Infertility is globally acknowledged to be a major health issue. It is estimated to affect 15 percent of the global population of reproductive age – this percentage is even higher in the Middle East.
The main causes of infertility include advanced maternal age, reproductive tract infections, polycystic ovary syndrome, endometriosis, uterine fibroids, psychological stress, intentionally delayed childbearing, environmental pollution, smoking, alcohol and dietary habits.
According to Dr Human Fatemi, Medical Director, IVI Fertility Middle East, there are unique and specific factors leading to infertility – social, cultural and religious in nature, which are different from western countries. Four of these factors which have a special impact on the fertility of the Middle East population are the higher prevalence of Consanguinity (marrying of first or second cousins), Vitamin D deficiency, obesity, and the desire to have larger families.
Consanguinity and Infertility:
Parental consanguinity has been associated with both male and female infertility in multiple cases. In females, it prematurely reduces the ovarian reserve – the bank of fertile eggs in women. Among males, it causes chromosome Y abnormalities, leading to genetic sperm defects.
A groundbreaking research paper published by Prof. Dr. Human Fatemi has revealed that consanguineous couples are a major cause of a higher level of infertility in the Middle East. It was proven that by the age of 20, women born of consanguineous parents have an extremely low ovarian reserve, which is normally found in women from the age of 40. These are findings with great impact worldwide, since over 20 percent of children have consanguineous parents.
Vitamin D Deficiency and Infertility:
The second most important factor for infertility in the region is Vitamin D deficiency. It is widespread because of insufficient exposure to direct sunlight and it adversely affects reproductive tissues including the ovaries, the endometrium and the placenta. According to Dr. Human Fatemi, “Vitamin D has a much bigger role in health than originally thought. A simple 10 minutes of daily exposure to the sun between 9am and 10am can help your body fight the deficiency.”
Obesity & Lifestyle
A higher prevalence of obesity, in this part of the world, is a result of the rapid economic development resulting in increased food access, consumption and lifestyle changes, opines Dr. Fatemi. Obesity causes menstrual irregularities and reduces chances of conception. It also leads to poor IVF outcomes due to inadequate response to ovarian stimulation, lower embryo implantation rates and increased miscarriages.
Desire to have large families:
It is very common in the Middle East for families to have multiple children. Delaying motherhood and advanced age for the second or third child are associated with a reduction in the number of resting follicles within the ovaries and lead to increased chromosomal abnormalities which are a leading cause of infertility.
Fortunately, science has the answer to most fertility problems. However, such treatments are successful only after the right tests and assessments to diagnose the exact cause of infertility. IVI Fertility is one such institution for infertility treatments and uses latest technologies and unique approaches to deliver one of the highest success rates in the region. “The Middle East poses a different set of challenges when it comes to fertility cases. At IVI, our extensive research in understanding ME-specific factors like consanguinity and its impact on fertility and customizing treatments to address those, is the backbone of a very high success rate here,” states Dr Fatemi.