May 2, 2023
Overcoming Challenges of Secondary Infertility

What is secondary infertility? Secondary infertility can be a painful setback for a couple that hopes to expand their family. It refers to the inability to conceive or carry a pregnancy to term despite having had a successful pregnancy in the past. While primary infertility, or the inability to have a first child, receives greater attention, the inability to get pregnant again is a growing concern that affects millions of families around the world. This condition can take a toll on a couple’s physical, emotional, and mental well-being, making it essential to recognize, understand and address the challenges that come with it. What causes secondary infertility? Secondary infertility in female This condition is often overlooked because of the misconception that having previous successful pregnancies would mean subsequent pregnancies will occur naturally. If you are wondering how common is secondary infertility, it occurs at about the same rate as primary infertility. It affects about 12% of the women trying for another child. Here are some causes that affect the secondary fertility problem as much as the primary one. –       Age As women age, their fertility naturally declines. It is due to decreased quantity and quality of their eggs. This decline typically starts around age 30 and accelerates after age 35. As a result, women trying to conceive later in life may have more difficulty becoming pregnant than when they were younger, even if they have previously had successful pregnancies. –       Ovarian reserve Women are born with a finite number of eggs, and this number naturally declines as they age. Women who have previously had successful pregnancies may have a lower ovarian reserve, making it more difficult for them to conceive again. –       Uterine issues The uterus or womb is where the fertilised egg implants and grows into a fetus/baby. Thus, any issues with the uterus can impact a woman’s ability to conceive and carry a pregnancy to term. Secondary infertility may be caused by fibroids, scarring or adhesions within the uterus, and polyps. These causes may interfere with implantation or cause miscarriage. –       Fallopian tube issues The fallopian tubes transport the egg from the ovary to the uterus/womb. If the tubes are blocked or damaged, it can prevent the egg from reaching the uterus and being fertilised by sperm. Some complications may occur in the form of chlamydia, gonorrhoea and pelvic inflammatory disease. –       Endometriosis Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus. In some cases, endometriosis can lead to secondary infertility. The scarring and adhesions caused by endometriosis can interfere with the normal function of the fallopian tubes and uterus. It can make the egg and sperm difficult to fertilise and implant in the womb. –       Polycystic ovary syndrome (PCOS) PCOS is a hormonal disorder that affects women of reproductive age. It’s one of the most common causes of female infertility and can contribute to the condition. Women with PCOS typically have elevated levels of androgens (male hormones), which can interfere with ovulation and make it more difficult for the egg and sperm to meet. It can result in irregular or absent menstrual cycles, making it harder for a woman to conceive. –       Secondary unexplained infertility Unexplained infertility can be a frustrating and challenging issue for couples. It may be due to age-related decline, changes in hormone levels, or lifestyle modifications. Regardless of the cause, it is essential to recognise and address the problem with the same urgency and sensitivity as primary infertility to increase the chances of conceiving. Secondary infertility in male Male infertility can be a contributing factor in cases of secondary infertility. Male infertility is responsible for up to 50% of all infertility cases. Several factors can cause male infertility, including: –       Low sperm count or poor sperm motility If a man has a low sperm count or poor sperm motility, it can make it more difficult for the sperm to fertilise the egg. According to World Health Organisation (WHO), a healthy sperm count should be around 15 million per millilitre ejaculation or at least 39 million per ejaculation. Any amount lower than the optimal level is considered to have a low sperm count. –       Abnormal sperm shape If a man’s sperm have abnormal shapes, it can also cause fertility problems. It is due to difficulty when penetrating the egg. –       Blockages or other structural issues If a male has blockages or other structural issues in his reproductive system, it can interfere with the normal flow of sperm. Some common causes of blockages and structural problems may be vasectomy, Epididymitis (inflammation of the tube that transports sperm) and genetic causes. –       Lifestyle factors Lifestyle factors also play a role in affecting secondary infertility. Factors such as smoking, excessive alcohol consumption, and being overweight or underweight can all impact fertility. Many factors can contribute to the fertility problem, and it’s often a combination of factors that leads to difficulty conceiving. It’s crucial for couples who are struggling with secondary infertility to work closely with a doctor to know what causes secondary infertility and develop a personalised treatment plan. How to diagnose secondary infertility? Diagnosing the problem involves thoroughly evaluating both partners to identify any underlying fertility issues. The diagnostic process typically begins with a comprehensive medical history and physical exam, followed by tests and procedures to evaluate fertility and identify potential problems. For women, the diagnostic process may involve the following: Ovulation testing Ovulation testing involves tracking a woman’s menstrual cycle to determine if and when she is ovulating. It can be done using ovulation predictor kits, basal body temperature monitoring, or ultrasound. Hormone testing Hormone testing involves measuring the levels of various hormones in a woman’s blood. It includes Follicle-Stimulating Hormone (FSH), Luteinising Hormone (LH), estrogen, and progesterone. Abnormal hormone levels can indicate issues

