Why Late Marriages, Lifestyle Changes and Stress Are Affecting Parenthood

Changing lifestyles, delayed marriages, career priorities and increasing health concerns are influencing fertility among both men and women. While infertility is often perceived as primarily a women’s issue, fertility specialists point out that male factors contribute significantly to infertility as well.

In a recent discussion with Sakshi Post, Dr Munaganuru Niharika, fertility specialist from Birthright Fertility by Rainbow Hospitals explained the growing fertility challenges faced by couples and highlighted the importance of timely evaluation, healthy lifestyles and preconception counselling.

Late Marriage and Delayed Parenthood

One of the major factors influencing fertility today is the increasing age at marriage and parenthood.

Women are increasingly focusing on their careers and many couples prefer to become financially stable before starting a family. As a result, pregnancy is often postponed for several years.

According to the specialist, female fertility is closely linked to age because the ovarian reserve gradually declines with increasing age. The reproductive years between the 20s and early 30s generally offer better natural fertility rates.

The doctor noted that delaying parenthood does not necessarily mean a couple will face infertility, but age is an important factor that should be considered while planning a family.

Infertility Is Not Just a Woman’s Problem

Infertility is a couple’s journey, and both partners need to be evaluated.

Female factors may account for around 30–40% of infertility cases, while male factors can contribute to a similar proportion, according to the specialist. Male fertility problems may include abnormal sperm morphology, hormonal problems and poor sperm parameters.

Lifestyle factors such as obesity, sedentary habits, excessive screen exposure, disturbed sleep and unhealthy food habits can also affect reproductive health.

Night-shift work, particularly among people working irregular hours, may disturb sleep patterns and potentially contribute to hormonal imbalance and increased stress.

Egg Reserve: Why Age Matters

For women who plan to postpone pregnancy, assessing ovarian reserve can provide useful information.

The evaluation may include an AMH blood test, along with an ultrasound assessment of the ovaries and an antral follicle count (AFC).

The specialist stressed that AMH levels need to be interpreted according to the woman’s age and overall clinical situation rather than viewed in isolation.

For women who know they may postpone pregnancy for several years, fertility preservation options such as egg freezing may be discussed with a fertility specialist.

Egg Freezing Can Offer an Additional Option

Egg freezing may be considered by women who are not yet ready to have children because they want to focus on their career, achieve financial stability or have not yet found a partner.

The specialist explained that freezing eggs at a younger age may offer better chances than waiting until later years. However, egg freezing should not be viewed as a guarantee of future pregnancy.

Instead, it can provide an additional reproductive option for women who expect to delay motherhood.

When Should Couples Consult a Fertility Specialist?

The doctor recommends that couples should not unnecessarily delay seeking professional advice.

Generally, if a woman is below 35 years and the couple has been trying to conceive for about one year without success, a fertility evaluation may be appropriate.

For women 35 years and above, consultation is generally recommended after around six months of trying without conception.

Evaluation may include checking ovulation, uterine health, fallopian tubes, thyroid and other hormonal factors, as well as semen parameters in the male partner.

PCOS and Thyroid Problems Can Affect Fertility

Conditions such as PCOS, thyroid disorders, diabetes and hormonal imbalances can influence reproductive health.

PCOS is not simply an ovarian problem. It is associated with metabolic and hormonal changes and may increase the risk of insulin resistance and diabetes.

However, the specialist emphasised that PCOS does not mean pregnancy is impossible. In many cases, lifestyle changes and appropriate medical treatment can help improve fertility.

A healthy diet, adequate protein and fibre, proper hydration, regular physical activity and maintaining a healthy weight can be important components of fertility care.

IVF Is Not Only for Older Couples

One of the common misconceptions about IVF is that it is meant only for older couples or should be considered only as a last resort.

The specialist clarified that IVF is recommended based on the individual couple’s medical condition and fertility diagnosis, not simply their age.

Blocked fallopian tubes, certain male-factor infertility conditions, previous treatment failures and some cases of unexplained infertility may lead doctors to consider IVF.

Another advanced procedure, ICSI (intracytoplasmic sperm injection), involves directly injecting a sperm into an egg and may be recommended in selected cases, particularly where male-factor infertility is involved.

