In this episode of The Care Circle by Motherhood Hospitals, host Sahiba dives into the often confusing and hush-hush world of fertility health with Dr. Sharvari Mundhe, Consultant Fertility Specialist at Motherhood Fertility & IVF, Sarjapur, Bangalore.

From AMH levels and egg freezing to pre-marital fertility checks for both women & men, Dr. Sharvari simplifies the science and clears the myths. This conversation is a must-listen for anyone curious about reproductive wellness, whether you’re actively trying, not ready yet, or simply planning for the future. With relatable analogies and non-judgmental advice, this episode empowers you to take charge of your fertility as an essential part of your overall health.

Here are the key takeaways you shouldn’t miss from this episode:

• Fertility is not just about getting pregnant; it’s about the overall wellness of your reproductive system, regardless of whether you plan to have kids.
• It’s wise to start fertility check-ups as early as 24 to 25 years old, even if you’re not actively planning a pregnancy.
• Egg or sperm freezing is a practical option for those unsure about parenthood or planning to delay; think of it as a biological SIP (systematic investment plan).
• Fertility challenges are not exclusive to women. Male fertility can be affected by age, health, lifestyle, surgeries, and stress.
• Pre-marital fertility testing is becoming common and includes AMH, semen analysis, hormonal panels, and screening for genetic or infectious diseases.
• AMH (Anti-Mullerian Hormone) reflects egg count, not egg quality. Low AMH isn’t the end of the road.
• Female fertility can be impacted by conditions like PCOS, endometriosis, fibroids, and autoimmune diseases. Early diagnosis helps with planning.
• Many couples face shared fertility challenges. It’s important to follow medical advice and not rely on internet myths or hearsay.
• Most fertility tests are non-invasive and don’t require time off work. Early screening can save precious time and emotional strain.
• Lifestyle choices play a big role in preserving fertility. Good sleep, regular exercise, home-cooked meals, and hydration make a difference.
• The emotional toll of fertility struggles is real. Couples should support each other and respond to social pressure with honesty and confidence.
• Final advice: Eat clean, sleep well, move often, and don’t wait for symptoms. Preventive care is powerful.

Dr. Sharvari Mundhe is one of the best Gynaecologists and Fertility specialists at Motherhood Hospital Sarjapur Road, Bangalore.

Dr. Sharvari Mundhe has over 12+ years of experience in obstetrics and Gynaecology. Dr. Sharvari Mundhe has completed her Masters in Obstetrics & Gynaecology from the prestigious Grant Medical College and Sir JJ group of hospitals, Mumbai, one of India’s largest and oldest medical institutes. Dr. Sharvari Mundhe has completed her fellowship in reproductive medicine at Craft Hospital and Research Center in Kerala. Dr. Sharvari Mundhe holds an advanced diploma in reproductive medicine from The University of Schleswig Holstein, Kiel, Germany.

Areas of interest:

• Endometriosis
• PCOD/PCOS
• Poor Responds
• Unexplained infertility
• Recurrent implantation failure
• Recurrent pregnancy losses,
• Male factor infertility.

Publications:

• Fallacious case of Ovarian tumour turned into genital tuberculosis (IJCR, Feb 2019),
• Successful Outcome of Non-Cirrhotic Portal Hypertension in Pregnancy: A Case Report (GJRA, Sep 2018),
• Study of Intrauterine death in a tertiary care hospital (IJRCOG, Mar 2019),
• Successful Management of Sickle Cell Anemia with Recurrent Vaso-occlusive Crisis in Pregnancy: A Case Report (IJSR, Jul 2017),
• Successful Outcome in a High-Risk case of ACHD with several pulmonary stenosis with Neurocysticercosis (AICOG 2016, MOGS 2016),
• Successful Outcome in High-Risk case of Pulmonary AV Malformation & Severe PS in Pregnancy (AMOGS 2016),
• Sequential v/s mixed transfer in patients of RIF- Retrospective cohort study (BMJ, May 2022).

