Bank Your Fertility
eard of Nothobranchius? Better known as annual fish, you’d find them in Africa and South America. Only, that is, if you looked for them in the rainy season; they spend their lives in rain-fed ponds and marshes. When the water dries up, they die. But before that, they breed, and bury their eggs under the soil, where they stay until the next rains, when, miraculously, they hatch. The younglings seem to know that the wetlands will dry out, and their lives are short. So, they quickly get down to business, and, like countless generations before them, bury their eggs. Then, of course, the rains end, the water dries up, and they die. But nature’s egg bank makes sure the species survives. Smart lady, Mother Nature.
Now, let’s switch to our own species. More and more people are postponing the decision to have children. Later marriages are becoming common; career goals are a priority at the age when our parents were having children. Which is a problem. The quality of sperm deteriorates as men get older. And for a woman, it’s an even bigger dilemma: She only has a certain number of eggs, and both quantity and quality keep deteriorating. After thirty, getting pregnant gets more difficult; by her forties, she is left with just about a thousand eggs.
Given this, is it possible for women to have children safely and successfully later in life? Yes, science caught up with the Nothobranchius a while ago, and there are now several options available.
Illustrations: Vidyanand Kamat
For men, sperm banking is fairly easy: Masturbate, collect sperm in receptacle, hand over to the lab assistant. Sperm banking, as a result, is quite common, especially in families where the time the husband and wife spend together is too short to guarantee conception. The husband’s sperm is stored, and artificial insemination takes place when it’s convenient for the wife. The practice is spreading. Dr. Pradeep M. Rao, specialist in foetal medicine at the Centre for Reproductive Medicine and Pre-Natal Diagnosis, Bangalore, says he sees a lot of young techies depositing their sperm, so that they can use it later. “They are busy catching up with their lives, going up the corporate ladder, so they postpone raising a family. And before they know, they are 30, 31, fertility is down, interest levels are lower and chemistry between husband and wife is not quite the same. So, they say, when everything is going well, let’s store it. It’s almost like putting money in your FD and encashing it whenever you want.”
Fear of age-related sterility also drives demand. Dr. Mirudhubashini Govindarajan, who has been in this field since the mid-nineties and practises in Coimbatore, says that some years back, causes were neatly symmetrical: Male infertility, one-third; female infertility, one-third; other reasons, one-third. Now, she says, thanks to a combination of stress-prone lifestyles and external factors such as pollution, the male contribution to the equation has gone up to half.
Sperm banks are one part of Assisted Reproductive Technology (ART), which covers various methods to achieve pregnancy artificially. Like in vitro fertilisation (IVF), where fertilisation happens outside the female body. (“In vitro” is the Latin for “within the glass,” referring to the test tubes and culture dishes in a laboratory.) Dr. Aniruddha Malpani, who runs Malpani Infertility Clinic in Mumbai, says that advances in ICSI (Intra Cytoplasmic Sperm Injection, which improves the chances of fertilising an egg even with a low sperm count) technology, has pushed down demand for semen freezing in his own clinic.
For women, for whom it’s more important given ovarian depletion, things are more difficult and complicated, not to speak of, expensive (it costs about Rs. 1.5 lakh to extract and freeze eggs). It requires ovarian stimulation for eggs to develop and often involves an invasive procedure. Chances of eggs damage are high, and the success rate for fertilising preserved eggs is lower than for fresh eggs.
Dr. Malpani says he meets at least one patient every month who wants to freeze her eggs. But, put off by the complexity and cost, few take it forward. “There was this lady who got married quite early in her life. The marriage did not work out, and she got divorced. She is now 34 and runs her own business. She wants to get married, have children and raise a family. But given her bad experience in the past, she does not want to hurry things up. So, her next marriage could take place tomorrow or may be three or five years later. She wanted to preserve her eggs till such time.”
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