“If 20 years ago it was a rarity for a 30 years woman to come and say she wants to give birth, now, this is natural and we wonder when we see a woman of 20 years”. It is the reality ascertined by the obstetricians, to whom come women that decide to deliver a baby. In Moldova, the incidence of infertile couples has increased twice in the last 10 years, according to a study presented by the Institute for Development and Social Initiatives (IDIS) “The Future”. It is a serious problem both nationally and globally, and the factors that contribute to infertility are diverse.

The main reason is that women postpone conception period of the child, and when they feel they are ready, appear issues related to fertility. It is one of the explanations given by Professor Vyacheslav Mosin, director of a private clinic in Chisinau. “We can not say how many young people in the category under 25 are infertile, because they still do not want a pregnancy.

If girls would propose to give birth at 18 years, we would not have problems in this regard and if a woman would give birth of the first two children by the age of 20 years, later she may also have fertility problems, but she is no longer bothered because she already has two children”, explains the specialist.

“Someday, a 20 years old girl was called an old girl. In a village, it was shameful to get to this age unmarried and everyone was interested “to get her to her home” as soon as possible. Women were marrying early, were giving birth to 4-5 children. Were doing fewer abortions. Were protecting less and, around the age of 35, were ending their reproductive function. Now, we are in the situation when the reproductive behavior has totally changed. During the Soviet Union it was a behavior, and now it’s totally different”, adds professor noting that, in the present, physicians have come to wonder when they see a young woman of 20 years that wants to conceive a child.

Moldova – sterility leader

“Delaying the period of conception is a European trend and our women are following it. Regarding the factor of conceiving late, we are getting closer to Europe, but unlike them, we are influenced a lot by the ecological factors, which are in a much worse state. We do not have food security. In addition, the number of viral infections is higher, and we have more abortions. They have a contraception culture, but in our country, people are not very educated in this chapter”, opines Vyacheslav Mosin.

“We know that infertility increases, but how and how much, we can not say because, in Moldova, we do not have official data and indicators on this phenomenon. But, according to regional and international reports, the incidence of infertile couples reaches 16%. In this context, Moldova is the country with the highest rates of infertility in Europe and the former Soviet Union”, mentiones the author of the study on “Reproductive Health”, Diana Cheianu-Andrei.

“We can not tell young people that they must give birth at 20 years”

The figures could be even higher, says Professor Viacheslav Mosin, but the age at which we relate matters, as the infertility rate increases gradually, depending on age. Up to 25 years, would be 5 % -8 %, at 30 years, up to 12%, and at 35 is close to 15 %. At 40 years we can say that the incidence of infertility may exceed the rate of 30%. Also, at 45, about 95 % of women are infertile. “These figures may be even higher. The trend is for couples to have fewer children. We can not influence the decisions of young people. We can not tell them they must give birth at 20 years. You can not tell her to do that, because there are other social factors that matter. One explanation could be that women are empowered, they want careers, material benefits and after that they think of children, but, unfortunately, it happens to be too late”, says Viacheslav Mosin.

World Health Organization data show that the percentage of infertile couples worldwide has increased over the past 20 years with 6.5 millions. Arriving from 42,0 millions in 1990 to 48,5 millions in 2010. According to the National Bureau of Statistics data, in 2012, for one woman of reproductive age would be 1.3 children, far less than is required for simple replacement of generations (2.14 – 2.15 children). “There are many factors that influence reproductive health, from the socio-economic situation of the country, to the attitude of society towards women, her role in society, but especially, women’s attitude towards their own health”, consider Diana Cheianu-Andrei.

“Now also the sperm quality of men is much lower”

According to Professor Vyacheslav Mosin also endocrine pathologies suffered by some of the women can cause infertility. “We have big problems with the thyroid gland, due to iodine deficiency. We have problems influenced by the explosion at Chernobyl. A major importance would have the psychological trauma, viral infections, febrete, smoking, drinking, not to mention that young people are very stressed now. All these factors have a negative impact. But in addition to factors related to the environment, are those related to unprotected sex leading to the emergence of diseases such as microplasmoza, chlamydia, gonorrhea etc. Besides the fact that these infections make the tubes to be impermeable and there are risks of ectopic, they can also reduce the endocrine function. “Specialist adds that infertility problems concern both women, and men, report being sometimes 50 /50.

“We have, on the one hand, women’s health, on the other hand, men’s health. Now also the sperm quality of men is much lower. If a study would be done, it would show that currently the sperm of a young man at the age of 18 is not as it was 30 years ago. There are many global studies showing that, biologically, sperm is not as qualitative as before. We also have cases where both partners have problems and in such case is more difficult to intervene”.

Up to 50 000 lei for a fertilization procedure

Arrived in such a situation, most often couples no longer seek a durable treatmen, but prefer faster and more efficient methods. Fertility in vitro is one of the methods that, in recent years, is applied in our country as well, although it is much less congested than in other states. “Now, young people do not have time to go to the doctors and to treat. Whether because they work, or they reach us at an age when they no longer want to postpone solving the problem. IVF is the only real solution as others do not really give results. Tubes, if blocked, no longer restore, as well as sperm quality – if reduced, is no longer restored. It would be years of therapy and, ultimately, is recoursed to fertilization anyway. In our country this practice is less required. Because it’s a bit expensive and not everyone can afford it.  It comes up to 40-50 thousand lei for a procedure. It happens, however, that some women may need more procedures to get pregnant”, says the specialist.

“Young people – illiterate in terms of sex”

Although we have a law on reproductive health, adopted in 2012, which provides that the state would give financial support in this regard, yet “the question remains in the air”, say those in the field.

“We must be careful how we live our lives and it would be good to have healthy life habits”, adds Mosin . “Is someone dealing with educating young people now? Of what help is if you know math and physics, if you don’t have life skills. You must know to protect yourself, but our young people are illiterate in terms of sex”, concludes Viacheslav Mosin.

Raisa RAZMERITA