Srinagar, Sep 07: As fertility rates continue to decline in Jammu and Kashmir, doctors and health experts have raised concern over a growing burden of infertility, with conditions such as Polycystic Ovary Syndrome (PCOS) and Polycystic Ovary Disease (PCOD) increasingly being reported among women of reproductive age.
Health experts say the changing social and lifestyle patterns of the younger generation are contributing to reproductive health problems. Delayed marriages, increasing obesity, sedentary routines, unhealthy dietary habits, stress, inadequate sleep and limited awareness about reproductive health and contraception are being identified as some of the factors that may adversely affect fertility.
Dr Rakshanda Akhter, a gynaecologist at the Directorate of Health Services Kashmir (DHSK), said infertility is influenced by several biological as well as social factors, with delayed marriage being one of the important concerns.
“Late marriage has become one of the common factors we encounter. Female fertility naturally declines with advancing age, particularly as ovarian reserve and egg quality decrease. Many women are now entering marriage in their late 30s or even after that, which can have implications for their reproductive potential,” she said.
She attributed the trend towards delayed marriages to several socioeconomic factors, including unemployment, prolonged pursuit of government jobs, financial pressures, expensive wedding arrangements and social expectations.
Dr Akhter said PCOS is among the common hormonal disorders affecting women of reproductive age and can significantly interfere with conception when ovulation becomes irregular or absent.
“PCOS is increasingly being seen among women of reproductive age. Obesity, sedentary lifestyle, unhealthy food habits, stress and metabolic problems can aggravate the condition. Since PCOS can result in irregular or absent ovulation, it can make conception difficult,” she said.
PCOS is a hormonal and metabolic disorder in which women may experience irregular menstrual cycles, excess androgen levels and problems with ovulation. Not every woman with PCOS is infertile, doctors point out, but the condition can reduce fertility because of irregular ovulation. With appropriate treatment and lifestyle modification, many women with PCOS are able to conceive.
Doctors say insulin resistance, excess weight, hormonal imbalance, genetic predisposition, physical inactivity, unhealthy dietary patterns, stress and inadequate sleep can all contribute to the development or worsening of PCOS.
Dr Akhter stressed the need for greater awareness about reproductive health and urged young people to adopt healthier lifestyles, including regular physical activity, balanced diets and weight management.
Another gynaecologist, Dr Shagufta from DHSK said that infertility cannot be attributed to PCOS alone and that infections and complications arising from unsafe reproductive-health practices can also have serious consequences.
She said pelvic inflammatory disease (PID), particularly when associated with untreated sexually transmitted infections such as chlamydia and gonorrhoea, can damage the reproductive organs and affect fertility.
“Pelvic infections, if left untreated, can cause damage to the reproductive tract and may subsequently result in infertility. Unsafe abortions and procedures carried out at unregistered facilities or by untrained persons can also lead to severe complications,” she said.
Dr Shagufta said severe infections following unsafe abortions can cause damage to the uterus and fallopian tubes, potentially affecting a woman’s ability to conceive in the future.
She also underlined the importance of contraception awareness, saying misconceptions and inadequate knowledge about reproductive-health services can expose couples to preventable risks.
Doctors said the reproductive health profile of the younger population has been changing amid a significant shift in lifestyle. Long working and study hours, prolonged sitting, lack of exercise, increased consumption of processed and fast foods, stress and uncertainty related to education and employment are becoming increasingly common.
They stressed that infertility is a problem affecting both men and women and should not automatically be viewed as a “women’s issue”.
“Timely medical consultation, healthy lifestyle practices, regular physical activity and proper reproductive-health education are essential. Couples facing difficulty in conceiving should seek medical advice rather than relying on misconceptions or delaying evaluation,” doctors said.
The latest National Family Health Survey-6 (NFHS-6), covering 2023-24, has also reported the Total Fertility Rate (TFR) in Jammu and Kashmir at 1.8 children per woman.
Health experts, however, caution that a declining fertility rate at the population level and infertility among individuals are two different issues. While TFR reflects the average number of children women are expected to have over their reproductive years, infertility refers to difficulty in achieving pregnancy despite regular unprotected intercourse over a specified period.
Doctors say continued changes in marriage patterns, lifestyle and reproductive behaviour warrant greater public-health attention. They stressed that improved awareness, access to timely gynaecological care, prevention and treatment of reproductive-tract infections, healthier lifestyles and evidence-based fertility counselling could help address some of the preventable contributors to infertility.
They also cautioned against generalising fertility trends or attributing infertility solely to PCOS/PCOD, saying each couple requires an individual medical assessment to identify the underlying causes and issues—(KNO)
