An Overview Of Fertility Rates In South Asia

When we talk about South Asian heritage we are usually referring to countries including Afghanistan, Bangladesh, Bhutan, India, The Maldives, Nepal, Pakistan, and Sri Lanka.¹

All of these countries have a rich culture with several values and practices. One thing common between all South Asian countries is that they prioritise building and nurturing their families. In these communities having children is highly desired and most couples eagerly anticipate parenthood.

In this blog, we will explore this aspect by looking at the fertility rates in South Asia, significant causes of infertility and ways to overcome these challenges. Let’s dive right in!

Fertility Rates In South Asia

Fertility trends in South Asia have illustrated a consistent decline over the past 50 years.² There is also strong evidence of an accelerated decline in sperm count in men in the century.³ Fertility is usually measured as the total fertility rate. The total fertility rate indicates the average number of children a woman would bear through her reproductive years.² Here are the most recent fertility rates in South Asia.⁴

People often underestimate the impact of age, poor diet and habits like smoking on their fertility. Additionally, other socioeconomic factors like rapid urbanization and higher costs of raising a child have led to a drift in the fertility rate in South Asia from 5.5 in 1970 to 2.4 in 2015.⁵

These statistics are quite the eye-opener for South Asian men and women to get their reproductive health checked and track their fertility status regularly.

Risk Factors For Infertility In South Asian Patients

Infertility is the inability to conceive even after a year of regular sexual intercourse without the use of contraception.⁶ WHO estimates that over 48 million couples and 186 million individuals live with infertility globally.⁷

Moreover, studies indicate that infertility rates in South Asia and a few other regions of the world like Sub-Saharan Africa and Central and Middle Europe have approximately 30% higher infertility rates when compared to other parts of the world.⁸

Here, we look at some of the factors that affect the South Asian population and perhaps contribute to higher infertility rates.

1. Polycystic Ovary Syndrome (PCOS)

PCOS is a condition caused by an imbalance in ovarian hormones. It leads to several symptoms like irregular and painful periods, adult acne and sometimes infertility. Fertility rates in South Asia are affected as there is a high incidence of PCOS amongst the women in these regions. PCOS effects are compounded by more severe symptoms and a relatively earlier onset than in groups from other regions.⁹

2. Diabetes

South Asians have a high prevalence of type 2 diabetes.¹⁰ Diabetes can become a risk factor for male fertility in the long term if it is not controlled properly. It can result in problems like:¹¹

• erectile dysfunction
• low testosterone levels
• reduced sperm quality
• delayed ejaculation

This is because glucose metabolism is essential for the motility and fertilisation capability of the sperm cells.¹² Therefore, it is advisable for diabetic males to assess their fertility by undergoing tests such as SpermScore, in order to make well-informed reproductive decisions.

3. Endometriosis

Women suffering from endometriosis have endometrial tissue growing outside their uterus.¹³ These women experience severe symptoms like pelvic pain and heavy cramps during their periods.¹³ This condition is highly prevalent in east and South Asian communities and can also affect the overall fertility rates in South Asia.¹⁴ This is because endometriosis can impact a woman’s chances of conceiving a child. In fact, approximately 30-50% of patients with endometriosis might experience infertility.¹⁵

4. Varicocele

Varicocele is a male reproductive condition signified by enlarged or dilated veins in the scrotum.¹⁶ They are often known to be a leading cause of male infertility.¹⁷ They are observed in 35% of men with primary infertility.¹⁸ Moreover, Asian countries like China observe a high prevalence of varicocele.¹⁹

5. Lower Success Rate Of Certain In-Vitro Fertilisation (IVF) Treatments

Ethnicity may play a role when women try to seek IVF treatment through fresh embryo transfer to overcome infertility. Fresh embryo transfer means that the doctors inseminate the eggs retrieved from the female partner, grow the embryo and immediately transfer it back to the uterus.²⁰ Studies show that South Asian women seem to have a lower live birth rate and overall inferior outcomes after IVF in comparison to caucasian women.^21,22

However, research shows that performing IVF process with a frozen embryo has similar outcomes from people with caucasian as well as South Asian heritage.²¹ So it's best to consult with your fertility expert and understand your options thoroughly as it is not a complete lose-lose situation.

How Can You Stay On Top Of Your Reproductive Health?

Despite some risk factors for fertility in the South Asian population, their fertility rates are  relatively higher compared to other regions across the globe.⁵ So, if you belong to a South Asian community, then the best way to stay on top of your reproductive health is to get a semen analysis test if you’re a man.  

In A Nutshell

In conclusion, the fertility rates in South Asia have been a topic of interest for many researchers and healthcare providers. By understanding the fertility landscape in South Asia, we can work towards promoting healthy pregnancies and families in the region. It is crucial for individuals, healthcare providers, and policymakers to understand the complexities of fertility in South Asia, and work together to address these challenges and support individuals in achieving their reproductive goals.