The pink file sat between Manjula and Praveen at the hospital waiting room. The epitome of a modern couple, the two are physiotherapists who lead busy, high pressure lives in Delhi, having re-located from this city. Barely two years after their wedding, they are at a clinic in Chennai for investigations into infertility.

At the hospital, pink files were given to idiopathic infertility cases : infertility for no known reason.

“About 10 years ago, women used to come in for termination of their pregnancies after two children. Now, there is a drop in the number of abortions and a rise in infertility, says Dr.M. Muthu lakshmi, head of the obsterics-gynaecology department at the Kilpauk Medical College Hospital.

Opinions on the reasons for this vary but most gynaecologists agree on lifestyle factors being a major contributor. “Nowadays there seems to be intense stress and pressure at the workplace. This combined with excessive junk food and lack of physical exercise are all contributing factors,” says Dr.Muthulakshmi.

“We hardly see each other,” said Praveen a dapper 29 year old who works 12 hours days, seven days a week. “By the time I’m home, all I can do is plop into bed and not wake up until the next morning.

Manjula is quieter. The family pressure to have a baby seems to be taking a toll on her. She works six days a week, leaves home at 8 am and returns at 5.30 pm to prepare dinner and see to household chores. There hasn’t been time to relax in the last two years and the strain of living in a strange city where everything is different has added to her worries.

With no leave allowed at either of their workplaces, Manjula and Praveen planned three months in advance to make this visit to Chennai. They are now waiting for results of the doctor’s investigations.

According to an estimate, one in five are childless after two years of marriage, despite efforts to conceive. For the last decade or so, doctors and gynaecologists have been viewing with increasing concern the gradual but unmistakable rise in infertility rates in the State, a phenomenon that affects thousands of couples who desperately want a child but cannot conceive.

Though the State government has no official statistics on infertility in the State Director of Public Health Dr.S Elango admits that it is a rising problem. “In fact, it has gotton to be so serious that we are considering assisted reproductive techniques, such as in-vitro fertilization in the government sector. So far it is only the cost factor that has been hindering us, “he said. At the Institute of Obstertrics and Gynaecology (IOG), the State’s referral government facility, a fertility clinic is run everday to deal with the large number of cases that come in.

Statistics from IOG show a gradual increase in the percentage of cases coming in for infertility treatment. The institute sees between 31,000 and 35,000 cases for gynaecological treatment every year. Of these, the percentage of cases for infertility has risen from 19.5 per cent in 2003 to 25 percent in 2006.

Figures from a private hospital also corroborate this. A leading hospital int he city has been a steady climb in its number of infertility cases in the last three years: from 2,447 in 2006 to 2,720 last year. Though these represent total figures from India and abroad, most of the patients seen were from Tamil Nadu.

Dr. Priya Selvaraj of the GG Hospital, a fertility research centre in the city, explained how men and women who were already genetically predisposed towards a disorder, such as diabetes or hypertension, were now getting it earlier than ever thanks to a high pressure lifestyle.

“With women, stress seems to lead to bad eating habits and no physical activity. This tips the balance in their acquiring conditions, such as polycystic ovarian syndrome to which they may be predisposed but could have avoided,” she said.

Another factor in this lay in the increasing number of couples postponing their first child. According to the State report of National Family Health Survey-3, the use of family planning methods was widespread with female sterilization accounting for 90 per cent of all contraceptive use. “The postponing of childbearing is definitely on the rise,” said Dr.Selvaraj, adding that even if career obligations were vital, couples should try to have their first child before the woman turned 30. “There is a need for balance in this regard,” she said.

Dr. Shanthi Dinakaran, Director of the IOG, put the spotlight on another factor late marriages. “After the age of 30 there is a definite decrease in the potential for conceiving. If this is combined with other life style factors, the chances become even slimmer,” she said.