Professional memberships:

• KSOG – Karnataka State Obstetrics and Gynaecology Association
• ISAR – Indian Society for Assisted Reproduction
• Karnataka Medical Association

0:06 – Relatable intro: “Googled AMH at 2 AM?” Let’s talk fertility health
0:30 – Fertility is more than baby-making: It’s a wellness report card.
1:21 – What does “fertility” actually mean?
2:04 – When should you start thinking about it? The case for early screening
2:52 – What if you’re not sure about having kids? Should you still test?
3:55 – Should couples get fertility checks before marriage?
5:18 – Pre-marital fertility tests: AMH, semen analysis, hormones, genetics
6:10 – Myth-busting: Is fertility only a woman’s issue?
7:00 – What affects male fertility? Lifestyle, libido, and more
7:51 – What affects female fertility? From PCOS to fibroids and uterus issues
8:58 – How these conditions block conception
10:02 – When both partners have fertility concerns
11:06 – Tried for months and nothing’s happening? What’s next
12:53 – AMH explained: Should you worry if it’s low?
14:14 – Does fertility crash after 30?
15:23 – Do men have a biological clock too?
16:11 – Who should consider egg or sperm freezing – and when?
17:52 – Managing emotions in the fertility journey
20:09 – Three things you can do today to support your fertility
21:34 – Dr. Sharvari’s golden advice: Go back to the basics – sleep, eat, move
22:14 – Episode wrap-up: Stay curious, stay informed, and take care of your body

(0:06) Sahiba: If you have ever silently panicked after the question, when are you planning kids, or googled AMH at 2 am, this episode is for you. Hi, I’m Sahiba and welcome to the Care Circle, a podcast series powered by Motherhood Hospitals. Today, we are starting a brand new series on something deeply personal, often misunderstood and weirdly hush-hush: fertility health.

(0:30) Sahiba: Because let’s be honest, most people only start thinking about fertility when they are ready for a baby. But what if we told you it’s about way more than just baby-making? It’s about understanding your body, planning, and not losing it when your auntie says, “Beta, when is the good news coming?”

(0:48) Sahiba: Joining us today is someone who answers these questions every single day with clarity and compassion. Dr. Sharvari Mundhe, a fertility specialist from Motherhood Fertility & IVF, Sarjapur, Bangalore. She is not just about science and scans, but real talk, practical advice and helping you feel a little less alone in this journey. So, doctor, let’s dive in. What does fertility really mean? Is it only about getting pregnant, or is it more like your reproductive system’s wellness report card?

(1:21) Dr. Sharvari Mundhe: So, traditionally, fertility was defined as the ability to reproduce naturally or the ability to conceive naturally. But nowadays, when we consider fertility as a word, we see that it is like the status of your ovaries, of your uterus. When it comes to men, regarding the sperm count, semen and also the libido, multiple things are included when it comes to fertility. So, it is not restricted only to conception. So, yes, it is a broader aspect. You can call it your wellness card.

(1:52) Sahiba: That’s a fresh outlook about it, doctor. So, doctor, I would also like to know when someone should start thinking about fertility? Like, is there a right age, or do we just wait till we want kids?

(2:04) Dr. Sharvari Mundhe: So, basically, the women or the men should take charge of their fertility as early as the age of 24 or 25. So, it does not depend upon your marital status whether you want to have kids or not. So, basically, you can just undergo a simple test like a semen analysis or AMH when it comes to females, just to know where you stand. And then, accordingly, you can go ahead with the steps. There are a lot of options, like freezing available. So, like people are not going to get bankrupt by the age of 50 or 60, but they do go for SIPs and mutual funds just to be secure.
So, it is similar in case of fertility as well. So, freezing is something that could be considered in the same pattern.

(2:43) Sahiba: That makes so much sense, doctor. It’s like getting regular health checkups, but for your reproductive system. I wish more people knew about it earlier.

(2:51) Dr. Sharvari Mundhe: True.

(2:52) Sahiba: So, doctor, what if someone isn’t sure they want children at all? Should they still be aware of their fertility?

(2:59) Dr. Sharvari Mundhe: So, like I said, fertility is multifactorial. It is not only restricted to the ability of reproduction. So, they can undergo the test that I mentioned. And then couples, if they are not sure that they want to have kids, I see a lot of patients who come at the age of 40 when, you know, realisation starts that no, we wanted kids. Or maybe after seeing the couples or peers of their age group that no, we also want to have kids. But then, by then, the biological clock has already started ticking to an extent where we have missed the bus. So, in that case, you can consider couples who are married; they can consider embryo freezing.