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March 24, 2023
When are you most fertile? A guide to understanding your fertile window

Do you know when are you most fertile? Check out these top 10 questions about fertility and pregnancy timing. You have decided to start a family and embark on the exciting pregnancy journey. One of the most important aspects of this journey is to find out when are you most fertile so that you can try to conceive during that time. There is a duration called the fertile window when you are most fertile and has a high chance of getting pregnant. By understanding your fertile window, you can plan the right time to have sex and maximise the chances of conceiving. Here are some commonly asked questions about ovulation, fertile window, and fertility. 1. What is ovulation? Ovulation is when your body releases an egg from your ovary every month for fertilisation. It happens during the mid of your menstrual cycle and lasts only for a day. On an average, most women have their ovulation around the mid-cycle or the 14th day of a 28-days cycle. However, it can vary according to women. Some may ovulate earlier or later, depending on their cycle’s duration. 2. How can I determine when I am ovulating? There are a few ways to determine ovulation: –       Tracking the menstrual cycle One of the most common and easy ways to know your ovulation day is by tracking your menstrual cycle. Ovulation occurs in the middle of the cycle. If your menstruation cycle lasts 30 days, then the ovulation day may occur between the 14th to 16th day. –       Basal body temperature becomes high Basal body temperature is the temperature when your body is on complete rest. It increases when you are nearing ovulation. Typically, body temperature will be around 35.5 °C to 36.6 °C before ovulation. During ovulation, the temperature will be higher than usual. You may be nearing ovulation if your body is heaty some days after menstruating. It is best to keep track of your body temperature in the morning before you get out of bed. –       Cervical mucus changes to a wetter texture Cervical mucus is a fluid produced by the cervix. During the fertile window, the mucus becomes clearer, wetter, and stickier. It also has a raw egg-white texture which enables the intercourse to be smoother. 3. When are you most fertile? You are most fertile during your fertile window, which includes the days leading up to ovulation, the day of ovulation, and the day after ovulation. The fertile window lasts about 5-7 days for most women and occurs during the mid-cycle. If you have intimate relations during this time, your chances of getting pregnant are high. It’s important to remember that every woman’s cycle is different, and tracking ovulation can help you determine the timing of your fertile window. In addition, a fertility calculator or ovulation calculator can help you determine your fertile window, provided that your menstrual cycles are regular and ovulation occurs regularly. To use the calculator, you simply need to input the first day of your last menstrual cycle and your average cycle length, and it will estimate your fertile window. 4. Should I have sexual intercourse daily during my fertile window? It is not necessary to have intercourse every day during the fertile window. However, it is important to have intercourse regularly during the fertile window to increase the chances of conception. Typically, the fertile window is the six-day period that ends around the day of ovulation. The optimal time to have intercourse is in the days leading up to ovulation when you are most fertile. It is recommended to have intercourse every other day during this period to ensure that sperm is present when ovulation occurs. Ultimately, the decision of how often to have intercourse during the fertile window is up to you and your partner. Thus, always remember to maintain a healthy and supportive relationship, communicate openly about fertility goals and preferences, and seek medical advice if needed. 5. Does age affect my fertility? Age impacts fertility rate. Women are most fertile in their 20s and early 30s. However, the older you are, the less fertile you can be. Women have a lifetime supply of eggs in the ovaries. The average number of eggs you have during the first menstrual cycle is around 250 000 eggs. As your age increases, the number of eggs decreases. When you are 30 years old, the number of eggs will be less than 52 000. By 40, it drops even lower to around 9 000. Thus, it is best to get pregnant when your egg count facilitates pregnancy. You can opt for egg freezing earlier to get pregnant after your 30s. If you have been trying for more than six months without success, it is time to seek a doctor. 6. Can stress or lifestyle choices affect my fertility? Stress and certain lifestyle choices can impact your fertility. Chronic stress can disturb your menstrual cycle and affect ovulation, making it harder to conceive. Having constant stress can lead to shutting down the hypothalamic-pituitary-gonadal axis, a hormone-regulating mechanism that controls the reproductive system. It can disrupt the connection between your brain and ovaries, causing delays and absences in ovulation or irregular periods. Lifestyle choices like smoking, excessive alcohol consumption, unhealthy diet and irregular sleep cycles can also impact fertility negatively.  7. When are you least likely to get pregnant? You are least likely to get pregnant during your period. During period, you may have a low level of fertility. It is because no matured egg is released, making it harder to conceive. During menstruation, the unfertilised egg disintegrates and sheds with the uterus lining built for egg implantation. Another phase where getting pregnant is less probable is during the follicular phase or the first part of the menstrual cycle. This is because the ovary is getting ready to release an egg at this moment, and the cervical mucus is not conducive to sperm survival. The time between ovulation and menstruation,

