical interventions, or assisted reproduction technologies like IUI or IVF.

1. FERTILITY vs INFERTILITY
Prof Suchitra A Rati

2. FERTILITY
The ability to conceive children or
young.
 It means actual bearing of
children
 Women reproductive period is 15
to 45 age
 If she get marriage at 15yr risk for
pregnancy is for 30 yr
 [can produce 15 children without
adopting any FP method]

3. Factors influence for high fertility
Age at marriage
 Early marriages are risk of high birth rate
 Marriage at 20 to21 makes reduction in
number of birth up to 20-30%
Duration of married life
 10-25% of birth takes place [ within 1-5 yr]
 50-55%of birth takes place [5 to 15 yr]
 After marriage couple can avoid/postpone
the pregnancy for 2-3 yr [planned
parenthood]

4. Spacing of pregnancy
 If all pregnancy has postponed for 1 yr the
total fertility period will reduce
 Minimum 2-3 spacing between two
pregnancy
Education
 High fertility has found in illiterate women
[5.3]
 Low fertility rate in educated women [3.9]

5. Economic status
 High fertility has found in low economic and
Low fertility high economic
Cast and religion
 Compare with Hindu Muslims have high
fertility [5.3],Hindu[3] and Christian[2.3]
Nutrition
 Low fed society had high fertility and high fed
society had low fertility
Family planning
 Non availability of FP also leads to fertility

6. FERTILITY TRENDS
 Present research indicates that crude birth
rate has been brought down from 29.5[1991]
to 23.5[2006] but still crude birth rate is high
in rural area.
 The total fertility rate also has come down
rural 5.3 to 3.1 and urban 4.1 to 2
POPULATION EXPLOSION
 Day to day the population is increasing and
which has become one of the measure
problem for India.
 It means rapid increase in the population size
 I.e. increase in birth rate [25/1000] and
decrease in death rate [8/1000] are the main
causes

8. Causes for high birth rate
 Early marriage
 Low standard of leaving
 Low literacy rate
 Tradition and culture
 Preference for male baby and demand of male
baby
 Children are god’s gift
 Ignorance of FP
 Lack of recreation

9. Causes for low death rate
 Absence of natural calamities
 Control of epidemics
 Advanced medical sciences
 Social awakening
 Consciousness of health among people

10. Effect of population explosion
Effects on nation-
 Inequitable distribution of food stuffs
 Lads low standers of leaving
 Unemployment
 Overcrowding
 Migration
 Increase in slum area
Effects on family
 Unable to cope up with additional
expenditure
 Like clothing, food etc

11. Effect on mother
 Impairment in health condition
 Anemia
 Infection
 Maternal death
Effects on child
 Premature baby
 Little attention
 Frequency of infection
 Malnutrition
 Accidents

12. In general It mainly effects on
 Agriculture, economy and urbanization
 Food and nutrition
 Literacy and education
 Labor force and employment
 Clothing and housing
 Health care services
 Water supply and housing
 [Increase in population –acquires more space and
accommodation, were as India depend on
agriculture]
 Increases in industrialization, urbanization and
slum areas
 Leads into decreased food production-which is
unable to meet needs of the population leads
into nutritional deficiency disorders

13. Infertility
 Infertility is fundamentally the inability to
conceive a baby. Infertility also refers to the
state of a woman who is unable to carry a
pregnancy to full term
 There are many biological causes of
infertility, including some that medical
intervention can treat.
 Infertility has increased by 4 percent since
the 1980s, mostly from problems with
fecundity due to an increase in age.

14.  About 40 percent of the issues involved with
infertility are due to the man,
 another 40 percent due to the woman,
 and 20 percent result from complications with
both partners.[3]
World Health Organization
 Infertility is the inability to conceive a child.
 A couple may be considered infertile if, after
two years of regular sexual intercourse,
without contraception, the woman has not
become pregnant (and there is no other
reason, such as breastfeeding or postpartum
amenorrhoea

15. Types Of Infertility
 Primary infertility is infertility in a couple who
have never had a child.
 Secondary infertility is failure to conceive
following a previous pregnancy. Infertility
may be caused by infection in the man or
woman, but often there is no obvious
underlying cause.

16. What are the risk factors of infertility?
 Age - a woman's fertility starts to drop after
she is about 32 years old, and continues doing
so. (male fertility progressively drops after the
age of 40).
 Smoking - smoking significantly increases the
risk of infertility in both men and women.. Even
when a woman gets pregnant, if she smokes
she has a greater risk of miscarriage.

