December 19, 2022
FAQ: Low Sperm Count

Top 10 Frequently Asked Questions about Low Sperm Count Most couples trying to conceive (TTC) experience a mixed range of emotions when they are not able to achieve their dream of having a baby easily. The intended parents may experience feelings of frustration, devastation, or even shame when they failed to conceive. Male infertility problems such as low sperm count is one of the reasons that reduce the chances of a successful pregnancy. It is important for you to note that this is not a rare condition and many men around the world face similar problems. Let us look into the top 10 most commonly asked questions by many men out there when they find out that they are having problems with their sperm counts and general sperm health. What is low sperm count, and how to know if I am having this problem? World Health Organization (WHO) declared that the average number of sperms should be around 15 million per milliliter (ml), or at least 39 million per ejaculate. If the semen analysis results show that you have 15 million sperm per milliliter, you have a normal, healthy sperm count. Anything below the average indicates that the sperm count is low. This problem is also known as Oligospermia.  Generally, when your partner has trouble getting pregnant, the fertility doctor will recommend you and your partner to get infertility testing. The male infertility tests include semen analysis to check your overall sperm health, especially the sperm count. Doctors often conduct two or three separate sperm analyses to get a good idea of your sperm’s health. Follow the instructions given by the doctor to get the best semen sample for analysis. The semen sample obtained will then be analysed in the laboratory. If you have fewer than 15 million sperm per milliliter of semen, your sperm count is considered to be lower than the average sperm count (low sperm count).  Your fertility doctor will then suggest appropriate interventions to treat your condition. Are there any obvious signs or symptoms that indicate decrease in sperm count? There aren’t any definite signs or symptoms to indicate problems with sperm count. However, there are some problems that are commonly associated with male fertility that may cause issues with sperm count. Thus, you are encouraged to get a consultation from doctor if you observed the following signs: –  A problem with maintaining an erection firm enough for sexual intercourse (erectile dysfunction). – Pain, discomfort, or swelling in the testicle area – History of prostate or sexual problems or male reproductive surgery. I was told that I have infections in the tubes that carry sperm. Does it affect my sperm count? Some infections may interfere with sperm production. Inflammation of testicles or sexually transmitted infections (STI) such as HIV or Gonorrhea may cause a decrease in sperm count. Thus, it is advised to consult the doctor and do a semen analysis to check your sperm health if you are diagnosed with infections. There are many treatments available to treat the condition before it becomes worse and lowers your chances of having a baby later in life. Shall I do semen analysis if my brothers are diagnosed with Oligospermia? Is this condition inherited from our father? There are chances that genetics could cause problems in sperm counts. Men can carry genetic disorders such as missing Y chromosome or the presence of extra chromosomes that may lead to a reduced sperm count. These disorders can be hereditary and thus it is best to inform your family history to your doctor or fertility specialist during the consultation. Can exposure to excessive heat affect sperm count? Excessive heat around the genitals does have effects on sperm count. If you frequently use saunas and hot tubs or place your laptop on your lap while working, it can lower sperm quality and potentially reduce sperm count. It is because testicles work well when the body temperature is slightly below your body temperature. When there is too much heat around the area, it can negatively affect your sperm quality. The good news is that the effect is reversible and does not cause a permanent impact on the reduction in sperm count. Provided there are no other fertility problems that affect sperm health, the sperm quality should return to normal if the exposure to excessive heat is reduced for a few months.  Can obesity or being overweight affect the sperm count? Obesity or overweight men may have diminished quantity and quality of sperm. Studies suggested that weight gain may affect male fertility and lowers the chances of fatherhood. Overweight men are 11% more likely to produce low sperm count than their normal-weight peers. Meanwhile obese men are 42% more likely to have fewer sperm counts. Your overall health including weight is one of the important factors in conceiving healthy baby. Thus, if you plan to have a baby, it is advised to seek help, reduce weight and get in the best shape as possible.   I don’t smoke but I vape and drink alcohol occasionally. Can it still affect my sperm count? Yes, vaping can still affect sperm count. You may assume vaping is a safer option, but they all share a similar type of effect. Be it smoke or vape, it contains nicotine which can significantly lower your sperm count, motility, and overall quality. Sperms are highly sensitive to oxidative stress. Smoking or vaping can lead to the body experiencing oxidative stress that can eventually cause damage to sperm quality. On the other hand, the effects of alcohol consumption on sperm count are subject to the amount of alcohol consumed. Not everyone will be affected by the same amount of alcohol in the same way. However, consistent heavy drinking or binge drinking can negatively impact your sperm health. It may lower your testosterone level and causes poor sperm health. Hence, if you are intending to build a family, it is best to stop smoking or vaping, reduce alcohol consumption and practice a

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December 14, 2022
Understanding Fertile Days, Pregnancy Calculator & More

