The journey to parenthood
28 December 2020
CONCEIVING may not be as simple or direct for all couples. Unfortunately, when infertility strikes, distress and finger pointing begins, often directed at the woman.
However, it's an issue that affects both men and women, with infertility among men on the rise.
According to a study by the National Population and Family Development Board (LPPKN), the fertility level among men below 30 has decreased by 15 per cent from 2010 to 2019.
The male factor is also thought to contribute to up to 30 per cent of cases of infertility.
Sunway Medical Centre Velocity's consultant fertility specialist, Dr Farah Leong Rahman says infertility affects 1 in 7 couples – some of the causes include lack of regular ovulation, blocked or damaged fallopian tubes, endometriosis and poor semen quality.
However, in a quarter of cases, it is not possible to identify the exact cause, in which case it's labelled as "unexplained infertility," she explains.
However, this does not spell the end for every couple as some of these causes can be addressed by making simple, but effective changes to their lifestyle.
A healthy and balanced diet is crucial in keeping one's body in peak condition, while smoking and alcohol consumption should be avoided.
Exercising regularly and maintaining an ideal body weight can also be of great help.
Dr Farah also stresses the importance of visiting a doctor to ensure any underlying medical conditions such as diabetes are treated and kept under control.
In the unfortunate event that a couple is unsuccessful in getting pregnant after a year, they should pay a visit to a trusted fertility doctor to figure out their next step.
"Do see the fertility doctor if the woman is 35 years and above, as fertility declines with age. The ovaries will have fewer eggs to offer and these may be of poorer quality. It is also important to take note of other factors such as the patient having undergone any treatment or procedure that may result in infertility such as cancer treatment, or any previous surgeries related to the female reproductive organs such as removal of fallopian tubes."
Doctors will usually carry out hormonal blood tests on the woman. One of the tests is called the "Anti-Mullerian Hormone" test which helps estimate how much eggs a woman has in reserve.
A tubal patency test is also advised to determine if the woman's fallopian tubes are blocked.
As for the man, a sperm test is necessary. Dr Farah explains that men with a history of undescended testes, problems with pubertal development, previous genital surgery or infection, fertility problems in current or previous relationships and problems with erection or ejaculation are advised to see a fertility doctor.
It would also be best if the couple are present together during consultation as the doctor will ask questions to get to know the couple better in order to help them.
"The doctor will also carry out an ultrasound to check the womb and ovaries. If you do have any previous test results please bring them along. A thorough discussion will be carried out and fertility tests offered if not done. Treatment options may be different for each couple depending on the underlying problem and discussions made."
Couples who face difficulty in getting pregnant may go through emotional and mental stress, with some even falling into depression, or experiencing bouts of frustration, anger or loss of self-esteem.
For this reason it's important for the couple to support each other through the infertility journey and also receive support from family members and friends.
"It is important to be honest about your feelings and be able to express them in the right way. There are also support groups out there and counsellors if one needs help. Good mental and emotional health should be present throughout this period and continue when you are pregnant. Always remember that you are not alone in this journey."
