Dr. Shaweez Faizi is a consultant in gynaecology and reproductive medicine at Unity Hospital Mangaluru.

Infertility by definition is the inability of a couple to conceive a child after 1 year of unprotected sexual intercourse. With the advent of science and research in this particular field, many couples who believe they have infertility have been regrouped as being sub-fertile where there is only a delay in conceiving. Unlike any other medical condition, the diagnosis of subfertility is not made in a day.

The sub-fertile couple

For the couple, it gradually sinks in when they realize that they have not been able to bear a child one month after the other. A negative urine pregnancy test where they are hoping for that second line of confirmation to appear, even faintly! Or the start of your periods- A sign that you are not pregnant is the sign and stuff that triggers a feeling that cannot be put in words by the couple.

However, like any other long-standing problem, the stages are probably the same. The realization of the problem, denial, trying for a few more months may help, re-realization! And finally gradual acceptance of the issue.

Then comes the next step- The decision to meet a doctor for an opinion. Several rounds of discussion, frustration-filled months, and depression may follow. Hesitation to visit a clinic, social stigma associated with the problem, worries of expenditures involved in the treatment process may lead to further delay in addressing the problem.

As doctors, we feel the society needs a change in the mental setup for this issue. Of course, there are couples who are showing up earlier, seeking treatment for want of a baby, but the above said hurdles still exist in all strata of the community. For the mental setup to change and more people to come forward for treatment, one of the most important factors is awareness of the issue.

The following section is a set of FAQ’s linked with infertility.

Q: Who should visit an infertility specialist?

A: A couple staying together and having unprotected intercourse with the inability of having conceived for 1 year.

Q: Should you consider visiting a specialist earlier than 1 year?

A: Yes, if the age of the female partner is ≥ 35years, if the couple suspects any underlying cause for infertility, it is advisable to get evaluated even 6 months after unprotected intercourse.

Q: What are the symptoms/pointers towards a potential underlying cause for infertility?

A: Female partner experiencing irregular, delayed periods/heavy bleeding/excessive pain during periods/during sexual intercourse. Male partner with difficulty in maintaining an erection/other coital difficulties.

Q: What to expect when visiting a fertility clinic?

A: Your preliminary visit will comprise a detailed history of your menstrual cycles/previous pregnancy details/past treatment history followed by initial hormonal evaluation, ultrasound, and semen analysis.

You will be explained in detail about the factors attributing to infertility for you as a couple and the possible treatment options.

For a better understanding, one must be aware of the natural process of conception/ becoming pregnant.

In a regularly menstruating woman, an egg is released between day 12 to day 14 of the menses cycle, which is carried by the fallopian tube. Following sexual intercourse after millions of sperms are released, the sperm must travel to the fallopian tube and fertilize the egg (in the fallopian tube). After fertilization, the embryo reaches the uterus 4 days later to attach to the inner uterine lining, following which the growth of the embryo occurs.

Depending on the risk factors/ pointers towards a problem, necessary investigations may need to be carried out and treatment will be planned accordingly.

Q: What can you do to contribute to better results in your treatment?

A: Lifestyle modifications such as maintaining a normal BMI, avoiding weight gain (both male and female partners), curtailing habits such as smoking/ consumption of alcohol/ junk foods will help a long way.

The process of evaluation and treatment for a couple with a fertility issue is a gradual one. Many investigations and treatments will be planned as per your menstrual cycles, few treatment results may need a follow up for even 3 to 6 months depending on the factors.

Hence it requires patience, persistence, and most of all a positive attitude by the couple to over the top of the issue goals.

Come start this journey with us and we assure you to guide you and partner in your journey towards parenthood. Meeting a fertility specialist is one of the several important steps you have to take to begin this journey so why postpone it for tomorrow!

 

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New Delhi (PTI): The India-Russia collaboration is not directed against any country and it is solely aimed at safeguarding the national interests of the two sides, Russian President Vladimir Putin has said against the backdrop of Washington's aggressive approach towards New Delhi and Moscow.