Like I said, like an SIP, it will be an SIP or mutual fund restricted to your fertility. So, even if you don’t want to have kids, it will be just there at the back of your mind. Whenever you are ready, you can use the embryos for the transfer. And if you don’t want it, later in life, you can take a decision to discard the embryos.

(3:55) Sahiba: That’s such a great point, doctor. Okay, doctor, the real talk. Should couples think about doing a fertility check the same way they plan pre-wedding shoots? Like is a pre-marital fertility test a smart move, or is it like too much?

(4:09) Dr. Sharvari Mundhe: So, definitely when we see the era of the 21st century that we are living in, we should not restrict our pre-wedding things to only the shoots, the menu, venue and shopping. So, the basic thing is that the partner which you are choosing, it’s a common saying that 99% of your life is going to be spoiled if you are going to be married to the wrong partner.

So, when they say this, they are including, like you should have certain logical conversation with your partner when it comes to finances, what is the role that you are expecting them to play in your life, when it comes to personal things, whether you want to have kids or not. And then certain tasks that you are expecting them to contribute to the household.

Okay, how is your routine going to be changed? Which place you want to get settled in? Are you going to be travelling the whole life? So, these are certain aspects. Very important is, of course, baby planning. So, definitely we see lot of couples stepping in recently, last 6 months, where people are willing to go for a semen analysis and the females are ready to go for an ultrasound or AMH. Of course, because they see themselves having kids or being parents in future.

(5:18) Sahiba: That’s actually practical advice, doctor. So, doctor, what kind of test can couples do before marriage or before trying, just to get a heads up on how their baby-making systems are doing?

(5:28) Dr. Sharvari Mundhe: So, the tests that we advise usually in pre-marital screening are categorised into 3 things. One is the fertility check that we do, that is a simple blood test, AMH, ovarian reserve test for females, semen analysis for the male. Then second is a hormone workup, where we prescribe a certain hormone blood test for the female, which is different from that we have for the male.

And third is genetic screening, where we include screening for genetic diseases like sickle cell, thalassemia, etc. And also it includes the STI panel, that is the Infectious Disease Control Panel, which includes HIV, HBSAG, BDRL and syphilis.
So, these are the tests that we usually recommend for couples who come for a pre-marital check.

(6:10) Sahiba: That sounds interesting. Let’s get into our favourite section, doctor, that is busting some myth. The first myth that comes to my mind is that fertility is only a woman’s issue.

(6:21) Dr. Sharvari Mundhe: So, I think everywhere it has been told that fertility needs an egg and sperm both to make a baby. So, we definitely need the other set of chromosome, which is coming from the husband. So, if he gives a Y chromosome, it is going to be a male child. If he is going to contribute X chromosome, it’s going to be a girl child. So, it is as simple as that. When the production requires both sperm and egg, so the problem cannot be limited to only one gender. So, that is completely a myth.

(6:48) Sahiba: That’s a nice approach of putting it together, doctor, that it’s not only her problem or his problem. So, doctor, what about men? Can they also have fertility issues? And what kind of things affect male fertility?

(7:00) Dr. Sharvari Mundhe: So, there was a saying earlier that, you know, men can reproduce till they die. So, basically, that holds true to certain extent because people who have a normal semen count, morphology, motility, then they have the power of producing sperm till they die. But then there are cases where the male is getting affected with certain genetic conditions, smoking, alcohol, lifestyle changes, if they have undergone any surgeries like hernia, hydrocele.

Or in general, there is unexplained less sperm count or zero sperm count which we call it as azoospermia. There can be some accident history where the sperm count can get affected. So, yes, and also one of the major issues is libido, where what we call it is a decreased libido or performance anxiety. So, these are many reasons where the male fertility issues also need to be evaluated.

(7:51) Sahiba: That’s really eye-opening, doctor. And for women, what are those roadblocks that make it hard for them to get pregnant? So, if we exclude the male fertility, then female, there is a wide range of spectrum.

(8:02) Dr. Sharvari Mundhe: So, basically there are, I always tell there are more than 100 reasons to not conceive. But the tests are limited. When it comes, testing involves only the test of the uterus, that is we do an ultrasound. Ovaries where we see the egg count and the tube status, whether the fallopian tubes are open or not. And here and there are some hormone profile. So, there are certain limitations where we cannot see the egg quality of the female.