Curious on How to Find Your Fertile Days? Pregnancy Calculator & Ovulation Calculator to the Rescue Do you know that nowadays, it is easy to calculate your fertile days? Pregnancy calculator or ovulation calculator are among the tools that you can use to help you plan your pregnancy wisely. Timing is important when you are planning to get pregnant. There is a specific duration of time each month called the fertile days for women. It is the time of the month where you ovulate. Having sexual intercourse during this period increases your pregnancy chances. Hence, for couples who are planning to have a baby, this is considered as the “right time” or “best time” to try to conceive. There are few ways to identify your fertile days. One of the simple and efficient method is using the fertility or ovulation calculator. This tool or apps is used to check your ovulation day and helps to determine your fertile windows during the month. Understanding Fertile days and Ovulation It is important for you to track and understand your menstrual cycle if you are planning to get pregnant. The menstrual cycle is caused by the rise and fall of hormone levels in your body. There are four main phases of the menstrual cycle, namely menstruation, follicular phase, ovulation, and luteal phase. The menstrual cycle is usually counted from the first day of a woman’s period until the first day of her next period. Understanding these phases helps you to identify your fertile days better. Menstruation phase This is the phase where you will be having your period. It usually lasts for five days. When pregnancy did not occur, the lining of your uterus will be shed out through your vagina. Follicular phase The next eight days after your menses are the follicular phase. The level of estrogen hormone rises during this phase and cause the lining of your uterus to grow and eventually becomes thick. This is important to prepare your womb for pregnancy. At the same time, another hormone called the follicle-stimulating hormone increases in your body to help form a fully mature egg (ovum). This usually happens between day 10 and day 14. Ovulation phase Ovulation happens when your ovary releases an egg(ovum). On average, it occurs on the 14th day of a 28-day cycle. Once the egg is released, it travels to the fallopian tube. It is where the egg usually meets the sperm and fertilization process occurs. If the egg is successfully fertilized by the sperm, it travels to the womb and attach to the lining of the uterus. Successful implantation indicates healthy pregnancy. Luteal phase This phase occurs after the ovulation phase. It lasts from day 15 to day 28. If the egg is not fertilised by the sperm, your estrogen and progesterone level drops. It then leads to menses. For couples planning to get pregnant, ideally you should have sexual intercourse during the ovulation phase. Thus, learning more about ovulation and fertile days helps you to track your menstrual cycle properly and plan your pregnancy well. How long does ovulation last? Normal ovulation lasts about 12 to 48 hours. After your ovary releases an egg, it stays at the fallopian tube for 24 hours. If fertilisation does not occur during this time, the egg and uterus lining will shed, resulting in menstruation after two weeks. The ovulation window only lasts about a day. However, it does not mean you should get pregnant within one day window. Typically, after sexual intercourse, sperm lasts for 3-5 days in your body. This is called the fertile window and it last about seven days. Five days before ovulation, on the ovulation day and the day after the egg is released. Technically, your chances of getting pregnant are bright if you have sexual intercourse during this time. How to Know If You Are Ovulating? Menstrual cycle can sometimes be irregular. Thus, determining ovulation time can sometimes be tricky. However, there are several ways that you may use to find out your ovulation day. Pay attention to the changes in your body, check your hormone level using the ovulation predictor kits or simply use the ovulation calculator to track and calculate your fertile days. Check out some of the changes that may occur in your body during the ovulation phase: Fertile Cervical mucus When nearing ovulation, the secretions near the cervix or the cervical mucus becomes wetter, stickier, and clear. It usually changes from watery texture to raw egg-white texture when you are ovulating. The cervical mucus makes sexual intercourse smoother as it helps the sperm to swim towards the reproductive system easily. Basal Body Temperature Rise You may face a slight change in your body temperature. After the release of an egg from the ovary, your body temperature rises and stays up for a few days. You can keep track of your body temperature every morning by recording the temperature at the same time every day. If your cycle is regular, the rise in your body temperature can help you to predict your next ovulation. Increase in sex drive The desire for sexual intercourse often increases before ovulation due to the changes in hormone. This can also help you to identify your fertile days. Calculating your fertile days? Pregnancy calculator or Ovulation Calculator – which one should be used? Sometimes, you may not notice the signs above and it is hard to keep track of the changes. Thus, you may prefer to opt for other methods such as using the calculator apps to count your fertile days. The right tool to use to calculate your fertile days is the ovulation calculator or fertility calculator. An ovulation calculator is a tool that provides an estimated date of your ovulation period, given that you are not having other fertility issues. The ovulation calculator helps you to calculate your ovulation and fertile days easily by following few simple steps. Steps to using Ovulation Calculator   Using the ovulation calculator is easy. You may follow

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November 17, 2022
Nobody is Infertile 

Nobody is Infertile: Hope after 50 As much as age affects infertility, did you know that there are still hopes to get pregnant for women who are in their 50s? I believe that nobody is infertile. There is always hope to get pregnant and have a healthy baby at an advanced maternal age. Many of you might wonder how is it possible for a woman in her 50s and above to get pregnant. Well, the uterus remains completely functional in most women of advanced age. Most infertility problems in women are due to germ cell deterioration. It is a condition related to ageing. Their ovarian reserve or eggs reduce when they turn 40. For women above 50 to conceive, they need an egg donor. The donor egg will be combined with the husband’s sperm to create an embryo. The doctor will then implant the embryo in the woman’s womb. Getting Pregnant at 52 My oldest patient was 52. She had tried fertility treatments in four different countries before she came to meet me for consultations. I was glad that the treatment went well and that she successfully got pregnant. Even though there isn’t a definite formula to make a fertility treatment successful, I would say that the latest advancements in fertility treatments and technology boost the chances of pregnancy. Thus, it is important to me as a fertility specialist to keep myself updated with the latest developments in procedures and technologies in fertility science. Furthermore, having a good lab that adheres to the highest standards and measures ensures the best chances of creating and growing embryos to facilitate successful pregnancies. Additional Tests to Facilitate the Success of IVF Couples who are in their 40s and 50s are usually advised to undergo IVF treatment to conceive. There are a few additional procedures done on top of IVF treatments to increase the success rate of the treatments. Procedures such as Preimplantation Genetic Testing (PGT), ensure that the best embryo can be selected for transfer, meanwhile, other tests like Endometrial Receptivity Analysis (ERA/MIRA) help doctors to determine the best time to transfer the embryo into the womb. • Preimplantation Genetic Testing (PGT) Preimplantation genetic testing (PGT) is used to choose an embryo that is free of any chromosomal abnormalities or genetic problems. The healthy embryo will then be transferred to the womb. This procedure may increase the chances of a successful IVF as it reduces the risks of miscarriages. • Endometrial Receptivity Analysis or Micro-RNA Based Receptivity Analysis (ERA/MIRA) ERA / MIRA determines the best time to transfer the embryo. The embryos shall be transferred at an optimal time during IVF to increase the success rate of the treatment. Usually, the window for implantation will be accurately predicted by referring to the number of days after ovulation. However, for some women, it is hard to predict the window for implantation. Thus, they will be recommended to take this test so that the doctor can implant the embryo at the optimal time. These additional tests for IVF have significantly contributed to the decrease in miscarriages. Thus, the success rate of pregnancy through IVF is almost 60% now compared to 20% previously Advanced-age pregnancy is not for everyone. Although nobody is infertile and there is a possibility to get pregnant after the 50s, advanced-age pregnancy is not advisable for everyone. Just because there are chances for pregnancy success does not mean you have to opt for it. Ethically, doctors must first confirm if you are healthy enough to carry a child. If not, you will be having difficulties during pregnancy, and this will be creating other health problems or complications for you. Understanding the Risks of Getting Pregnant After 40 Pregnancy at an advanced age might not be an easy journey for most of the women. It comes with several risks. Therefore, it is best to know the risks before you plan to conceive. • Longer time to get pregnant The rough egg count for a woman is around 300 000 – 500 000 when she reaches puberty. It will slowly decrease as you age. When you reach your mid-30s, the quality and quantity of eggs will slowly decrease. You may face infertility issues or problems. This can delay the pregnancy. • Higher Risks of Babies Born Prematurely Women getting pregnant at an older age have higher chances of delivering premature babies. These babies may suffer from health complications such as breathing problems or heart problems. • Miscarriages Miscarriages may occur when the embryo has abnormal chromosomes or if the uterus is not receptive to the embryo. Taking additional tests during the IVF treatment can help to reduce risks of miscarriages. The Earlier the Better When it comes to fertility, the fundamental message is –don’t wait until it becomes a challenge. The older you are, your chances of getting pregnant decrease. On top of that, it increases the possibility of having an abnormal child. If for some reason, you are not ready to have children in your 20s or even 30s, you can still ensure your chances of having a healthy embryo via egg freezing. It is a method that enables you to delay your pregnancy. Your eggs are extracted, frozen, and stored for future use. Later when you are ready to have children, you may use your preserved eggs to get pregnant via infertility treatments such as IUI or IVF. Dealing with Fertility Problems Earlier I often stress the need to deal with fertility problems as soon as the warning signs are apparent. Couples should see a fertility specialist after six to twelve months of trying but failing to conceive. Nobody is infertile. Some people need a little help. Fertility is a potentially treatable problem. There are many possible causes for infertility problems. During consultations, the fertility doctor will conduct necessary tests to understand your fertility issues. Upon diagnosing and getting a clear understanding of your fertility issues, they will suggest personalized treatment plans that may work for you. Some of the tests that