In the context of India's energy ties with Russia, Putin said certain "actors" dislike New Delhi's growing role in international markets in view of its close relations with Moscow and these elements are aiming to constrain India's influence for political reasons by imposing "artificial obstacles".

In an interview to India Today news channel that was released on Thursday evening, the Russian president, referring to Western sanctions against Moscow, said his country's energy cooperation with New Delhi largely "remains unaffected".

Putin landed in New Delhi this evening on a two-day visit to hold summit talks with Prime Minister Narendra Modi.

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His trip comes at a time India-US relations are going through possibly the worst phase in the last two decades after Washington imposed a whopping 50 per cent tariff on Indian goods, including 25 per cent levies for New Delhi's procurement of Russian crude oil.

"Neither me nor Prime Minister Modi, despite certain external pressure we face, have never approached our collaboration to work against someone," the Russian president said in response to a question on Washington's aggressive approach.

"President Trump has his own agenda, his own goals, whereas we focus on ours -- not against anyone, but rather aimed at safeguarding our respective interests, India's and Russia's interests," he said.

Rejecting Washington's objection to India procuring crude oil from Russia, Putin said if the US has the right to buy Russian fuel, why "shouldn't India have the same privilege".

"As for India's purchase of energy resources from Russia, I would like to note and have already mentioned this once, the US itself still buys nuclear fuel from us for its own nuclear power plants," Putin said.

The Russian president also responded to a question on India lowering procurement of crude oil from Russia in view of Western sanctions on Moscow.

ALSO READ: Russian president Putin arrives in Delhi on 2-day visit

"Well, there is a certain decline in overall trade turnover during the first nine months of this year. This is just a minor adjustment. Overall, our trade turnover stands almost at the same level as before," he said.

"I can't give you exact monthly figures right now, but trade in petroleum products and crude oil, as well as the production of petroleum products for consumers of oil, Russian oil, is running smoothly in India," he said.

Putin also said that India cannot be treated the way it was several decades back.

"Prime Minister Modi is not someone who succumbs to pressure easily. The Indian people can certainly take pride in their leader. This is absolutely obvious," he said.

"His stance is unwavering and straightforward, without being confrontational. Our goal is not to provoke conflict; rather, we aim to protect our lawful rights. India does the same," he said.

On the Ukraine conflict, Putin said he believed the US is actively seeking a solution to this problem. "I am absolutely certain, with no doubt at all, he (Trump) sincerely aims for a peaceful resolution."

Putin said Trump genuinely wants to end the hostilities and prevent further loss of lives. "But there could also be political interests tied to ending the confrontation between Russia and Ukraine, or economic motives too."

On bilateral trade, Putin said over 90 per cent of "our transactions are already conducted in national currencies".

"While some complications arise due to the presence of numerous intermediaries, there are also solutions," he said.

The Russian president also complimented PM Modi's leadership.

"Our collaborative endeavours with Prime Minister Modi carry significant weight because they transcend our mutual ties," he said.

"Given its direct relevance to both nations, ensuring stability in key areas of engagement is crucial, as it helps secure the fulfilment of our objectives. Prime Minister Modi sets very challenging tasks for the country --and for himself in the first place, then for the administration, and eventually for the nation," he said.

The Russian president did not give a direct reply to a question on if India was looking at procuring additional batches of S-400 missile systems.

"India stands out as one of our reliable and privileged partners in this area. We are not merely selling something to India and India isn't merely buying something from us in the sphere of defence and security.

"It is a different level, a different quality of relations we have with India, and we value this. We see how India values this relationship too," he said.

Putin said Russia is not simply selling defence technology to India but it is sharing it with the country.

"It is a very rare thing to see in the sphere of military-technical cooperation. It speaks to the level of trust between the two countries and the level of trust between the two peoples.

"We have a broad portfolio indeed, including naval construction, rocket and missile engineering, and aircraft engineering," he added.