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March 7, 2023
Where does fertilisation occur?

Where does fertilisation occur? All you need to know about fertilisation. You might be planning for a pregnancy or trying to understand how successful pregnancy happens. One of the fundamental keys to a successful pregnancy is knowing about fertilisation. Knowing where does fertilisation occurs and the importance of fertilisation can bring you one step closer to figuring out successful pregnancies. To understand the process, here are a few things you should know.   What is fertilisation? Fertilisation is when a sperm and an egg combine to form an embryo, which will develop into a baby after nine months. Fertilisation is a crucial step in pregnancy. Without fertilisation, you cannot get pregnant.   Where does fertilisation occur? Many people might misunderstand that fertilisation occurs in the uterus. However, it is not true. Fertilisation occurs in the fallopian tubes. After intercourse, the sperm from the ejaculate travels through the cervix into the vagina (womb). Then, it travels further through the fallopian tube to reach the eggs. The eggs are typically released from the ovary during ovulation. If one of the sperms manages to combine with the egg, it indicates that the fertilisation process is a success. After fertilisation, the combination of egg and sperm forms an embryo which will be implanted in the womb. If a couple has fertility problems, they may have trouble conceiving. Thus, they would have to undergo fertility treatments like IVF treatment. IVF treatment will have the egg and sperm fertilised outside of the uterus. It will be done in a laboratory on a petri dish. After fertilisation, the doctor will insert the fertilised egg or embryo into the womb to form a baby.    When does fertilisation happen? Fertilisation usually occurs during the time of ovulation. Ovulation is the process where a matured egg is released from the ovary. It will then travel through the fallopian tube, where it waits to be fertilised by the sperm. If fertilisation does not occur, the egg will shed along with the uterus lining through menstruation.   How fertility problems affect the chances of pregnancy Fertility problems can significantly impact a couple’s chances of getting pregnant. The effects of fertility problems can be devastating, and heartbreaking and may even cause emotional stress in relationships. Understanding how fertility problems can affect the chances of pregnancy is crucial for couples trying to start a family. Here are some of the issues that reduce the chances of conceiving: –          Blocks in the fallopian tube Knowing where does fertilisation occur will show you that the fallopian tube is an essential organ in the female reproductive system. When there is a problem in the fallopian tube, it indicates signs of fertility problems. Blocked fallopian tubes are a common problem faced by women with fertility issues. When the fallopian tube gets blocked, it restricts the passage for sperm to travel towards the egg. Thus, fertilisation does not occur. Doctors recommend fertility treatments like IVF to help with conceiving when the tubes are blocked. –          Endometriosis   Endometriosis is when the tissue that usually lines the inside of the uterus grows outside. The growth of the tissues can interfere with fertilisation by blocking or distorting the fallopian tube. It eventually affects their normal functioning, making it difficult for sperm to reach the egg. –          Polycystic Ovarian Syndrome (PCOS) PCOS is a hormonal disorder that can affect a woman’s chance to conceive. World Health Organization stated that around 116 million women suffer from PCOS. In PCOS, high insulin levels in the body can lead to an increase in androgen, a male hormone in women. It can cause changes in the ovaries and interfere with ovulation. The hormone imbalance can lead to the enlargement and development of cysts due to eggs not maturing and releasing as they should. It can lead to irregular or absent menstrual cycles and disrupt ovulation, making it difficult for a woman to get pregnant. Women with PCOS need proper treatment to balance their hormone levels and increase pregnancy chances. –          Male infertility Male infertility refers to the inability to contribute to conceiving a child. It can affect fertilisation negatively. For fertilisation to happen, the sperm’s health should be in good condition. A healthy sperm count should be at least 15 million and above, and the sperm should have good motility and shape. If the sperm’s health is below average, then it may not be able to penetrate the egg and fertilise it. –          Unknown reason It is a situation where the regular fertility test cannot detect the cause of infertility. Even though it is difficult to figure out, it can be caused by conditions and factors like age-related infertility, ovulation problem, and many more. These conditions can impact the ability of the egg and sperm to meet and fertilise, resulting in difficulties in conceiving. It is essential to consult a doctor earlier to check the fertility status.   What are the differences between natural fertilisation and fertilisation through treatments? Natural fertilisation is when sperm and egg fertilise naturally in the fallopian tube without medication intervention. When sexual intercourse happens, sperm are deposited into the vagina. It then passes through the uterus towards the fallopian tube, where it encounters the egg released from the ovary. Fertilisation through treatments refers to medical procedures that assist the fertilisation process. However, where does fertilisation occur with medical intervention? That can vary depending on the procedure. There are different types of fertility treatments: –          In Vitro Fertilisation (IVF) It is the most well-known form of fertilisation treatment. Eggs are collected from the ovaries and fertilised with sperm in a laboratory dish. Upon fertilisation, the embryo will be transferred to the womb. IVF may be suggested for endometriosis, PCOS and more. –          Intracytoplasmic Sperm Injection (ICSI)  ICSI involves injecting a single sperm directly into an egg. ICSI is suggested when the sperm has