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November 17, 2022
Main causes of infertility in Females and Males

What are the Main Causes of Infertility in Females and Males? Infertility can be caused by a single issue or a culmination of a few problems. Finding the main causes of infertility in females and males is essential to help you to get the proper treatment. This can further help to ease your pregnancy journey. Knowing Why: Root causes of infertility There are some main causes of infertility in females and males that most of my patients share. Most of the reasons are common, and only some are rare. These common conditions could affect your chances of conceiving. Hence, you will need treatments for it. Here are some common conditions, followed by suitable treatments for each situation. 1. Age Female Age Women are born with a lifetime supply of eggs. However, with age, they gradually decrease in both quality and quantity. The average number of eggs you have during the first menstrual cycle is around 300 000 to 400 000. As you grow old, the number of eggs starts to drop. By 30, the egg count stands between 39 000 to 52 000. By age 40, it reduces, even more, between 1 200 to 9 000. In determining fertility, a woman’s ovarian reserve must be of a level that facilitates pregnancy. If you plan to delay pregnancy, it is best to freeze your eggs. Start freezing at a younger age, so you have better chances of a successful pregnancy. What tests are conducted? To check the egg count, you may be suggested to take the Anti-Mullerian Hormone (AMH) Test. This test is usually conducted to assess a woman’s ovarian reserve or egg count. The level of AMH in a woman’s blood is generally a good indicator of her ovarian reserve. If your ovarian reserve is high, you have more chances of getting pregnant. If it is low, you may face problems conceiving. This also means that you may need to take treatments soon to get pregnant. Treatment options You can get some treatments if the leading cause of infertility is age. For women around 35 to 45 years old, there are options like: – In vitro fertilisation (IVF) – Your egg is fertilised with a sperm in the laboratory. After fertilisation, the egg will be transferred to your womb so you can get pregnant. – Preimplantation Genetic Testing (PGT) – An additional test conducted during IVF. It helps to find any genetic defects in embryos before transferring them to the womb. – Endometrial Receptivity Assay (ERA / MIRA) – This procedure is conducted to check whether the endometrial cavity is ready for embryo implantation. 2. Fallopian Tube Obstruction This is another leading cause of infertility in women. Your fallopian tubes may be blocked because of scar tissues, infections and pelvic adhesion. It means sperm cannot pass through to get to the egg. Moreover, fertilised eggs also may not pass through to the uterus. This main cause contributes to about 25 to 30 per cent of infertility cases. The condition includes cases of completely blocked fallopian tubes and cases where just one tube is blocked, or scarring narrows the tubes. What tests are conducted? Hysterosalpingogram (HSG) X-ray This X-ray checks the fallopian tubes and uterus for any blockage. It usually takes a few minutes, and the patient can go home the same day. Laparoscopy It is a surgical procedure to check and if possible repair the fallopian tube. During this procedure, a thin tube with camera is inserted through a small incision in the patient’s belly button. It allows the doctor to inspect and find out the problems that causes the fallopian tube blockages. Treatment Option One of the common treatments suggested for this problem is IVF or the test tube baby. Since this procedure involves fertilisation in the lab, the sperm and egg are not required to travel through the fallopian tubes. The fertilized embryo will be implanted straight in the womb. This may increase chances of successful pregnancy. 3. Uterine Fibroids It is a type of tissue growth in the uterus. It is a very common condition among women. Up to 40 per cent of women have at least one fibroid. They even tend to increase with age. They are not cancerous or otherwise harmful to health. However, they may make you feel uncomfortable. Most fibroids do not affect fertility and do not need any treatment. The critical aspect affecting fertility is whether the fibroid is distorting the lining of the uterus or if it is located inside the uterus itself. What tests are conducted? If you feel uncomfortable around your abdomen, the doctor may do an ultrasound scan. It is used to confirm the presence of uterine fibroids. It uses sound waves to get a picture of the uterus to confirm the diagnosis. It is also used to map and measure fibroids. Treatment Option Laparoscopic Surgery – This type of surgery checks the abdominal and pelvic areas. During this surgery, a small cut is made to insert a narrow tube to remove the fibroid. It is usually recommended if you have smaller and few fibroids. Myomectomy – A surgical procedure that removes fibroids while preserving the uterus. It is an option for you if you are considering getting pregnant in the future. 4. Polycystic Ovarian Syndrome (PCOS) This is another common condition when the ovaries develop numerous small collections of fluid (follicles) and fail to release eggs regularly. This results in irregular menstrual cycles. 25 per cent of women of childbearing age have PCOS, but most do not even know that they have it until they begin trying to get pregnant. What tests are conducted? – Ultrasound Scan – An ultrasound scan can indicate the presence of these follicles. – Blood Tests – Blood tests can measure your hormone level. You may have higher levels of testosterone. You might also have elevated Luteinising Hormone (LH). Blood tests may also indicate a change in blood glucose and insulin levels. – Pelvic Exam – A pelvic exam is also

