AskMeDoctor! Clearblue Episode 02: Frequently Asked Questions on Fertility

Tick, tock, tick tock... our biological clock is ticking away! As women, sometimes we get pressured into having kids before we’re ready because they say the older we get, the harder it is to conceive. But is this really true? Today, we have Dr Natasha, a Fertility Specialist and mum to a pair of twins who is on a mission to help couples with infertility. Q1. What causes infertility? Us or just mother nature? Dr Natasha: When a lot of couples are trying to conceive, they would have at the back of their minds, wondering if they have any sub fertility or infertility issues. A couple may have some fertility issues if they have been trying to conceive by having regular sexual intercourse for at least 12 months and they’re still unable to conceive. Some of the factors causing sub fertility in couples could be due to: • female factors. • male factors • a combination of both male and female partners. So, don’t entirely blame the females because men are also contributors in this factor. The most common for male fertility issues are due to abnormalities of their sperm count, the movement of the sperm, and also the shape or the quality of the sperm. For females, the most common factor is due to ovulation disorders, Polycystic Ovarian Syndrome (PCOS). It’s one of the more common disorders that may cause women to not have ovulation. And the other few factors are tubal issues. Damage to the tubes, infection, and also another disorder called endometriosis. And some abnormalities of the uterus such as fibroids and ovarian cysts. Besides that, the overall health of a couple is very important. So, if I were to see a couple in the clinic, I also would like to have a look and discuss their lifestyle factors. And maybe if they’re too overweight or thin, this might also cause them to have some fertility issues. Smoking as well. So, if you are trying to conceive, we would strongly advise you to actually reduce or stop smoking. Q2. Does age really impact fertility? Dr Natasha: Yes, unfortunately. Especially for women. We do have a biological clock. We have about a million eggs in our ovaries when we were born. Unfortunately, when we go to the reproductive age, we’re only left with 400,000 of eggs to be used during our reproductive years which reduces very rapidly. Not only the number, but the quality also declines. So that contributes to this term called 'biological age'. As we grow older, the number and the quality of the eggs decline, quite rapidly. So, if we were to look at the age of a woman, let's say if she is about 30 years old, her chances of conceiving naturally each month is about 20% compared to a woman who is about 40, whose chances is only about 5%. But saying that, don’t be too sad cause we do have older women conceiving, even naturally. So, don’t give up, not all hope is lost. There’s still hope. So, don’t worry! But also, for men, don’t be too, you know, relaxed about it. Because even for men, their fertility would start to decline as they get a bit older due to the quality of the sperm. But we’re looking at maybe about the age of 40, late 40s. Q3. When should I seek medical treatment? Dr Natasha: This depends on the age of the female actually, and whether she has any underlying gynaecological problems. So, consider seeing or seeking help from a medical doctor if, let’s say she is less than 35 years old, she has regular period, after 1 year of trying. If she is more than 35 years old, or she has irregular periods, then seek earlier help. Maybe after 6 months of trying. This is not a blanket rule and does not apply to everybody. So, if you feel that you are trying to conceive, and you’re just anxious and you’d like to see a doctor, you can just see any time when you’re trying, maybe even as fast as 3 months. There is no fixed rule. In addition, we can also investigate and help to see whether the female partner is ovulating. There are few ways of doing this. If you have a regular menstrual cycle, you can actually do an ovulation test to detect when you are ovulating and know when’s the best time to have sexual intercourse. But if you are unable to conceive after several times of doing this, then you will need to seek medical help. This is probably not suitable for those of you who have irregular periods because then it’s a bit difficult to use this ovulation test. Q4. What are some treatment methods to help a couple conceive? Dr Natasha: Depending on the results of the fertility evaluation that we’ve done, some couples may need extra help. We call this Assisted Reproductive Treatment. Some of the treatments are: • Intrauterine insemination (IUI) This is a technique where we just process the sperm. When we process the sperm, we get the best swimmers. And we insert it into the woman’s uterus. It’s a very simple procedure, it can be done at a daycare. Then you go back home and just relax. And you will see in about 2 weeks' time after the procedure whether you’re pregnant or not. • In vitro fertilization (IVF or test tube baby) So, test tube baby is a bit more invasive. This is where we need to stimulate the woman’s eggs daily with hormonal injections, and then extract the eggs from the ovaries. This is also a daycare procedure with no cuts on the tummy. It’s all done through the vagina. And we’ll take the eggs to be fertilised outside the body with the sperm in the lab. Once it’s fertilised, then we’ll put it back into the uterus. It has helped lots of couples conceive, like way back in 1978. But every patient and every situation are different. So, we will do a thorough evaluation, a fertility evaluation, before we recommend which is the treatment that is best for that couple. Q5. Will having fertility treatment guarantee that I will be pregnant? Dr Natasha: I wish this was true. There’s no guarantee for treatment, but we hope to increase your chances for conceiving. I had undergone through my fertility journey myself, where I need to undergo a few IVF treatments. So, I do understand what it feels like to be in fertility journey. But that said, with the right fertility treatment, a lot of couples will eventually successfully conceive and deliver their own healthy children. We’d like to give hope to a lot of couples who are trying outside there. As a matter of fact, the statistics in our clinic for IVF pregnancy rate from 30 to 39 years old female age, we have a success rate of about 40%-50% of the pregnancy rate. It’s not 100%, so they’ll be like, “What! That sounds little.” So, you’ll be surprised, but we hope to give the best success rate for patients, or couples trying to conceive. https://www.youtube.com/watch?vjiW55aw-cAQ Clearblue Takes Charge of Women's Reproductive Health Today's episode is graciously sponsored by Clearblue. At Clearblue, we put women at the heart of everything we do to empower and transform the way women manage their reproductive health. Whether you’re trying to conceive or you think you may be pregnant, we give answers that are accurate, quick and clear from the comfort of your own home. We hope you enjoyed and learned from today’s program on fertility. Stay tuned for our next episode of AskMeDoctor! for more health tips for the family. Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner. For more insightful stories and fun recipes, stay tuned to Motherhood Story!

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