By Chingakham Dina, Arambam Karamjit
Infertility is caused due to problems associated with both men and women. We focus on infertility and its possible reasons among Manipuri women in this article. Infertility problems of Manipuri women become widespread issue now. This causes mental stress and financial burdens in the family. There are many women who are unable to get pregnant in Manipur. Many women are moving out of Manipur for treatment. Interviewing with leading fertility experts from Pratiksha Hospital, a leading infertility treatment centre in Guwahati, came to know that there are several patients from Manipur.
A record of about 60% infertility women from whole northeast region excluding that of Assam in this hospital are from Manipur, is alarming wake up call for Manipur society. Many more women are getting treatment in Manipur too. Large number of patients are also moving to Delhi, Kolkata, Mumbai etc. to seek medical helps. There are other numerous clinics and hospitals in Guwahati itself where many Manipuri women have been getting treatment related to infertility and IVF procedure. If we count all the women having infertility issues including IVF treatment, there could be thousands of Manipuri women suffering from infertility problems. Many women also return home as their reproductive health is beyond the limit of medical help. Health and nutrition are important factors to keep biological continuation from one generation to next. Regarding to nutrition, women from Manipur, Mizoram and Nagaland have better status than other states in northeast India according to one of the leading doctors from Pratiksha Hospital. If nutritional intake of Manipuri women is better among north easterners, then why especially so many Manipuri women are vulnerable to infertility problem?
To understand the underlying problems, we sat and interviewed the founder and leading infertility specialist Dr. Pramod Kumar Sharma and another infertility specialist Dr. Diganta Deka, from the same hospital.
Causes of Women Infertility. There are different reasons for causing women infertility. General issues of infertility are related to- late marriage, working women (have more stress), life style, lack of knowledge, infections, smoking, alcohol abuse, genetics, environment pollution, multiple partners and abortion without proper precaution. Late marriage was considered as main cause of infertility a decade ago but now more and more younger couples are also coming for IVF treatment. When couple could not get pregnant in six month or one year, mental pressure grows up with psychological fearsome of social stigma of childless couples’ fate. This mental pressure is also another factor to compound to the issue of infertility. Life style, working women, smoking and alcohol abuse will not be main causes for Manipuri, which are not in severe situation compared with other societies. There are not many people with couch potato life style in Manipur society. Late marriage is one of the main causes that egg quality declines over the age, which cannot be prevented by modern scientific technology. There are many late marriages in another society too but the issue of infertility is too far bigger for Manipur couples.
Reasons of Increasing IVF Patients. The number of IVF patients have been increasing over the past one decade. Patients are more aware of the cause and concerns of infertility and people are coming out more openly to IVF now. A decade’s ago, when doctor asked to write the reason for medical leave, patients were not willing to mention IVF as reason of medical leave. Today, the scenario has been changed and IVF is accepted as reason for medical leave in any office. With more exposure to media, the news of the technology has been reached to more people. People used to try natural things only to get pregnant after getting married in the past. In our society, couples without children were stigmatized. In order to avoid this social stigmatization, people are encouraged to do IVF by spreading success news from mouth to mouth, and through media. This directly helps to come out patients to increase the number of women getting IVF treatment. However the scenario of Manipur is not only because of exposure to media but something abnormal increase in infertility figure.
We examine to find the possible links to the main causes of the issue by analyzing statistics figure. Every state has some specific issues related to infertility problem regarding to their society and life style, environment, lack of knowledge etc. When the issue of infertility is focused on Manipur society, fertility doctors opine something else, and the possible causes come down to some specific points. This analysis is based on patients statistics record, so there needs scientific research to pinpoint the core issues of infertility.
- Chemical Pollution.
Using Insecticide and Harmful Chemical. Farmers use heavy dose of chemicals, insecticide for crops/grain and growing vegetable. There are stories of immediate effect after consuming vegetables from market. It is commonly known facts about chemical usage in the field. Passing chemicals to human from food is one of the possible links. Cancer causing reason is also reported before from heavy usage of chemical in the field.
- Food Adulteration.
Fermented fish (Ngaree). One of the leading doctors assumes that the widespread issues of infertility in Manipur could be related to using fermented fish. The possible problem is not the fermented fish itself, it could be related to chemical pollution. There have been stories for using formalin, a carcinogenic agent in preserving iced fish transported to Manipur from Andhra Pradesh. Some villagers also reported that people use insecticide to catch fish at border area in Myanmar and the fish is transported directly to Manipur. Regarding to fermented fish, the raw material for making fermented fish is transported in bulk from other states. Dried fish or semi-dried fish easily attracts warms, insects, flies and maggot. In order to protect the raw fish from insects and warms, there might be good chances that the fish stocks were preserved using harmful chemicals. Unconfirmed sources also suggest that some scrupulous business people use chemical such as fertilizer/urea to fasten the process of fermentation while making fermented fish. If the hypothesis turns out to be true, the whole Manipur society is in critical situation because fermented fish is widely used like salt, and chili while cooking in every Manipuri household every day. The infertility cases are also more number among the valley people who consume fermented fish than hill people that mostly depend on meat from animal.