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November 17, 2022
Infertility in Malaysia

Infertility in Malaysia – Making Babies A Reality Infertility in Malaysia is on the rise. Many couples are going through different infertility problems and seeking treatments to get pregnant. With the technological advancement in today’s world, many cases of infertility can be treated, making babies a reality for infertile couples. There Is A Way   Infertility is when a couple cannot get pregnant due to problems in their reproductive system. You may be considered infertile if you find it difficult to get pregnant after 12 months of unprotected sexual intercourse. It can be caused by female issues, male issues or even due to problems in both of the couple. I believe that infertility is treatable. I have helped many couples to conceive, including women in the advanced age group and men with severe infertility issues who had given up almost all hope of having a child of their own. Many options today are available to treat infertility in Malaysia. No matter what the issues are and whether it is male or female infertility, there is a way to have your baby. The severity of the cases depends on the patients. Some issues might be easily treated. Some may need to go through complicated procedures. Nevertheless, they can still be treated, and you can still get pregnant. What Causes Infertility? Infertility may be caused by various different reasons.  Understanding the cause of infertility is important especially when you are planning to get pregnant. You are usually advised to meet a fertility doctor if you have been trying to get pregnant for one year and have not yet conceive. Fertility specialist can help you to find out the cause of your fertility problems and plan suitable treatments for you. Some common reasons for infertility in women include: – Ovulation disorder – This disorder affects the release of eggs from the ovaries. You may have irregular periods or experience mood changes and weight gain or weight loss due to the ovulation disorder. It can also result in hypothalamic dysfunction, Polycystic Ovary Syndrome (PCOS), premature ovaries failure, and many more. – Uterine or cervical abnormalities – A condition where your uterus and cervix are abnormally shaped. Such conditions may lead to problems like Uterine Fibroid, which may block your fallopian tube. This may potentially lead to infertility problems. – Fallopian Tube block – This is a common condition that affects infertility. The blocked tube can prevent the sperm and egg from fertilizing. This causes problems to get pregnant. The tubes are usually blocked by scarred tissues or pelvic adhesion. It can also occur due to Pelvic Inflammatory Disease, Endometriosis, Fibroids and other conditions. – Endometriosis – Endometriosis happens when the endometrium tissues grow outside of the uterus. It may affect the functions of the ovaries, uterus and fallopian tubes. Some common reasons for infertility in men include: – Low sperm count – Low sperm count means the fluid that is ejaculated by the man contains fewer sperm than usual. It can be due to genetic problems, defect in testicles, and health problems like diabetes. – Problems with sperm delivery – This condition can happen because of sexual problems, genetic diseases and injuries in the reproductive system. – Overexposure to environmental factors – Infertility can happen due to overexposure to chemicals, pesticides, and radiation. Smoking, taking drugs, and consuming excessive alcohol can also lead to infertility. Can couples battling with infertility conceive naturally? Some couples with infertility issues can conceive naturally without attempting the assisted reproductive methods such as IVF. If we can help a couple conceive naturally, then why not? Sometimes what they need is a little help like Ovulation Induction, which encourages eggs to mature and ovulate or they could just need fertility-sparing surgery to fix a problem that is impeding pregnancy. If there are no immediate indications of severe infertility issues, I will usually suggest the couples to first use conservative approach like timed intercourse or try ovulation induction that helps couples to conceive naturally. Timed Intercourse Timed Intercourse is one of the simple and cost-effective approach to get pregnant. I usually recommend this method for patients who have no problems with their uterus and fallopian tube. This method is also suggested to those whose male partner has no issues with their sperms. Timed intercourse refers to having intercourse at the right time which is during the ovulation time. Thus, it’s important to determine the ovulation window of the female partner. Women usually ovulate about 12 to 14 days before new menstrual cycle starts.  The fertile window is about seven days in total beginning with 5 days before ovulation, the ovulation day and a day after the ovulation. This will be the best time for sexual intercourse and to try to get pregnant. Ovulation Induction Ovulation induction is the process of using hormonal therapy or medications to stimulate egg development and release, or ovulation. Ovulation induction helps to increase a woman’s chance of conceiving a child naturally through sexual intercourse or other fertility treatments. Fertility Care: Natural Treatments (Infertility in Malaysia) If my patients have other preferences like natural treatments, I will embrace them. Natural treatments, such as acupuncture or Chinese herbal medicines, may help them to get pregnant. Finding solutions for infertility in Malaysia in relation to natural treatment can be easy as there are many licensed acupunctures practitioners to do acupuncture. Thus, it is advised to talk to the fertility doctor to plan your fertility care and fertility journey effectively. Safety and Comfort Throughout my practice, I focus on the safety and comfort of my patients. I don’t encourage risky procedures such as implanting more than two embryos at a time. It is more important to me that the mother has a safe and comfortable pregnancy and that her baby is healthy. Any other outcome is heartbreaking. How to Cope during IVF Journey? Battling infertility issues can be stressful. The process of assisted reproduction itself can lead to psychological distress. It can cause you to have stress, anxiety and depression. The situation

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October 26, 2022
Our Pregnancy Success Rate