There is no test available for it. So, these are somewhat roadblocks. And then certain conditions like polycystic ovaries, endometriosis, multiple fibroids, and then certain autoimmune conditions like rheumatoid arthritis, SLE. There are multiple medical disorders also, which directly, indirectly affect the fertility as well. So, these are certain roadblocks that we see when it comes to women when they are planning for pregnancy.

(8:50) Sahiba: If you could explain a bit in detail, doctor, that how these roadblocks, how these conditions are affecting the fertility of women.

(8:58) Dr. Sharvari Mundhe: So, basically when it comes to PCOS, of course, the major roadblock is ovulation. When the ovulation is not happening, it becomes difficult for the couple to try within the fertile window. Then when it comes to endometriosis, in those cases, it depends upon how severe the endometriosis is, whether it has affected the fallopian tube, whether it has affected the egg quality, or the cyst or the endometriotic cyst are so big that they are not causing ovulation to happen.

These are certain things. When it comes to fibroids, the major issue that we see is defect in the implantation. The baby is not able to implant or repeated miscarriage is what we see, if the fibroid is located inside the uterine cavity. Then there are other medical conditions like autoimmune conditions or any problems in the uterus. If the uterus has defect in the structure, bicornuate uterus, septate uterus, again they face issue in implantation. So, these are overall net-net what we see in day-to-day basis.

(9:54) Sahiba: That’s quite insightful, doctor. Also, doctor, do you see couples where both partners are dealing with fertility challenges?

(10:02) Dr. Sharvari Mundhe: So, yes, we come across couples where both of them need special attention. So, recently we had a case where the AMH was low, 0.4, female was 38.
And when it came to male factor also, they had tried for a very long time, IOI is done. And then we noticed that the sperm motility was very low. Also, the count and morphology was towards the lower side.

So, in these cases, we make a proper plan. When they come, we make them understand that this is what if we wait for more long, what are the chances of pregnancy going to be and if we go for treatment right away. So, yes, there is a lot of responsibility on the couple as well when it comes to following the doctor’s advice also. So, in such cases, I highly recommend them to, you know, whatever the doubts and difficulties are there, they should come directly to the doctor and discuss with them rather than going for internet and AI.

Because it is also going to be little misleading and super confusing. Because the fertility is not something which is, you know, 2 plus 2 is never 4 when it comes to fertility.
So, I advise all the patients that whatever doubts you have, you speak with the doctor, you be in constant touch and then follow the proper advice.

(11:06) Sahiba: Interesting, doctor. So, if someone’s been trying for a while and nothing is happening, what’s the plan? What are the tests or signs that help give a full picture of someone’s fertility, and do these tests hurt?

(11:18) Dr. Sharvari Mundhe: So, most of the tests are usually non-invasive tests. The beauty of fertility is that you don’t require much leaves also from the office. And mostly they don’t require much time-consuming, also, it is not there. So, definitely, if you have been trying for pregnancy earlier, the definition of infertility was that if you have been trying for one year without protection and pregnancy is not happening, then you should consult the doctor.

But the recent guidelines say that as soon as you start thinking of pregnancy, you should first meet the doctor. The reason being a lot of hormonal imbalances is what we have seen also. People don’t focus on their diet and lifestyle. They just try to bypass it and directly jump on pregnancy planning. So, definitely, if you want a healthy pregnancy natural conception, you should first visit a doctor. You should check your baseline test done, which are mostly an ultrasound or semen analysis and here and there blood test.

So, which is not at all painful. And then you get much more confidence in trying naturally after knowing that, okay, all my reports are normal. On the other hand, if you come across any issue which can be caught little earlier, for example, if there is any problem in the uterus or if there is any problem in the semen test, then you save the time from delaying when you start coming to the doctor after six months.

That six months is actually wasted when you have tried without any supervision. So, at least one preconception counselling is what I advise everybody to take, irrespective of the age, irrespective of when you are going to plan. Just meet a doctor, get yourself evaluated. If everything is good, start trying naturally with proper supplements and lifestyle changes.

(12:53) Sahiba: That sounds so reassuring, doctor. So, doctor, you have used the term AMH quite a lot of time. Everyone’s heard of it. Everyone has Googled it. But what exactly is it? And is it really worth losing sleep over if the number is low?