IVF Babies Are Not Automatically at Higher Risk

The interview also addressed another widespread misconception—that babies conceived through IVF are inherently more likely to have abnormalities.

The specialist explained that IVF is primarily a method of fertilisation. Once conception occurs, the embryo continues to develop inside the uterus.

The doctor stressed that IVF conception itself should not be considered a reason for assuming that a baby will be abnormal. The risk of genetic abnormalities and miscarriage is influenced by several factors, including genetics and maternal age.

Modern fertility practice also increasingly considers single-embryo transfer in appropriate situations, which can help reduce the risk associated with multiple pregnancies.

Recurrent Miscarriages Need Detailed Evaluation

Repeated pregnancy loss can be emotionally devastating for couples. Rather than simply attempting another pregnancy without investigation, couples experiencing recurrent miscarriages may benefit from a detailed medical evaluation.

Possible factors can include uterine conditions such as fibroids or adenomyosis, hormonal problems including thyroid disorders and other health-related factors.

Identifying the underlying cause can help doctors plan appropriate treatment before another pregnancy.

Male Fertility: Don't Ignore Lifestyle Factors

Male reproductive health is equally important when a couple is trying to conceive.

Smoking and alcohol consumption may affect sperm quality, while factors such as sperm count, motility, morphology and DNA fragmentation may also need evaluation in selected cases.

The specialist also discussed advanced sperm-selection techniques, including microfluidics, which may be considered depending on the individual clinical situation.

The key message is simple: fertility evaluation should involve both partners, rather than placing the responsibility entirely on women.

Does Stress Cause Infertility?

Stress alone should not automatically be labelled as the sole cause of infertility.

However, severe or prolonged stress can act as an additional risk factor. Increased stress can affect the body's hormonal environment and may indirectly influence reproductive function.

Therefore, managing stress, getting adequate sleep and maintaining a healthy routine can be beneficial for couples planning pregnancy.

Folic Acid Before Pregnancy

Women planning pregnancy are generally advised to discuss folic acid supplementation with their doctor before conception.

The specialist recommended beginning folic acid before pregnancy, noting its importance in reducing the risk of neural tube defects.

Along with supplements when medically indicated, maintaining a balanced diet, being physically active and obtaining adequate nutrition are important components of preconception health.

What Should Couples Eat While Planning Pregnancy?

A healthy, balanced diet is important for both men and women preparing for pregnancy.

The specialist highlighted the importance of adequate protein, fruits, vegetables, fibre and healthy food choices while limiting unhealthy, highly processed and high-glycaemic foods.

Good nutrition can support overall health as well as reproductive health, while maintaining a healthy body weight is also important.

Planning Another Pregnancy After Miscarriage

After a miscarriage or abortion, couples may need some time before attempting another pregnancy. The appropriate interval can vary depending on the individual's physical and emotional recovery and the circumstances of the pregnancy loss.

The specialist suggested that, in general, allowing around two to three months before trying again may be advisable in many situations, while individual medical advice remains important.

When Should Couples Plan for a Second Child?

Fertility can change between the first and second pregnancy, particularly as maternal age increases.

The specialist explained that the timing of a second pregnancy depends on several factors, including the mother's age and the mode of delivery.

After a normal delivery, couples may be advised differently from those who have had a Caesarean section. Following a C-section, a longer interval may be recommended to allow adequate recovery of the uterus.

The Importance of Preconception Counselling

One of the strongest messages from the specialist was that couples do not necessarily need to wait until they encounter fertility problems before consulting a doctor.

Preconception counselling can help couples understand whether their reproductive and general health is suitable for pregnancy and identify potential concerns early.

Depending on the individual, doctors may assess ovarian reserve, ovulation, fallopian tubes, uterine health, thyroid and hormonal status, as well as male fertility parameters.

Treatment should always be personalised based on the couple's medical condition.

The Bottom Line

Fertility is influenced by several factors—not just age or gender. Delayed parenthood, lifestyle changes, obesity, poor sleep, stress, hormonal disorders and male reproductive health can all play a role.

At the same time, a fertility concern does not mean that parenthood is impossible.

The specialist's advice is to seek the right information at the right time, avoid fertility myths and consult a qualified fertility professional when concerns arise. Early evaluation and personalised treatment can help couples understand their options and make informed decisions about starting or expanding their families.