The Key to Our Pregnancy Success Rate Having to go through repeated miscarriages and failed embryo transfers can be heartbreaking. However, opting for the right treatment at the right time has a high potential to improve the patient’s chance of conceiving and increase our pregnancy success rate. It is important to do the necessary tests to find out the problems and try appropriate treatment. There are various treatment options to treat your fertility issues and help you to get pregnant.  Improving the Odds For some couples, having a child can be a difficult process due to physiological factors. Did you know that up to 25% of clinical pregnancies end up in failure? Clinical pregnancy here refers to the pregnancy verified by the doctor through an ultrasound or fetal heartbeat. There are various reasons for clinical pregnancy to fail, but I believe that the combination of the right treatment at the right time can increase the chances of successful pregnancies.   Reasons for Failure There is a number of reasons why some patients did not achieve live birth or clinical pregnancy. Here are a few reasons why your IVF might have failed. –     Chromosomal Abnormalities For an IVF process to be successful, there must be a ‘chromosomally normal’ embryo where the number of chromosomes is perfectly normal. If it is not, it will lead to failure of the procedure or worse, a miscarriage. The abnormal chromosomes affect the quality of the embryo. In many cases, this condition occurs more commonly in women over 35. –     Age Chances of miscarriage increase as you grow older. You gradually lose the best eggs. If you are 35 and above, you have a higher risk of getting a miscarriage. At 35, the percentage of miscarriage is about 20%. At age 40, the percentage increases to 40% and at 45, it shoots up to 80%. Thus, when you conceive, there is a high chance that the embryos may be abnormal. –     Blood disorder Another possible reason is when you suffer from blood disorders which affect the immune system. A condition that can occur is Anti-Phospholipid Syndrome. It refers to abnormal clots forming behind a growing placenta, leading to miscarriages. –     Health issues Women with underlying health issues, such as uncontrolled diabetes or thyroid problems, may have chances of miscarriages. A womb with an abnormal shape can also be a contributing factor in miscarriages. The womb should be of normal shape and dimension with a smooth inner lining. Besides that, if the woman has a polyp or uterine fibroid making the womb lining irregular, it can also cause miscarriages. What aspects do we look into before suggesting the right treatments? Once the problem is detected, the treatment can be decided. The treatment will be personalised according to the patient’s chances of conceiving. To personalise the treatment, there are four areas that we look into: –     Ultrasound Scan of The Womb and Ovaries Ultrasound scans are done to check for problems in the womb and ovaries. It can detect abnormal structures of ovaries or unusual growths like fibroids or cysts. –     X-Ray To Check For Blocked Fallopian Tubes This X-ray test is done to check the uterus and fallopian tubes. It can help detect fertility problems that occur from blocked fallopian tubes. If the tubes are blocked, the sperm can’t travel to the egg or fertilized egg cannot pass through to the uterus. This leads to infertility problems. –     Hormonal Blood Test This test helps to identify hormonal imbalances that can affect infertility. The blood test checks a hormone called progesterone. It checks whether a low level of progesterone influences the infertility rate. The Anti-Mullerian hormone level is also tested to check the ovarian reserve which refers to testing how many eggs you have. Other tests include checking the level of Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), thyroid and prolactin in the blood. –     Sperm Test Sperm tests check the health of the sperm. It helps to determine if there is any sperm dysfunction that may cause failure in pregnancy. If there are low sperm counts, there may be lifestyle changes you have to make. Moreover, you might be given medications to increase sperm production. You may also have to undergo ICSI or IVF treatment depending on the sperm count.  What are the treatment options available? There are many treatments available for infertile couples. However, finding the proper treatment at the right time is the key to our pregnancy success rates. Here are a few treatment options that may be suggested by your fertility doctor after assessing your condition.   –     Timed Intercourse Firstly, we can advise couples to have intercourse around the most fertile day of the woman’s ovulation cycle. Timed intercourse is simple and can be effective for some couples. Firstly, you have to determine your ovulation or fertility window. It is usually 12 to 14 days before the next period starts. Having intercourse during this time increases the chances of pregnancy. –     Prescribing Hormonal Medications We can also prescribe hormonal medications to help regulate or induce ovulation. The medicine helps to increase the production of eggs in a woman. –     Intrauterine Insemination (IUI) IUI is suggested for patients who do not have complicated infertility issues. The husband’s sperm is processed and injected directly into the womb during this treatment. The semen sample collected will be washed to concentrate the sperm and remove the seminal fluid. It will then be injected near the patient’s ovulating time to increase conceiving. IUI procedure can increase the success rate of conceiving by 15% to 20%. The Test Tube Option In Vitro Fertilization (IVF) It is popularly known as a ‘test tube baby.’ A woman is given a hormonal injection for ten days during this process. It will help the eggs to mature quickly. After that, we will extract the eggs while you are under anesthesia. Upon egg retrieval, sperm is injected directly into the egg to fertilise. We will then

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October 18, 2022
Success Stories of IVF