(13:08) Dr. Sharvari Mundhe: So, basically, AMH stands for Anti-Mullerian Hormone, which is a simple blood test, can be done any time of your menstrual cycle for a female at any age, just to know the status of the egg count. It has nothing to do with the quality of the eggs. So, even if the AMH is low, I would request everyone or advise everyone to just take a fertility consultation. Even if you are not planning for pregnancy, you can just go and take a test just to know where you stand when it comes to the count.

It is just like how your bank statement will come every month. This much is debited, this much is credited. But our ovarian bank does not have any credit happening. It is only debited. So, in that case, you can just know where you stand. And you can think accordingly.

There is no need to panic or take stress when it comes to low AMH. I have a patient less than 0.1 also. They have conceived naturally. So, it depends. A lot of other factors are there.
Based on AMH, nobody is going to tell you to go for IVF. It is just that you will get a direction that, okay, where do I stand and what next should I plan. That’s it.

(14:14) Sahiba: I love how you explained it, doctor. So, moving on, let’s get into some rapid fire questions. Is it true that fertility drops after 30? Do female eggs just pack up and leave? Does everyone experience that drop at the same time? Or can your lifestyle or health make a difference?

(14:33) Dr. Sharvari Mundhe: So, yes, it is completely a myth. It’s not like you blow the candles at the age of 30 and the next day the egg count is going to go down.
It’s not like that. It’s a gradual decline, which is going to be a little bit visible after the age of 30. But again, a lot of lifestyle changes are there which can help us preserve the quality of the egg.
Again, quality is very important about quantity when we try for pregnancy or when it comes to fertility overall. So, whoever is not planning for pregnancy can consider freezing. Who is planning for pregnancy can consider consulting someone who can guide you.

And then, of course, it is just a myth that, you know, it is going to just vanish. The eggs are going to drop down like anything and you have to have a baby before 30. But yes, lifestyle matters a lot. If you are healthy, even if the AMH is low, even if the count is low, you still can conceive naturally.

(15:23) Sahiba: Great point, doctor. Do men also have age-related fertility issues or do they also have a clock ticking? Or is it mostly a female concern?

(15:32) Dr. Sharvari Mundhe: Clock is there in men and women both. But I think the clock is ticking faster when it comes to females. And also, the advantage that men have is that the sperm production is going to happen till the age they die. So, spermatogenesis, that is sperm production, is a continuous process.

Unlike females, where they are born with a certain number of eggs and they cannot produce eggs after the birth. So, when it comes to men, the fertility issues can be like the morphology or the abnormal sperm increase, the motility issues are there, the DNA fragmentation index increases. So, basically, they may conceive. But a slightly increased risk of miscarriage is what has been found in the recent studies.

(16:11) Sahiba: I feel this will open a lot of needed eyes to this matter. Back to the questions, doctor. A lot of people today are thinking about freezing their eggs or sperm. Who should consider it and when is the best time?

(16:24) Dr. Sharvari Mundhe: So, sperm freezing and egg freezing, yes, we are seeing a lot of people coming ahead for it. At least the number of enquiries have increased in the past one to two years. So, freezing, anybody can do it above the age of 23. So, men, if they are not married, if they are undergoing any cancer treatment, or they have any surgery related to surgical history when it comes to hernia, hydrocele, or based on their travel plans, or couples who stay apart, in them the semen freezing works.

Then, when it comes to egg freezing, a female at any age can go for egg freezing. The only thing is, the earlier the better. So, usually we tell that 10 is the number of eggs that we usually want to freeze. The 10 mature eggs is what we expect when we are going ahead for freezing. So, definitely people who are younger, they are going to need only one cycle.

Above 37-38, I have done egg freezing for some female, where we have done cycles for like 2-3 months consecutively, and then pooled the cycle and pooled the eggs. So, the quality again, like I kept saying, quality matters over quantity.

So, even if the quantity is low, but the quality of the eggs are good, then it is, we are good to go. So, freezing can be considered by anybody and everybody who wants to have kids or they see themselves as parents someday or the other, not sure, but they don’t want to, you know, compromise or do anything in the present moment. So, this is something like an investment, you can think, from a biological investment.

