Fertility and Nutritional Wellbeing

Dr Navdeep Singh Pannu and Dr Arifah Binti Mohd Amin share their professional medical insights. Couples who undergo fertility treatments face physical and psychological demands that can be disconcerting and unsettling. Worse still, societal prejudices can make infertility, as prevalent as it is, the loneliest club to belong to.  In this casual conversation, Dr Navdeep Singh Pannu, Medical Director of TMC Fertility and Women’s Specialist Centre and Dr Arifah Binti Mohd Amin, Obstetrician and Gynaecologist (with special interest in Nutritional and Integrative Medicine)  share their extensive experience and lend their professional insights into how good nutrition forms the building blocks that positively impacts one’s journey towards building a family.  Q: Having a baby is a celebrated experience for a couple. Do share an indelible moment or experience close to your heart. Dr Navdeep: In February this year, I handed a 52-year old patient her first child. It was hard to tell at that very moment, who was more excited.  After having journeyed with a couple through fertility treatments, it is a defining moment of joy when we see a ‘+’ sign, and when I am able to hand the baby over to its parents.  It is important to note that prior to the joy of holding your baby, the journey towards having a baby can sometimes be tumultuous. To me, it is important that I am with my patients every step of the way, and this is what keeps me coming back day after day. Dr Arifah: I have lost count of the number of patients I have had who experienced emotional instability caused by the process of having a baby. Some come in for postnatal check-ups feeling depressed, dispirited and dejected. I was desperate to help them, and this was a key reason why I furthered my knowledge in nutrition. I am convinced, now more than ever, that proper nutrition is essential to fertility and a healthy motherhood.  This is a great motivation to me.  Being able to help my patients be healthy gives me a sense of joy and purpose. Q: We know that there is a rise in the cases of infertility. Is infertility a growing concern? Dr Navdeep: Yes, there is concern that infertility is becoming prevalent. Whilst the causes for infertility is unexplained, my personal experience indicates that our state of health plays a big part in the bigger picture. We have to pay more attention to inculcating a healthy lifestyle in our children from the time they are babies. Poor nutritional choices and unhealthy habits may compromise fertility and our chances of building a family. Dr Arifah: As a working woman, I know the demands and stresses of a career.  I am also aware that infertility can be caused by both or either partner. However, I want women to know that the choice we make to focus solely on our careers can chip away at our fertility window. The fixation on getting the house in order can give rise to overwhelming financial demands and upstage plans to start and raise a family. These are very real and present issues and many households face them. Q: In your opinion, what are some of the misconceptions that surround infertility? Dr Navdeep: I have come across many but the one that stands out the most is ‘it is always the woman’s fault’.  To me, this is very concerning. Sometimes the husband is so confident that it is so, he does not even come in for an evaluation. I have treated cases that would beg to differ. Whilst the causes of infertility can sometimes be unexplained, in most cases both parties share the odds that the problem is due to either one of them.  There are also instances when the source of the problem could be attributed to both partners. Dr Arifah: In my opinion, our belief structures and customs can be a proponent of myths. Amongst those that I have come across are that some fruits are ‘hot’ and some are ‘cold’. Watermelons, for instance must be avoided as they are deemed to make the womb cold. Others are inspired by astronomy, such as whether it is a half or full moon. As the term itself suggests, the efficacy of myths is difficult to prove scientifically. Q: In your experience, what are the primary causes of infertility? Dr Navdeep: For men, it is normally a low sperm count. Unhealthy lifestyle choices such as smoking, vaping and alcohol consumption as well as excessive body weight can also have negative effects on fertility. Infertility in a woman can be caused by Polycystic Ovarian Syndrome (PCOS), irregular period cycles, endometriosis and pre-existing medical issues amongst others. These conditions are treatable either with medication or lifestyle tweaks. Dr Arifah: Predisposing medical conditions such as obesity, diabetes and hypertension are some of the known causes. Oxidative stress is another concern where there is an imbalance between free radicals and antioxidants in the body. Similar to those mentioned by Dr Navdeep, these conditions too can be relieved by a conscious decision to observe a healthier diet and lifestyle. Q: What is the one thing that couples take for granted when trying to get pregnant? Dr Navdeep: Couples sometimes think that getting pregnant is a ‘given thing’ in a marriage. I would like to encourage couples to consider undergoing Pre-Conception Consultation even before you decide to have a baby. This consultation can be done with and by their family doctor and it ascertains your state of health. Anomalies if any, can be duly detected and measures to deal with the condition put on track. Don’t wait until you decide to have a baby to get checked as lifestyle alterations could take some time before any effect is noticed. Dr Arifah: Every individual should make it a habit to attend annual health check-ups. I wish this fact could be emphasised right from school, in fact, better still, integrated into the education curriculum. Also, we should be open to visiting a dietician or a nutritionist