For many women, pregnancy may not be an overnight miracle. It can be a journey fraught with disappointments and failure.
But not all hope is lost in your attempt at motherhood.
With so much medical advancements and scientific research, there are better options for women now to conceive a child.
We sat down with Dr Liza Ling Ping, Consultant Obstetrics, Gynaecologist, and Fertility Specialist at TMC Fertility to learn more about infertility and how to address it.
Q1: What are some common causes of infertility that you encounter in your practice?
Both male and female contribute equally to the causes of infertility.
Some common causes are:
- Women with anovulatory cycles and they usually present with irregular menstrual cycles. Due to hormonal imbalance, these women fail to ovulate every month. Therefore, they do not experience a ‘fertile window’; hence, their infertility.
- Advance maternal age 35 years and above.
- Women with diminished ovarian reserve—which means her egg reserve is low based on her age.
- Male counterpart problems such as abnormal sperm analysis parameters which may be due to low sperm count, poor sperm movements, low percentage of normal shaped sperm
Q2: How does infertility impact women mentally, physically, and emotionally?
Since ancient times, a woman has been shouldered with a great responsibility that is to bear a child.
Times may have changed. Now, women may have more freedom, voice and power to decide on their future.
But, the responsibility to bear a child is still hers.
Women must tolerate a great deal of anxiety as they are blamed for their inability to childbearing, even though data shows men and women contribute equally to causes of infertility.
Infertility causes women to experience changes in different aspects of their lives.
The stigma of being infertile has devastating consequences to these women such as feeling of worthlessness.
This may eventually lead to emotional, psychological, and social disorders, which may in turn affect their quality of life.
Q3: What are some of the unique challenges that women with infertility face in Malaysia?
Malaysian being a conservative society perceives infertility as a stigma.
There are some who still believe women are to be blamed if they are unable to bear a child.
Due to this social stigma, many delay in seeking treatment thus denying them the opportunity to get help early and optimising their chances to conceive at a younger age.
Q4: How can society and individuals be more sensitive and supportive towards people facing infertility?
Infertility is recognised as a disease with latest data from the World Health Organization (WHO) showing every 1 in 6 couples worldwide suffers from infertility, and it does not discriminate between high-, middle- or low-income countries.
Infertility can cause significant stigma, anxiety and emotional distress, and financial hardship as most fertility treatments are self-funded.
Infertility can be difficult to talk about and many of us are not sure how to approach conversations with friends and family who are affected by it.
What people facing infertility usually want is for someone to listen, to support and acknowledge their feelings.
A good way to start to show your support, first is to educate yourself about infertility so that you can empathise with them.
Show your support by inviting them to express what they are going through without prying and intruding into their private grief.
Listening to them is way more helpful than speaking and giving suggestions or advice.
Q5: What role does the emotional wellbeing of a woman play in her fertility journey?
Infertility is emotionally taxing and fertility treatment can cause couples tremendous amount of emotional turmoil.
This is one of many reasons relationships can get strained.
On your fertility journey, taking care of your emotional wellbeing is one of the most important things you can do. It is okay to experience these emotions.
What is important is you engage or participate in activities that will bring you joy and one you are comfortable with. For e.g., meditation, yoga, acupuncture, journaling.
Developing coping skills and healthy communication patterns with your partner during these difficult times has been shown to positively impact couples following infertility treatment, improve quality of life, pregnancy rates, and emotional wellbeing.
Q6: Can you share some success stories of couples who have overcome infertility challenges?
To me, every couple who overcomes infertility challenges deserves a huge applause.
However, I would like to share stories of these 3 couples whom I think deserved to be heard.
Their determination, perseverance and never giving up clearly showed there’s always a rainbow after the rain.
Couple A came all the way from Hong Kong to seek fertility treatment in Malaysia. She was 37 years old with her partner suffering from azoospermia (no sperm in semen ejaculate).
They tried IVF with surgically retrieved sperm and only succeeded on their third try and delivered a healthy baby boy.
They wanted to try for another child but due to the COVID-19 pandemic, their plan was disrupted.
Once the country’s borders opened, they didn’t waste any time to resume their IVF treatment as she was approaching 41 years old already.
After 2 unsuccessful IVF cycles, they receive good news in their third try. They are currently waiting for the arrival of their second child.
Couple B started their IVF journey in 2015 with every IVF cycle treatment a no joy.
Despite the many hurdles and heartaches, they finally succeeded 8 years later, in March 2023 on their 8th try.
Couple C, she has been suffering from endometriosis for years which affected her egg reserve and damaged her fallopian tubes.
IVF was her only choice of treatment to conceive. Her IVF journey started in 2022 and she succeeded on her first attempt.
Q7: What are some of the latest advancements and treatments available for infertility in Malaysia?
Advancement in IVF technology has come a long way since the birth of the world’s first test tube baby, 45 years ago.
Current IVF treatment are personalised for each patient which is more precise and safer.
From high quality medications to state of art laboratories technologies including media for better sperm selection, embryoscope & time lapse machine to monitor embryo development, preimplantation genetic testing to identify normal embryos and AI assisted embryo selection.
Now, there are tests available to identify the receptive implantation window of a woman. For e.g., ERA (endometrial receptivity array) and MIRA (MicroRNA endometrial; receptivity analysis) to improve embryo implantation especially for women who experience repeated implantation failure.
Fertility gene code is the latest addition in advancements for infertility treatment in Malaysia where a couple will be able to identify gene affecting poor IVF outcome.
Q8: How important is it for women to seek professional help and guidance when facing infertility?
Infertility may be caused by several different factors, either from male or female partner or from both.
Therefore, the importance of seeking professional medical help is to establish a proper and accurate diagnosis early, and perform thorough investigations, so that treatment could be initiated as soon as possible to help couples to find a family.
Having mentioned this, infertility is not just about getting a diagnosis and treating the problem.
Infertility may take a heavy toll on a couple’s mental health, experiencing significant anxiety and emotional distress, especially women are often perceived to suffer from infertility, regardless of whether they are infertile or not.
Seeking proper professional guidance may ease the distress and help them cope well.
Q9: What advice would you give to couples who are struggling with infertility and feeling discouraged?
Couples walking down this journey is no bed of roses and to add on to this is the emotional roller coaster that these couples may experience.
Every couple’s journey is different, every couple’s story is unique. Some may take years to achieve their dream to become a parent and these couples never lost hope and persevered.
Do know that you are not alone. Talking to your partner, family and friends does wonders.
Never give up, even miracles may take a little time.
Q10: In your opinion, what can be done to raise awareness and reduce the stigma surrounding infertility in Malaysia?
It starts with the word—educate.
According to the World Health Organization, infertility is defined as “a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse”.
Educating the public that infertility is a disease and there are treatments available and are within reach. This will raise awareness and to understand what infertility is all about, to understand that women are not always to blame.
Family physicians, general practitioners, obstetricians and gynaecologists play a key role and can contribute to educating a wider population to challenge stigma and taboos and to help couples facing infertility.
Source: Dr Liza Ling Ping, Consultant Obstetrics, Gynaecologist, and Fertility Specialist at TMC Fertility
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!