Dr Lim Min Yu
Obstetrician & Gynaecologist
Have you and your partner been trying to conceive for what seems like ages with no luck? Well, you're not alone. Infertility is a common problem that can have a crippling psychological effect on aspiring parents. No doubt you would have already scoured the internet or received advice from well-meaning family or peers. However, it can sometimes be difficult to separate fact from fiction so let's take a look at some things you may have heard about infertility, and whether they are true.
Infertility is defined as being unable to conceive after 12 months or more of regular, unprotected sex. It can be the result of reproductive issues in women or men, or a combination of both. In Singapore, approximately 15% of couples are affected.
Let's examine some common misconceptions, and the truth (or not!) behind them.
Female infertility accounts for more than a third of cases. However, both men and women can experience problems with their reproductive system.
Problems that affect a woman's reproductive system include:
According to the World Health Organization (WHO), the overall quality of semen has suffered globally over the years. Similarly, healthcare institutions in Singapore have seen an exponential increase in the number of men seeking fertility treatments over the past few years.
Among men, some causes of infertility include:
As causes of infertility can be attributed to reproductive issues found in both women and men, or a combination of both, it's important for both parents-to-be to be checked for possible reproductive problems before you start trying to conceive.
Women are generally born with an estimate of 1 million eggs, and the quality of eggs slowly decreases over the years hence age certainly plays a significant role in a woman's fertility. By the age of 35, the number of eggs would be down to 50,000 and by menopause, 1,000 or less.
Once a woman is over 35 years old, her chances of conceiving naturally fall by half; and by the age of 41, her chances would have dropped to a mere 4%. The cell division process that occurs during ovulation may become abnormal, and this leads leading to an increased risk of miscarriage or giving birth to a child with a genetic disorder.
However, infertility can affect young women too. For instance, women under the age of 40 with primary ovarian insufficiency (a condition where the ovaries stop working normally due to depletion or dysfunction of ovarian follicles) or those suffering from polycystic ovarian syndrome (a hormonal imbalance that interferes with normal ovulation) will find it challenging to conceive.
When a couple is unsuccessful in trying to conceive, it is natural to fear that infertility may be the cause. However, it may be a premature assumption as underlying conditions such as polyps, endometriosis, or sperm count issues can make it more difficult to conceive.
If you are still at an early stage of trying to conceive, it may help to check for these conditions so they can be rectified early.
Couples who are having difficulty conceiving should consider going for fertility screening. In addition to taking a detailed medical history, your doctor may recommend several tests to check for common problems.
To pinpoint the cause of infertility among men, your doctor may recommend:
Screening tests for women may include:
It has been over 40 years since the successful birth of the first baby conceived using IVF. Since then, more than 8 million babies have been born using this method. However, while it is not the only solution to infertility, it is common for people to assume that couples struggling to conceive will try IVF.
To understand more about fertility issues that affect men and women, couples are recommended to go for fertility screenings so that doctors can recommend a method that is suitable for them.
Depending on the cause of infertility, your doctor may recommend one of the following:
However, IVF is not a one-size-fits-all solution hence it is important to come to IVF consultation with an open mind and realistic expectations. You will need to undergo multiple tests and consultations and you will need to fully understand the risks and requirements, and what the procedure will involve.
Couples should optimise their general health when they are trying to conceive. Not only can this improve chances of becoming pregnant, but it can also lower the risk of complications during pregnancy. Eating sensibly and having regular exercise are strongly recommended.
Infertility can be incredibly frustrating. However, it doesn't necessarily mean you will never get pregnant. Consultations with fertility experts can provide you with valuable insights on the multitude of options and solutions available to help you conceive your little bundle of joy.