Success stories of IVF: Giving Hope After a Failed IVF When your IVF treatment fails, it is common to undergo moments of grief. In times like this, the success stories of IVF can help to make you stay positive and hopeful. Many couples who have conceived and have a baby via the test tube baby method have previously experienced multiple failures. One thing common in most of these couples is their persistence and determination to fulfil their parenthood dream. IVF journeys can be rough and drain you emotionally, mentally and psychologically, but always remember that there is hope after a failed IVF. You can also be a part of the success stories of IVF.   The Impact of failed IVF The “what ifs” and blaming after a failed IVF can be endless. Whenever a couple fails to get pregnant after the IVF treatment, they usually go through grieving. It starts with denial, where they refuse to accept that the treatment has failed. It then leads to feeling angry towards everything. They begin to blame the situation and everyone for the failure. They will start to ask questions like, “What if my IVF failed because I parked the car too far from my workplace and exerted myself whilst walking?” or “Doctor, maybe you didn’t do enough for this IVF to be successful”. These “what ifs” scenarios and unhealthy thoughts make them more depressed and exhausted. Then, slowly, the couple starts to accept the situation. The grieving they go through is somewhat similar to one who has lost a child. As much as a failed IVF affects couples, it affects our fertility team too. Any unfavorable outcome is devastating for us. My nurses, my embryologist and I put in our hearts and soul to do everything possible in hopes of a successful IVF outcome. We do everything possible to deliver happy news to couples. However, sometimes it just doesn’t happen. The average success rate of IVF globally is under 50 per cent. More than half of those who undergo IVF do not get pregnant. A hard fact to digest, but it is the truth. Coping with Failed IVF Going through various steps during IVF may exhaust you physically and emotionally. The process, which includes hormone injections, egg extraction and an embryo transfer over 2 to 6 weeks, can be tiring for those undergoing the IVF treatment. It is a challenging journey for many couples out there. Thus, I understand how devastating it must be for you when the treatment fails. I usually suggest my patients to give time for their body and mind to rest and heal. Here are some suggestions that you can considered if you have failed your IVF treatments. • Stop Blaming Yourself  The failed IVF treatment may cause you to think of all the “what ifs” and you may start to blame yourself for the failure. It is important for you to know that IVF success rates are affected by various factors. Even under promising cases, the transfer of fertilised eggs may not end with a positive result. Anything can happen. The fertility specialist will usually analyse and explain the next step after IVF. So, stop blaming yourself. Talk to your fertility doctor and plan your next step patiently. • Take a Break I would advise a couple that failed IVF to take a break. You may feel the rush to hop on to do another IVF cycle. However, give yourself and your partner a break. Stop all medication and take as much time as you need to grieve and accept the failure. Some patients even deeply mourn after a failed IVF. To these couples, I advise them to seek the right help. Getting proper aid will direct you to prepare emotionally and physically for the next cycle or to take the next step. • Approach a Fertility Coach For couples who are deeply mourning and do not know what to do next, I suggest they meet our Fertility Coach, who will help them cope with their failed IVF. You may feel depressed, guilty, and worthless. Sometimes, the inability to express emotions can also be overwhelming and isolating. Our Fertility Coach is a great help. She provides extra mental and emotional support while assisting couples in navigating through their fertility struggles. She can help couples work through their feelings and advise them on the best fertility plan. She will give you the support you need to function through the grief. • Read or listen to Success Stories of IVF Reading or listening to success stories of IVF is an excellent way to cope. These stories shared are usually filled with the struggles and emotional rides couples faced during their journey. It may not be the same for you. However, hearing similar stories may give validations to your feelings. The stories could be a reminder that you are not alone in this journey. It can give you hope and help you cope with your journey. • Get Involved with Fun Activities Couples need to engage themselves in different activities that can distract them from their problems. They may go cycling, attend yoga classes, watch movies, gardening, take art classes and many more. Such activities may give them peace of mind and make them feel good. It also is a good distraction from dwelling much on the failure of IVF. What to Do Next? I see failure as an opportunity to begin again – but more intelligently. When an IVF fails, there can be various reasons. Usually, I will review a couple’s latest IVF procedure to determine which areas could be improved to help boost the odds of success the next time. Depending on a couple’s situation, I may order additional tests such as: Immune System Tests- It is a test that figures out any issues that may cause the IVF treatment to fail. It checks different aspects of the immune system. When the immune system is over- or under-activated, it may result in repeated pregnancy loss or infertility.

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October 14, 2022
Rawatan Lelaki : Male Infertility

 Importance of Fertility Treatments for Men (Rawatan Lelaki) It is becoming common for men to face fertility problems. If you or your partner have been diagnosed with fertility issues, that does not mean that you can’t achieve your parenthood dream. There are many treatments (rawatan lelaki) and procedures that can help you to conceive and have a baby. What Is Male Infertility? Male infertility (kesuburan lelaki) means that men have problems with their reproductive system. They have difficulties to impregnate their partner. Male infertility is a common condition, and it happens due to various reasons. Therefore, it is best to understand the causes and seek proper treatments. The sooner you get treatments, the better it is. What Causes Male Infertility? Healthy sperm is the key to male fertility. Usually, men are unable to father a child if there are problems with sperms. Similarly, problem during ejaculation or erection may also cause male infertility. Below are some common causes that you should know if you are facing difficulties to have a baby. Problems with Sperm Healthy sperm is needed to fertilize your spouse’s egg. It must be matured, in normal shape and able to swim well. If not, it is considered to be unhealthy. No sperm in the semen When there are no healthy sperm, it is difficult for your partner to conceive. Thus, it is important to consult the fertility specialist and assess your situation. They can help you to find appropriate fertility treatment for you. Enlarged Veins (Varicocele) Enlarged veins in your scrotum area affect fertility too. It causes the quality and quantity of sperm to decrease. It is a common condition that some men may even go unnoticed throughout their lives. The exact reason for this condition is unknown. Infection Infections can lead to infertility. It may happen in the tubes that carry sperm or testicles. When there is an infection in the mentioned areas, it can lower the production of sperm. Moreover, it may also cause scarring that blocks semen from passing. Immunity Problem This condition occurs when your antibodies fight sperm from your own body. Your immune system mistakenly sees it as something harmful. Thus, it attacks. Cancer Cancer can affect the male reproductive organs through glands that produce reproductive hormones. Moreover, chemotherapy, radiation, and surgery can also affect your infertility rate if you undergo surgery. After your treatment, sperm production may slow down or might even stop. Unhealthy Lifestyle  Drug Intake Consuming drugs can lead to infertility. Taking steroids for example, may cause testicles to shrink. Smoking and Vaping This habit can lower the sperm counts.  Secondary smoking or vaping may also affect your sperm quality. Heavy Alcohol Consumption Heavy alcohol consumption leads to infertility. It harms your health and can lower testosterone levels, leading to lower sperm production. You may also get erectile dysfunction. It means you fail to have and keep an erection firm enough for sexual intercourse. Such a condition may lead to infertility. Overexposure to Environmental Factors Overexposure to the environment with chemicals, heat, and toxins can also affect your infertility rate. Certain chemicals, pesticides and paint may reduce sperm counts. On top of that, overheating the testicles may also decrease their production. Frequent use of saunas and hot tubs can lower the count. Sometimes, sitting for a long time with tight clothes can also cause a rise in temperature in your scrotum and leads to infertility. Stress Level Higher stress levels have connections with infertility. It can interfere with the hormones needed to produce sperm. It can contribute to lower sperm movement and lower sperm quality. Being Overweight/Underweight Being overweight or underweight can indirectly affect the infertility rate. Weight problems can cause hormonal imbalance. The disruption in hormones may lead to lower sperm count. Obese men had lower sperm counts than normal-weighted men. Some obese men even produce no sperm. How is Male Infertility Diagnosed? Every diagnosis starts with a doctor’s consultation. The doctor will go through a few tests and examinations to check the general state of health and other issues related to infertility. During the diagnosis, the doctor may examine your genitals and ask about your history of medical conditions affecting your fertility. The doctor may also ask about your sexual activities and sexual development during puberty. After evaluation, the doctor will recommend a suitable treatment. (rawatan lelaki) Treating Male Fertility (Rawatan Lelaki) Sperm health can be vulnerable depending on the circumstances. It can reduce the quality and quantity of sperm. Hence, protect your fertility by being aware of the factors. You may take the following steps to care for your male fertility. Medications and Hormone Treatments Certain medications, such as Beta-blockers, antidepressants and antiandrogens, can contribute to fertility issues. Steroids also have the same effect. It is better to consult your doctor concerning the medicines that you are on. Lifestyle Change Exercise Regularly Regular exercise can improve your fertility. It may increase testosterone levels, produce better semen quality, and protect sperm compared to inactive men. However, avoid heavy exercise as it may have the opposite effect. Include Zinc in Your Diet  This essential mineral is found in food like fish, meat, eggs and shellfish. Getting enough zinc is the key to male fertility. Zinc deficiency is related to low testosterone levels. It also causes low-quality sperm, leading to male infertility. Thus, make sure to consume food rich in said mineral. As an alternative, you can also take zinc supplements. Having the right amount of zinc is best to increase your fertility rate. Maintain A Healthy Weight Maintaining a healthy weight can contribute to your fertility rate. If you are overweight, it is better to lose weight. Losing weight can increase semen count, mobility and overall sperm health. If you are unsure of what exercises you can do, consult your doctor. You may also discuss your weight loss goals with them. Limit Your Alcohol Heavy drinking affects your infertility rate. Cut down on your alcohol consumption if you are a heavy drinker. A few drinks occasionally might