Dry Fish. Unconfirmed by highly reliable sources also reveals that diesel oil is injected in the body of semi rotten dead fish before heating and drying on the fire. This process makes the fish more firm their bodies, keeping more healthy looks and it avoids breaking down the body while drying. Medical experts confirmed that diesel fuel exhaust fume causes cancer to complicate heath problem. Long term exposure and getting in human body also causes kidney damage and unable blood clotting.
Immediate Attention Needed
Statistics correlation between the food and fermented fish is not scientifically proof officially. In order to confirm the hypothesis, it is time for food safety authority to investigate adulteration of food by collecting sample, certification of products selling in the market to greater extend. Unhealthy citizen will bring burdens to the society economically and socially, and this infertility issue itself brings great harm to our society. Save generation before it is to late by investigation for common interest for public health.
Advice from Doctor. The advancement of science and technology cannot challenge the conformity of nature. In spite of great scientific skill, biology of human body will go on its natural pace. As one gets older, naturally the quality of egg will decrease and chances for pregnancy is comparatively lower. Try to get pregnant during optimal conceivable age. Beyond that, nature is hard to be challenged.
Writer’s profile:
Chingakham Dina- Working at Pathumwiali School, Pathumthani Thailand. Also taught in Cambodia / Can be reached at chingakham(at)yahoo(dot)com
Arambam Karamjit- Teacher SKN School, Nonthaburi, Thailand/Former Retail Outlet Manager, Hang Ten Co Ltd, Singapore / Can be reached at ronin9992008(at)gmail(dot)com
This is really very very important. I am so grateful that I have come to this blog! This detailed information about IVF is really very much important. I am so happy that there you have shared such a needful content to the world. Thanks a lot for sharing
Not convincing enough. If you write ‘worms’ as ‘warms’ though you use the spell checker or not, its not acceptable. What was the editor doing? Remember you are writing a science related article and misspellings give a different meaning. I tried hard to establish a connection between Manipuri foods and Infertility in your article but you know what, after reading through it all..properly….I can only conclude that Manipuri foods contains carcinogens in some form or the other.
Appreciate the work don’t blame…. ! They have done something for the society….
Dear Writers,
This is a simple response to your article where it says
“Immediate Attention Needed:
Statistics correlation between the food and fermented fish is not scientifically proof officially. In order to confirm the hypothesis, it is time for food safety authority to investigate adulteration of food by collecting sample, certification of products selling in the market to greater extend. Unhealthy citizen will bring burdens to the society economically and socially, and this infertility issue itself brings great harm to our society. Save generation before it is to late by investigation for common interest for public health.”
Ngaree packets of 250 gms were easily available in almost all the grocery stores here in Manipur. Well, the Ngaree factories have step up to a level where they now started packaging with proper processes to keep the material safe and sound for human consumptions. It’s been happening since some 4 to 5 years.
You will find FSSAI (Food Safety and Standards Authority of India) logo and their unique license number printed on each and every package. Speaking to one of my friend who is into ngari production and packaging, he gave this information that they send their samples to FSSAI and they got their proper license from FSSAI.
FSSAI already knew about Ngaree and they have given the approval for mass production.
A humble request, please don’t publish anything before proper validation. It clearly shows that you didn’t have that much of resources and information for your article.
The writers profile don’t fit to write such an article which needs medical research. At the same time, the publisher also should think twice before publishing such an article which may misguided many people.
Why is tobacco use/abuse not considered as one of the reasons? It is a known fact that both men and women, young or adult, in our society use tobacco in one or the other forms like cigarette, zarda paan(kwa), talap and the like.
We all know that majority of the families in Manipur prefer male child and this may be one of the reason for IVF. Mine is simply an assumption and require further research. I agree with Bijananda Chabungbam.
A plausible hypothesis, but with no data to back-up the claim, it’s not very convincing. Also, I find this a very sexist article.
Some questions that comes to my mind are:
1. Why blame only the women? How many of the infertility cases are attributable to men and how many attributable to women?
2. What are the breakups of the age of different women undergoing infertility treatment?
3.”60% of the patients (in Pratiksha Hospital) coming from outside Assam is from Manipur”… This doesn’t necessarily mean other states have low infertility rate… Maybe the patients of other states are going to some other hospital.. Without confirming this, the data doesn’t really give much insight.
4. To ascertain the cause of infertility, one needs to isolate the different factors and focus in to one and two factors. I believe the hospital should have this data. Or a survey can be conducted.
5. Finally, establishing a causal relationship between food and infertility needs to be done carefully. Does Manipur have a higher rate of infertility than other states? Is the relationship between food and infertility causal or just correlational? Has ngari and vegetables been tested for harmful chemicals that might cause infertility?
So, without addressing these questions with relevant data, no conclusion can be made from the article. But a nice try, nevertheless.
Pls write when you are sure.