Tapasya and her husband are upset and angry. They have just returned from a family function and it seemed that every one of their relatives had only one question. “You have been married for six months, and you are not pregnant yet?” Tapasya feels unnecessary pressure: is there anything wrong with her?

Tanvi has been married for the past 2 years. For the first year, she had used birth control pills to avoid a pregnancy. Now it has been a little more than a year after stopping birth control but she has not conceived yet. Should she and her husband seek advice from a gynaecologist?

Unfortunately, culturally the onus for not being able to conceive is placed squarely on the woman. In many instances, the wife may be asked to undergo many expensive and invasive investigations and treatment cycles before any attempt is made to investigate the husband. The first step in investigation should always be the sperm count for the husband. This is a simple test and allows the couple and the treating gynaecologist to make decisions about further modes of management.

Modern lifestyles are also playing an important role in infertility. Many young couples are in jobs which have odd hours or require one or both to travel extensively. In this situation, the inability to conceive is primarily due to an erratic lifestyle.

What is infertility?

If a couple has not achieved a pregnancy after having regular sexual intercourse for a year without using contraception, they may be considered infertile. If the woman is 35 or older, investigations may be started after six months of trying. Approximately 15-20% of couples may not be able to conceive and may require investigations and treatment to achieve a pregnancy.