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

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

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