17.  Alcohol consumption - a woman's pregnancy
can be seriously affected by any amount of
alcohol consumption.
 Being obese or overweight - in industrialized
countries overweight/obesity and a sedentary
lifestyle are often found to be the principal
causes of female infertility. An overweight man
has a higher risk of having abnormal sperm.
 Eating disorders - women who become
seriously underweight as a result of an eating
disorder may have fertility problems.
 Over-exercising - a woman who exercises for
more than seven hours each week may have
ovulation problems

18.  Not exercising - leading a sedentary lifestyle is
sometimes linked to lower fertility in both men
and women.
 Sexually transmitted infections (STIs) - chlamydia
can damage the fallopian tubes, as well as making
the man's scrotum become inflamed. Some other
STIs may also cause infertility
 Exposure to some chemicals - some pesticides,
herbicides, metals (lead) and solvents have been
linked to fertility problems in both men and
women.
 Mental stress - studies indicate that female
ovulation and sperm production may be affected
by mental stress. If at least one partner is stressed
it is possible that the frequency of sexual
intercourse is less, resulting in a lower chance of
conception

19.  Ovulation disorders
◦ Premature ovarian failure - the woman's ovaries
stop working before she is 40.
◦ PCOS (polycystic ovary syndrome)
Hyperprolactinemia - if prolactin levels are high and
the woman is not pregnant or breastfeeding, it may
affect ovulation and fertility.
◦ Poor egg quality - eggs that are damaged or
develop genetic abnormalities cannot sustain a
pregnancy. The older a woman is the higher the risk

20.  Overactive thyroid gland
◦ Underactive thyroid gland
◦ Some chronic conditions, such as AIDS or cancer
 Problems in the uterus or fallopian tubes
◦ Surgery - pelvic surgery Cervical surgery can
sometimes cause scarring or damage to the fallopian
tubes.
◦ Sub mucosal fibroids Endometriosis - cells that are
normally found within the lining of the uterus start
growing elsewhere in the body.

21. • Previous sterilization treatment - if a woman chose
to have her fallopian tubes blocked. It is possible to
reverse this process, but the chances of becoming
fertile again are not high.
• Medications - some drugs can affect the fertility of
a woman. These include:
◦ NSAIDs
◦ Chemotherapy -
 Radiotherapy -
 Illegal drugs - some women who take
marijuana or cocaine may have fertility
problem

22.  Semen
Abnormal semen is responsible for about 75%
of all cases of male infertility. :
 Low sperm count (low concentration)
concentration should be 20 million sperm per
milliliter of semen. If the count is under 10
million there is a low sperm concentration
(sub fertility

23.  No sperm –
 Low sperm mobility (motility)
 Abnormal sperm - perhaps the sperm has an
unusual shape, making it more difficult to
move and fertilize an egg.
 Mumps - this viral infection usually affects
young children. However, if it occurs after
puberty inflammation of the testicles may
affect sperm production.
 Hypospadiasis- the urethral opening is at the
underside of the penis, instead of its tip.
 Cystic fibrosis

24.  Radiotherapy
 Medications
 Sulfasalazine - this anti-inflammatory
drug can significantly lower a man's sperm
count..
Chemotherapy - Illegal drugs - consumption
of marijuana and cocaine can lower a man's
sperm count.
 Testicular infection
 Testicular cancer
 Testicular surgery
 Overheating the testicles –

25.  Ejaculation disorders –
 Varicocele
 Undescended testicle
 Hypogonadism - testosterone deficiency can
result in a disorder of the testicles.
 Genetic abnormality - a man should have an
X and Y chromosome. If he has two X
chromosomes and one Y chromosome
(Klinefelter's syndrome) there will be an
abnormal development of the testicles, low
testosterone, and a low sperm count
(sometimes no sperm at all).

26. Treatment
 At-home conception kit
 Assisted Natural Conception]
 Medical treatments
 If conservative medical treatments fail to
achieve a full term pregnancy, the physician
may suggest the patient undergo

27. ART [Assisted Reproductive Technology ]
 techniques generally start with stimulating
the ovaries to increase egg production. After
stimulation, the physician surgically extracts
one or more eggs from the ovary, and unites
them with sperm in a laboratory setting, with
the intent of producing one or more embryos.
Fertilization takes place outside the body,
and the fertilized egg is reinserted into the
woman's reproductive tract, in a procedure
called embryo transfer.

28.  IUI,
 In Vitro Fertilization ( IVF).

29. THANK YOU