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'Secondary infertility' rates in UAE among highest in the world

Abu Dhabi - There is a significant drop in the number of children born in the UAE.

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'Secondary infertility' rates in the UAE are among the highest in the world, which is causing a massive decline in the country's population and the population will continue to rapidly drop if changes are not made, warn doctors.
"There is a significant drop in the number of children born in the UAE and this has a huge impact on the total population," Dr Human Fatemi, professor of reproductive medicine and medical director of IVI Fertility Clinic in Abu Dhabi told Khaleej Times.
The United Nations reports revealed that the prevalence of infertility is rising, while demographics is declining significantly, from 6.6 births per woman in the 1970s, to 5.22 children in 1980-1985 to 1.73 between 2015-2020, which Dr Fatemi said is largely related to people's lifestyle choices.
The number of births in the UAE is anticipated to drop to 1.66 per couple from 2020-2025. "To recover the mortality rate, we need to stay around 1.9 to 2 children per couple. We have a significant drop in population."
According to the Dubai Health Authority (DHA), around 50 per cent of the women face infertility issues. Statistics also reveal that women in Dubai seeking treatment per year could nearly double, from 5,975 in 2015 to 9,139 by 2030.
Dr Fatemi pointed out that the prevalence of primary and secondary infertility rates worldwide is around 15 per cent among women. "Unfortunately, we don't have the exact data in the UAE, but the impression is that the prevalence of both conditions is higher than the rest of the world, due to multiple factors, which are very specific for the UAE."

Top causes of secondary infertility in UAE

Dr Fatemi pointed out that obesity is one of the top causes of infertility cases in the country. "The prevalence of obesity among women is higher in the UAE than the rest of the world, which is related to reducing egg quality and receptivity of the uterus."
Another factor, which is specific to the population in the UAE, is the lack of sun exposure. "Many women are completely covered, while others don't want to sit outside because it's too hot, and vitamin D deficiency among women has reached 100 per cent. The lack of sun exposure significantly reduces the number and the quality of eggs which increases the prevalence of abnormal eggs in the ovary."
He said that some doctors would simply prescribe Vitamin D to the patients in the form of pills or injections, adding: "But it doesn't work that way, we are fooling ourselves by just treating people symptomatically. The vitamin D, which is administered orally or though injections, is not the same vitamin D that the sun gives to the skin."
He thus recommends 20 per cent exposure of the body at around 10:00am, which is when the UVB light has the strongest exposure.
Dr Fatemi said the UVB light is crucial for converting cholesterol into Vitamin D. "Many women in the UAE have high levels of cholesterol, but it's not only related to bad diet and lack of physical activity - it's largely linked to the lack of sun exposure."
The timing of sun exposure varies between skin colours and ethnicities: Around 20 minutes for fair skin, 30 minutes for olive skin, and around one hour for dark-skinned women.
Another factor causing a rise in secondary infertility is the popularity of consanguinity, which Dr Fatemi said is among 60 per cent of the UAE population.
"If a man or woman marries within the family, they will not face infertility issues, but half of the couple's daughters conceived will have infertility problems later in life. At the age of 20, the daughter will have the eggs of a woman who is 60 years old."
He said that after the fourth-fifth generation, all the children will be completely infertile.

STATISTICS

Demographics in the UAE
>6.6 births per woman in the 1970s
>5.22 children in 1980-1985
>1.73 between 2015-2020
>1.66 per couple anticipated drop during 2020-2025
Women in Dubai seeking treatment
>5,975 in 2015
>9,139 by 2030
Prevalence of infertility rates among women
Worldwide - 15%
UAE - 50%
Timing of sun exposure
>20 minutes for fair skin
>30 minutes for olive skin
>1 hour for dark-skinned women

Treating secondary infertility

Before turning to treatment, the couple must understand the cause of infertility, stressed Dr Human Fatemi, professor of reproductive medicine and medical director of IVI Fertility Clinic in Abu Dhabi. "Unfortunately, no one has done any research in the past, and people were just reading the symptoms without looking at the causes - everyone was doing IVF without even knowing the problem."
Based on the causes, there will be various personalised treatments, such as genetic testing, IVF, preparation of the uterus and simulation. He noted that although IVF can help some couples, it may not help women whose eggs have dropped below significant numbers. "We must adjust the lifestyle and patients must be informed about obesity, vitamin D and marriage within the family."
jasmine@khaleejtimes.com