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March 7, 2023
What is IUI Treatment?

What Is IUI Treatment? Here Are 6 Things You Should Know Before Considering the Treatment There are many couples out there who dream of holding their babies. While some couples are lucky enough to have a smooth pregnancy, there are others who may struggle to conceive. If getting pregnant seems to be a problem, do not worry. With today’s technology in the medical field, there are multiple ways you can get pregnant despite your fertility problem.  Intrauterine Insemination (IUI) is a type of fertility treatment where sperm is placed directly into the womb. It is a common treatment for couples having fertility problems planning to conceive. If you are trying to understand what is IUI treatment, here are six things you should know before considering the treatment   IUI treatment is less painful. IUI treatment, in general, is less painful. It uses less invasive tools than other fertility treatments like In-vitro fertilisation (IVF) or Intracytoplasmic sperm injection (ICSI). Doctors use a catheter, which is a flexible tool, to place the sperm into the womb. Some women might feel slight discomfort or cramping during the insertion, but the pain usually subsides within hours. If you experience pain for a prolonged period, you may call your doctor to get checked.      You can opt for IUI treatment if you have mild fertility problems. IUI treatment is usually recommended if couples have mild fertility problems. Mild problems may include the following: Low sperm quality A healthy sperm quality depends on healthy sperm count, motility, and shape. According to World Health Organization, a healthy sperm count should be around 15 million per millilitre (ml) or at least 39 million per ejaculation. Good sperm motility means at least 40% of sperm should swim forward with no problem. A sperm count within 10 to 15 million sperm per millimetre shows mild oligospermia; Sperm motility below 40% suggests low sperm motility. Doctors may recommend IUI treatment if the female counterpart has no fertility issues. However, it is best to consult the doctor so they can advise the best option for the fertility problem. Mild endometriosis Endometriosis is a condition where the endometrium tissues grow outside the uterus. These growths are known as endometrial implants. Usually, these tissues build and shed every month during menstruation. However, the tissues that grow outside of the uterus cannot be shed, thus, gets trapped. These trapped tissues then form scarring and cysts. Mild endometriosis is a condition that includes a few small implants and scarred tissues in the reproductive organs. Doctors may suggest undergoing a few rounds of IUI treatment for this condition. However, if the endometriosis is severe, you may be requested to take other fertility treatments like IVF. Cervical issues The cervical issue can also reduce the chances of pregnancy. If sperm cannot pass through the cervix, it may not reach the egg and fertilisation may not happen. Additionally, if the cervical mucus is thick and sticky, it can slow the sperm or even block the sperm from reaching the egg. IUI treatments allow the sperm to skip the process as sperm is directly placed in the uterus. Unexplained fertility It is a condition whereby a standard fertility test cannot detect the cause of a couple’s fertility problem. You and your partner may have a healthy uterus, good sperm count and egg count but still unable to get pregnant. In this case, doctors may suggest IUI treatment to help couples get pregnant.    