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October 13, 2022
How much for Egg Freezing?

How much for Egg Freezing and 25 Commonly Asked Questions about Egg Freezing Many of my patients asked me about the egg freezing procedures, how much for egg freezing and more. People nowadays are conceiving in their later age, thus opting for egg freezing. It is the chosen option to store eggs for future pregnancy planning. If you have questions about egg freezing, clarify them before you start with the procedures. Here are the most frequently asked questions for your easy reference. What Do You Need to Know about Egg Freezing? 1. What is egg freezing? Egg freezing is a procedure to preserve a woman’s eggs. This technique allows a woman to store her eggs for later pregnancy.  2. Who should consider egg freezing? You should consider egg freezing if: You plan to get pregnant at a later age You are diagnosed with cancer You want to store eggs instead of frozen embryos for religious and/or moral reasons 3. How are the eggs stored? The eggs are frozen and stored at a temperature of -196 degrees Celsius. 4. How long can the eggs remain frozen? Frozen eggs can be optimally stored for as long as 10 years. 5. How does egg freezing work? Eggs are frozen using a flash-freezing process known as vitrification. It is a simple, efficient and harmless method. The process of egg vitrification is done using an ultra-rapid cooling method. Egg freezing prevents cell damage when immersed in liquid nitrogen and stored at -196C. 6. What Goes on During the Egg Freezing Procedure? The eggs will be removed from the ovaries and will be freezed. They are frozen using the flash-freezing method and then stored below freezing temperature. When you are ready to get pregnant, the frozen egg will be thawed and let to fertilise. Upon fertilisation, it will be inserted into your womb so you can get pregnant. 7. How are the eggs retrieved? You will be given 9 to 10 days of hormone injections to stimulate the ovaries and multiple mature eggs. During the removal process, you will be placed under light sedation. A needle attached to a catheter is guided through the vaginal wall. One by one, the eggs will be drawn out using light suction. The doctor then collects the eggs in test tubes labelled with your name and unique identification number, which will be handed to the embryologist for the storing process. 8. How many eggs will be retrieved? We will attempt to retrieve as many eggs as possible. The number can be higher or lower depending on your quality of eggs, your age and other factors. 9. How much for Egg Freezing? It is common for many to ask questions like how much for egg freezing. The cost of egg freezing can differ for each person. It might vary depending on your medical conditions. The process of each egg retrieval can cost between RM10,000-RM15,000. The yearly fee to store the eggs is about RM1,000. However, these are just indicative figures. If you are wondering how much for egg freezing and want to find out the exact cost, do contact us for the latest fees. 10. How do I start with the Egg Freezing Process? It is an easy process. Contact the fertility treatment centre of your choice and book an appointment. After your appointment, your fertility specialist will guide you through the process of egg freezing. 11. Is the thawing process safe? Yes, the thawing process is safe. More than 90% of eggs have survived the thawing process. 12. Is egg freezing safe? In a study, more than 5000 babies are born from frozen eggs. Over 900 babies showed no increased rate of congenital disabilities. There were no pregnancy complications after egg freezing. Even though these numbers are reassuring, it takes years of follow-up to check that babies born from egg freezing technology have no higher rates of congenital disabilities. 13. Can egg freezing guarantee a live birth? Unfortunately, no. Many factors can affect your pregnancy, like age, the number of eggs, and health history. 14. What is the egg freezing success rate? The success rate is often difficult to predict. The success rate is high if the woman’s eggs were taken before 30. What do you have to do after the Egg Retrieval process   15. How do I care for myself after the egg retrieval procedure? – Take good rest for a couple of days – Take the medications given by the doctor – Avoid any sexual intercourse for about 2 weeks after egg retrieval 16. What food can I consume after egg retrieval? – Have a balanced intake of protein and carbohydrate – Eat fibre-rich foods like beans, broccoli, berries, whole grain food, apples, etc. – Add more vegetables to your diet – Stay hydrated with water and fresh juice 17. What food should I avoid after egg retrieval? It is better to avoid having food such as below: – Inflammatory food that includes sugar, refined carbohydrate, fried food, processed food and red meat 18. When will my period return after egg retrieval? If you have a regular period cycle, you should get your next period on the next cycle. It usually takes about 28-30 days. Fertility and Age 19. When is the ideal time to freeze eggs? The ideal time to freeze eggs is in your late 20s to mid-30s. It is best if you can freeze eggs before 35 years old. It is because age affects the eggs. The younger you are, the better the egg counts and egg quality.  20. What is egg count? Egg count is the potential eggs remaining in your ovaries. Women are born with 1-2 million eggs and lose more than 100 per month during menstruation. The rate of eggs decreases after 35. Lower egg count can lead to infertility. 21. How can I check my egg count? There are two tests that can be used to check the egg counts: Egg counts can be tested through Antral Follicle Count.

