Wellness, as we know, is multidimensional and includes physical, mental and emotional wellbeing. It is also related to the feeling of being empowered to make our own decisions without any societal pressure and an area of women empowerment that is not often talked. It is important for a woman’s sense of wellbeing, including her reproductive or fertility health. In fact, this area of fertility health needs urgent attention primarily for two reasons:

• Incidences of infertility is rising rapidly among couples because of late marriages and delayed childbearing
• Motherhood, even today, is so intricately intertwined to a woman’s holistic wellness.

In an interview with HT Lifestyle, Dr Shanujeet Kaur, associate director – Department of Obstetrics and Gynecology and fertility specialist at Cloudnine Group of Hospitals in Chandigarh, explained the journey to empower women on their fertility health -

1. Age and Fertility:

It is important for women to know that they are born with a finite number of eggs that decline in both quantity and quality with age, particularly after the age of 35. As women are delaying marriage and childbirth for various reasons, they may face challenges in conceiving naturally due to age-related fertility decline. Add to that is the myth that with in vitro fertilization (IVF) technique it is possible to become a mother at any age. This is not true. The success rate of any fertility treatment including IVF, depends heavily on a woman’s age. Here comes the role of Social Egg Freezing which allows women to preserve their eggs when they are younger and typically have better egg quality. 

This option gives women more control over their reproductive timelines and can mitigate some of the fertility issues associated with ageing. The best age to get social egg freezing done is 30 to 37 years. At age 38 years and beyond the quality and quantity of eggs goes down significantly and the carry home baby rates with frozen eggs is around 20% which is quite low. At age 44 years and above, egg donation may be the only option to achieve a pregnancy. Incorporating social egg freezing in discussions on women’s health can empower women to make informed decisions about their reproductive health, especially in the context of changing societal norms and delayed family planning.

2. Early detection of conditions such as endometriosis and PCOS (Polycystic Ovary Syndrome):

These conditions can significantly impact reproductive health and fertility outcomes and identifying them early allows for timely intervention and management.

a. Endometriosis: Endometriosis is a condition where tissue similar to the lining inside the uterus(endometrium), starts growing abnormally outside the uterus too. e.g on or inside the ovaries, fallopian tubes, abdominal organs, lungs etc. It can cause pelvic pain, irregular periods, and in severe cases, infertility. It is a progressive disease as it is linked to the monthly menstrual cycle .Early detection helps in:

• Improved Management Options: Early diagnosis allows for the implementation of appropriate treatment plans, which may include pain management strategies, hormonal therapies that temporarily stop the progression of disease or in some cases surgical interventions to remove endometrial implants.
• Preservation of Fertility: Endometriosis can lead to the formation of adhesions or scar tissue that may affect fertility by interfering with the function of the ovaries, fallopian tubes, or uterus. Early intervention can help preserve fertility potential and improve the chances of successful conception. International guidelines advocate egg freezing in women diagnosed with moderate to severe endometriosis who wish to postpone pregnancy by a few years.

b. PCOS (Polycystic Ovary Syndrome): PCOS is a hormonal disorder characterised by irregular menstrual cycles, excess androgen (male hormone)levels, obesity in some cases and a distinct morphology of the ovaries called polycystic ovarian morphology (PCOM). It is one of the most common causes of infertility in women. Early detection of PCOS is important because besides causing infertility , women with PCOS are at higher risk for developing conditions such as insulin resistance, type 2 diabetes, hyperlipidemia, hypertension and cardiovascular disease (Metabolic Syndrome). An important part of managing PCOS is lifestyle modification. Balanced diet and physical activity like aerobic exercises, swimming, cycling etc are encouraged to maintain a lean body mass. Maintaining abody mass index (BMI0 of around 23.5-24.5 can offset a lot of harmful effects of PCOS both in short term like regularizing menses, improving fertility, having a smooth pregnancy journey, as well as long term health scares like diabetes, heart diseases, breast and uterine cancers.

3. Fertility Planning:

Understanding the impact of PCOS on fertility early on can empower women to make informed decisions about family planning. Fertility treatments, such as ovulation induction with medications or assisted reproductive technologies, can be considered if natural conception proves challenging.

Last but not the least , encouraging routine health check-ups to gynecologist for examination and screenings is the best way to ensure early diagnosis of any health problem that has the potential to blow up and become big in future.

4. Future strategies:

Let’s take the solution at the doorstep. Women form a large percentage our workforce across all sectors. It will be a good strategy for companies to recruit health counsellor wherever possible as it will hugely improve the accessibility to information and management of fertility health .

5. Support Networks:

Establishing support groups or online communities where women can share experiences, seek advice, and find emotional support related to fertility challenges associated with endometriosis and PCOS will go a long way in improving the reproductive health of women.

In conclusion, by promoting awareness, advocating for improved healthcare access and supporting research efforts, we can enhance reproductive outcomes and quality of life for women.

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