Infertility is becoming more common than it is believed. Many-a-times, the infertility is brought about by previously existing conditions like urinary tract infections (UTI) or
endometriosis that reduce the chances of a woman conceiving. While the former is known to affect half of the women at least sometime in their life, the latter is a perennial condition.
City-based gynaecologists got together to discuss the two disorders recently at a CME organized by Nagpur Obstetrics and Gynaecological Society (NOGS). Senior physician from the city Dr Jay Deshmukh spoke about UTIs while Dr Kaustubh Kulkarni, a member of the American Society for Reproductive Medicine (ASRM), who runs an infertility clinic in Mumbai, spoke about endometriosis calling it an enigmatic disease.
"Everyday we have girls from all age groups come to us with symptoms like very painful periods and pain during intercourse. These may point towards the prevalence of diseases that can lead to several problems including infertility. Since these problems can be due to various reasons, women confuse them with fungal or vaginal infections," said Dr Ankita Kothe, president of NOGS.
Though it is known that every fifth girl suffers from endometriosis presently, the disorder is underdiagnosed and is often detected very late, said Dr Kulkarni. "Studies have shown that it is a big problem in BRIC countries. The problem with endometriosis is that it is an accelerating condition, or one that gets worse with time. If detected early, the woman can make a choice whether or not to have children and how," he said.
Therapy for the condition has to be tailor-made to suit the social, economical and other situations of the patients. "A woman with this disease is like a swimmer in shark-infested waters. It may be possible to help her conceive, if she is lucky. The chances of natural conception increase if the girl gets treatment early. At times, even younger girls need to take help of assisted reproductive techniques. Since, pregnancy suppresses the progress and progression of the condition," said Dr Kulkarni. In some Western countries, the norm is to give strong therapy if there is even a little suspicion of the condition, he said.
Former president of NOGS Dr Ujwala Deshmukh says that even some teenagers are now being detected with the disorder. "We encourage these girls to marry and have children as early as possible. With the right medication and support, most of them do conceive. The increasing number of women suffering this condition is due to delay in pregnancy, due to late marriages and being career-oriented," she said.
"Out of the 50% women who have UTIs, 5% may end up with chronic kidney failure. During pregnancy, these infections can harm both the mother and the foetus. It may lead to low birth weight babies or still births. In mother, it may cause sepsis or multi-organ failure," said Dr Deshmukh. Women are more prone to these infections just before adolescence, just after marriage or becoming sexually active, during pregnancy and in the post menopausal phase, he said. Giving more attention to personal hygiene and routine urinary examinations can help in early detection of the disease, he advised.
If a woman has any manifestation of the symptoms, she should immediately consult a doctor. "Avoid self medication as it may mean you are taking wrong or incomplete dosage of medicines. Also, it will build immunity towards the antibiotics used," said Dr Vaidehi Marathe, secretary of NOGS.