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September 28, 2022
(Fertility Malaysia): Seeking Help

Fertility Clinics in Malaysia (Fertility Malaysia) – When to Seek Help for Infertility? Couples who have infertility problems struggle to get pregnant.  You may try to get pregnant for almost a year and fail to conceive. When this happens, you may be confused and worried. Many couples do not know the right time to seek help. It is advisable to consult a fertility doctor after 6 months to 1 year of trying to get a baby. There are many fertility clinics all over Malaysia. (Fertility Malaysia) You may book a consultation with a fertility specialist in a fertility clinic. Early consultation helps to identify infertility problems. When problems are known, it’s easier to find the right solution. Infertility: An Invisible Disease   Often, couples do not realise they have infertility problems until they start trying to conceive. Infertility is considered a male and female reproductive system disease. It means failing to achieve pregnancy. If you cannot get pregnant after 6-12 months of trying, there are high chances that you are infertile. On top of that, age affects fertility too. As they grow older, they may have lesser eggs or lower quality sperm. This may cause infertility problems. Thus, seek help at fertility clinics as the problems are considered time-sensitive matters. Why is it Important to Seek Infertility Treatments? Infertility is a disease. Thus, it needs specific treatment and care. Meeting a fertility specialist, helps you to understand your problems better. You can find out the cause of your infertility problems and design an individualized treatment plan. This may help you to get pregnant and build your dream family. What Happens When You Meet a Fertility Doctor (Fertility Malaysia) to Seek Infertility Treatments? Family Health History The fertility specialist will usually ask about your family health history and your personal medical record. These crucial details are important for them to find the causes of your problem and suggest effective treatment plan. Blood tests and Physical Examination The fertility specialist will then conduct few tests such as blood test and pelvic examination that are needed to diagnose your problem. Period Cycle You may also be asked to keep track of your period cycle and plan intercourse during ovulation or fertile period. Ovulation is when the ovary releases an egg into the fallopian tube to achieve pregnancy. It usually happens midway of your menstrual cycle. Why Couples Don’t Seek Infertility Treatments? Some couples do not seek help even after knowing their infertility state. One of the reasons are because many thinks that the only fertility treatment available is IVF. This is a very popular misconception in fertility care. Here are some of the few common reasons why some couples choose to not seek infertility treatments. A Taboo Subject Some couples do not seek help because of cultural and religious reasons. In their surroundings and communities, infertility is considered a taboo subject. It is one of the reasons why couples do not consider the IVF (in vitro fertilisation) method. They think of it as an unnatural way of conception. For me, IVF is like a God-sent method. It helps many childless couples to get pregnant and have baby. I respect the couples religious and cultural belief. So, usually I will suggest them other options besides IVF. Many of them are open to try the alternative methods. They may opt to boost their fertility through medications and supplements. Some are willing to do IUI treatment.  IUI (Intra Uterine Insemination) is a quick and painless method.  The sperm is processed and placed in a woman’s uterus for fertilisation. This method may not work for everyone due to various factors. Hence, it is better to consult with your fertility specialist first before going through this procedure. A Burden on The Pocket Infertility treatment can be costly. For example, IVF procedures can range from about RM15,000 to RM25,000. It can be a burden on the pocket. Unlike other medical procedures, IVF is not covered by insurance. Thus, it can hurt financially for struggling couples. However, there is another option. The government recently allowed EPF withdrawal for fertility treatments. You can access Account II to withdraw money for the treatments. Legally married couples below 55 years old are allowed to withdraw the money for IVF, IUI and ICSI (Intracytoplasmic Sperm Injections) procedures. Apart from that, the government also allows tax relief up to RM6000 for medical expenses. The expenses are for serious illness, which also includes fertility treatments.  Therefore, consider these options if you are financially struggling to get infertility treatments. At The Crossroads: Career or Pregnancy?   Many career women struggle to pick a priority. Should they get pregnant now or later? It is a tough choice for them. Egg freezing can help to preserve healthy eggs so that you can get pregnant later. The fertility specialist will extract, freeze and store the egg for future use. When you are ready to have child, the fertility specialist will then insert the fertilized egg to your womb. This helps you to get pregnant. It is best if you freeze eggs at a younger age (around 25-30 years old). The quality of eggs is better when you are younger. Infertility Support Infertility creates psychological stress. You might wonder why you have difficulties making your own family, which can slowly affect your mental health. Seeking treatments from professionals can help you gain strength throughout the fertility process. During fertility treatments, your body undergoes physical changes as well as hormonal imbalances. It can affect your emotional state, and you may even go through anxiety or depression. A healthy support system will give you strength and help you manage yourself while undergoing fertility treatment Where To Seek Support? You may consult Fertility Specialists at Fertility Centres (Fertility Malaysia) for support. They will recommend you to fertility counsellors who are trained to provide support for infertility.  When To Seek The Right Support? Couples who have been trying to conceive for a long time can grow impatient. It can lead to having struggles in

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