Infertility In Your 20s: Everything You Need To Know

Fertility problems are often considered to be the bane of older couples. And so, when we envision IVF clinics, we assume that it’s a place for childless couples in their late 30s and early 40s. But with changing lifestyles and long working hours, couples in their 20s have been facing fertility issues too—making seeking counsel from an infertility specialist imperative for them. 


To tell you whether you fall into this bracket of couples and what you need to do to get pregnant, we picked Dr Nisha Bhatnagar’s brain. Dr Bhatnagar—who is the medical director of Aveya Fertility & IVF Centre in New Delhi—specialises in infertility management, natural cycle IVF, and minimal stimulation IVF. And this is her advice for young couples. 


If you’ve had STIs before, you might need fertility help 

“Because of sexually-transmitted diseases and infections, a lot of women have issues with the tubes and ovaries,” explains Dr Bhatnagar. This rings true even more in cases of repeated STIs, which can also impact the anatomical relationship between tubes and ovaries in women. 


Certain gynaecological conditions can impact your fertility in your 20s too

 As the incidence of PCOD and endometriosis is increasing in Indian women, so is sub-fertility. And while PCOD can still be managed with lifestyle measures, endometriosis can render women infertile. 


Says Dr Bhatnagar: “Endometriosis not only decreases the ovarian reserve, but it also causes tubal sinking and adhesions. So even in their early 20s, women with endometriosis may need the help of fertility treatments to get pregnant.” While the grade of endometriosis dictates whether or not the woman needs an advanced ART treatment, when the condition starts impacting the tubes and ovaries and makes sexual intercourse painful for the women, then IVF often becomes the only way for the women to conceive. 


“In the case of PCOD, we try to correct the hormonal balance in women in their early 20s, because they have time and they are not under pressure to go for IVF,” she adds. That’s why in a majority of cases, women with the syndrome are asked to lose weight, exercise regularly, and correct their diets in order to get a handle on their reproductive health. 


You also need to monitor your body to know whether subfertility is likely to be a concern

 “If you are very thin or obese and have a BMI which is not ideal, then it is time to get your hormones checked,” suggests Dr Bhatnagar. For women, apart from weight, the most important thing to pay attention to is their menstrual cycles—because irregular periods can very well be a tell-tale sign of trouble down there. 


“If you have irregular cycles, if your periods are not on time, if your cycles are either too prolonged or too short, then it’s time to get yourself tested,” she adds. Dr Bhatnagar also suggests getting an AMH test done—a simple blood test, which can be done on any day of the cycle, and suggests what your ovarian reserve is. 


“These days because of poor nutrition, low exposure to the sun, and poor vitamin D levels women have very low ovarian reserve even at a younger age. So if you’re married for six months or a year, and you want to check your fertility status then visit your fertility doctor and get your AMH checked,” Dr Bhatnagar suggests.  


But the need for gynaecological testing is not just something that only women should pay heed to. The expert suggests that men should get a semen analysis done to check the sperm count and motility, amongst other things. 


Your lifestyle could very well be putting you at risk of infertility 

“Your lifestyle can be the reason why you’re struggling with infertility,” stresses Dr Bhatnagar. “Nowadays, we are seeing high blood pressure and diabetes in patients as young as 26 – 27. I have also heard of cases where patients in their late 20s have had heart attacks, which was never heard of earlier. So lifestyle plays a very important role as far as infertility and other things are concerned,” she adds. 


See a fertility doctor sooner rather than later

 If you have been engaging in regular unprotected intercourse for six to nine months that hasn’t yielded a pregnancy, then according to Dr Bhatnagar it’s time to see a fertility expert. “You obviously don’t need to go in IVF straight away, but just opt for an investigation. At least you’ll know what’s going on with your body and what kind of support you need,” she says. 


If pregnancy is on your mind, then this is Dr Bhatnagar’s advice for you

“Some 40 years back, infertility wasn’t this prominent. But now the incidence of infertility is so high that out of 10 couples, at least two to three of them are facing problems. So we need to understand that the thing that has mostly changed is our lifestyle—our eating habits, our level of physical activity, our level of mental stress. If your body is healthy, conceiving is not an unnatural thing,” explains the expert. 


In short, what you need to start your fertility or pregnancy journey with is fixing your lifestyle. Eat healthily, exercise more, keep your stress in check, and monitor your body. “Even if after giving yourself and body sufficient time (nine to 12 months) you’re not pregnant, then it’s time to see an expert and get your basic investigations done. You also need to take out time for yourself and spend some quality time with your significant other. Don’t be in a hurry to get pregnant. When your mind is at rest, sometimes pregnancy happens on its own,” Dr Bhatnagar concludes.