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Two little known infertility causes highlighted.

Dubai: Two little known causes of infertility specific to the Middle East were highlighted by specialists in reproductive medicine on Tuesday.

The decline of ovarian function in young women, a common infertility issue, is linked to vitamin D deficiency, and in Arab women specifically, the decline is the result of being daughters from consanguine parents or parents who are related. The two contributing factors have been overlooked until recently, said the specialists during an event organised by pharmaceutical company MSD.

They also estimated that though infertility affects one in six couples globally, the rate could be much higher than the global average in the UAE and the region due to the aforementioned factors and the lack of a central registry documenting medical conditions.

Speaking to Gulf News, Dr Human M. Fatemi, Senior Medical Director for the Centre of Reproductive Medicine in Brussels, Director of the Burjeel Hospital Centre of Reproductive Medicine in Abu Dhabi, and speaker, said, "We see different causes of infertility in this region compared to Europe." In his experience in Brussels where more than 500 couples from the region seek fertility treatment every year, women are increasingly diagnosed with premature reduced ovarian reserve - a measure of decreased fertility.

Citing a study titled aACAyPremature reduced ovarian reserve in daughters of consanguine unions', of which he is the lead author, he said, the second generation of consanguine parents has a significantly reduced ovarian reserve. (The study will be published in July during the annual European Society of Human Reproduction and Embryology meeting - a global event in reproductive science and medicine.)

"Based on the study of 300 Arab couples, we noticed consanguineous parents do not have any problem with fertility. However, their children - or the second generation, show poor ovarian reserve. Women who are 25 have ovarian reserves of a 50 year old woman," he said.

Furthermore Dr Fatemi said that new research is pointing to the role of vitamin D in fertility.

Available statistics by the Dubai Health Authority (DHA) peg the prevalence of vitamin D deficiency at 81 per cent - or two out of three women, estimating that the deficiency level could reach 100 per cent in the Middle East.

He explained that the ovaries need calcium for effective fertilisation to take place. "We have recently detected that there is a direct correlation between vitamin D [a fat-soluble vitamin that helps the body absorb calcium] and ovarian reserve. The lower the vitamin D, the lower the ovarian reserve. This applies to Arabs as well as non-Arab population," he said.

Speaking about the rise in infertility, Dr Awatif Juma Al Bahar, Medical Director, Dubai Gynaecology and Fertility Centre (DGFC), Dubai Health Authority (DHA) told Gulf News that several factor contribute to the rise.

"In women, the causes include delayed marriage due to increased education and work opportunities for women, deferred motherhood, and the presence of Polycystic Ovary Syndrome (PCOS) [a condition that affects how a woman's ovaries work]. Male infertility is often due to sperm problems," she said.

Apart medical causes, lifestyle factors including diet, obesity and stress contribute to the infertility rate, she said.

Dr Awatif added, to tackle the rate, the DHA launched in January the Amal (meaning hope in Arabic) initiative to provide free fertility treatments for Emirati couples through the Dubai Gynaecology and Fertility Centre (DGFC).

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Publication:Gulf News (United Arab Emirates)
Date:May 22, 2013
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