(17:52) Sahiba: That’s really valuable information, doctor. It sounds like timing is everything with fertility preservations. How do you help couples manage the emotional overload, especially when every other Instagram post is a baby announcement? I have seen friends burst into tears after getting a low AMH result, or worse, after one insensitive comment from a relative.

(18:14) Dr. Sharvari Mundhe: So, basically, fertility, when it is not going in the direction that you expect, is going to be a roller coaster ride, no doubt. So, in this, a lot of role is played by the doctor, the counsellor, and the couple in themselves also. So, for example, I always advise the couple that if one is feeling low, the other has to boost the partner rather than getting involved like, yeah, so, for example, a couple is saying, no, I don’t know whether we’ll be able to conceive, my AMH is low, I have fibroid.

It’s the responsibility of the partner to boost her up, to make her realise that whatever it is, we are in together. Similar stands for the men also. If the sperm count is low and the female partner tests are all normal, in that they have to stand up for each other and take it as like it is a journey where they both are going to be equally responsible, no matter whose tests are normal, whose tests are having some issues.

So, first, the couple needs to be strong within themselves. Only and only then the counsellor and the doctor can help. And a kind request to all the people, especially the elder people, that everybody is trying their best, just don’t get behind anybody. It is like a touching point when they keep asking. So, the thing that I advise the couple is whoever asks you that when are you going to give good news or when are you planning pregnancy or whoever is going to lecture you for that, you can just tell them in one straight line that we are taking treatment and we will give you the news as soon as we get it first. That’s it.

You have to face the people. There is no way of running away from people and running away from comments because somewhere or the other, the other person may be genuinely concerned for you that you should plan pregnancy early so that you get rid of complications and you don’t suffer in future. I don’t think everybody has a bad motive when they are trying to question you. So, in that case, you can be straightforward, accept it and tell them straight away that okay, we are taking treatment, we’ll let you know. That is a statement that they can go rather than taking it in a negative way.

(20:09) Sahiba: That makes perfect sense, doctor. This is like a team effort, and both partners need to be equally informed and involved in this. Let’s end on a hopeful, empowering note because this is not all doom and gloom. What are three easy things people can do right now to support their fertility health even if kids are years away?

(20:29) Dr. Sharvari Mundhe: Three things that I would like to tell is first and foremost, sleep well. Get up on time, wake up on time, sleep on time. Second is exercise. So, whatever is your schedule, however busy you are, spare at least 20 minutes for yourself where you can do some meditation, some exercise at least 5 days a week.

So, I know when we start scrolling social media, or we start googling anything or when we start going on the internet, then we don’t know how the time flies. It may be 20 minutes, 30 minutes, 40 minutes. But when it comes to exercise, I often hear that I have a busy schedule, I am overworked, I have too much work pressure. So, we need to prioritise our health because the body is something which is going to give you returns. If you have a good body, if you are going to have a fit body, that is what is going to matter in the long run. And third is that get yourself tested.

So, not always the body will show symptoms. It is wise to catch before the body starts showing you that okay, I am having this symptom, that symptom because of diabetes, because of thyroid, etc. So, these are the three things that I would like to tell everybody.

(21:34) Sahiba: I feel those are such simple and doable steps. I love that they are things that benefit overall health, too, doctor. And finally, what’s that one golden piece of advice you wish to give to our listeners, doctor?

(21:44) Dr. Sharvari Mundhe: The golden advice that I would give everybody is please have a good diet. As much as possible, please go organic. Focus more on home-cooked meals. Avoid packet processed food and overall have a good sleep. And you know, rather than going for fancy things, focus on basic things what our previous generations used to do. (22:05) Eat well, sleep well, exercise well and drink lot of water. So, these are the basic things that I am going to tell everybody which nobody else will tell.

(22:14) Sahiba: That’s a beautiful advice, doctor and perfect note to end on. Thank you, Dr. Sharvari, for making this conversation so easy to understand and full of hope. Whether you are thinking about starting a family, not quite ready yet or just curious about your options, remember, fertility health is a part of your overall health and being informed is the best gift you can give yourself.

We’ll be covering more topics in this fertility series. So, follow the care circle and as always, take care of your body, ask questions and know you are not alone on your journey. We’ll see you next time.

Until then, stay healthy and take care.