IUI procedure is less complicated. The duration of a complete IUI cycle can vary depending on your fertility problem. If only one counterpart has fertility problems, the process may end quickly. However, if a couple has fertility issues combined, it may take slightly longer to get pregnant. It may require more time, but the process is less complicated. Here is the step-by-step process for any IUI treatment so you can understand what is IUI treatment all about and what to expect during the procedure. Step 1: Consultation with a doctor Generally, a couple will start the IUI journey by consultation with a doctor before the procedure. The doctor may require the medical history of a couple. They may proceed with a blood test, a semen sample, an ultrasound scan and other relevant tests to determine the cause of the fertility problem. Step 2: Ovarian stimulation Depending on the problems, the doctor may give fertility medications or injections to stimulate the ovaries. It helps to increase the number of eggs released during ovulation. Step 3: Monitoring and ultrasound While taking medications, the doctor may ask to visit a few times to monitor the ovaries and the development of eggs. It ensures that the progress is going smoothly without complications in the development. Step 4: Ovulation induction Once the eggs mature, the doctor may give a ‘trigger’ shot to stimulate ovulation. It shortens the time of ovulation. These four steps can be skipped if the inability to get pregnant is due to male infertility. Step 5: Sperm preparation On the day of the procedure, the male counterpart will provide a semen sample. It is then washed to remove immobile sperm, debris, seminal fluid and other substances resulting in a highly concentrated sperm. This step is done to avoid any irritation in the uterus, and it also increases the chances of pregnancy. Step 6: Insemination During insemination, the doctor will use a catheter to insert the highly concentrated sperm into the uterus. There may be slight discomfort during the insertion, but it is entirely normal. The process takes only a few minutes to complete. Some women may be required to undergo a second insemination depending on their fertility problem. Step 7: Pregnancy test After the procedure, progesterone tablet will be prescribed. It is a hormone that prepares the uterine lining for a possible pregnancy. You may visit the doctor after three weeks of the procedure, to check whether or not you are pregnant. Alternatively, you can also check at home using the pregnancy kit.   IUI may not be

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February 15, 2023
Everything You Need to Know About BMI in Malaysia (BMI Malaysia)

What is Body Mass Index (BMI) and how does it affect your ability to get pregnant? (BMI Malaysia) Body Mass Index or BMI is a measurement or tool used to estimate your body fat. It is calculated based on your height and weight. BMI is often measured to determine if you are underweight, normal weight, overweight, or obese. However, do note that BMI does not accurately measure your body fat but only provides the estimated percentage of the body fat. The calculation is done by dividing your weight in kilograms (kg) by the square of heights in meters (m2). Alternatively, you can also use a BMI calculator, where you have to key in your weight and height to get the results. After getting the results, you can check your measurements in the standard weight categories. According to the BMI Malaysia chart, the measurement for normal BMI is 18.6 – 25.0. If your BMI measurement is below 18.5, then it is considered underweight. If it is around 25.1 – 30.0, it is categorised as overweight. Meanwhile, you are considered to be obese If the numbers show 30.1 or higher. It is no secret that weight problems may impact your fertility. If you are in the category of overweight or obese, do not lose hope as pregnancy is very much possible despite the fertility issues that you may face. It is advisable to consult a fertility doctor if you have trouble getting pregnant within six months of trying. The fertility team will then help you to plan your journey to achieve your dreams to be parents. I have been consulting and helping many patients who had overweight issues to get pregnant over the years. Thus, I believe with proper fertility treatment plans and a weight loss strategy, you have a brighter chance to conceive and welcome a bundle of joy in your life this year. What is The Ideal BMI To Get Pregnant? A healthy weight with a normal BMI helps to lessen the time and health complications so that you can have a smooth delivery and a healthy baby. If your BMI is high or low, you can still get pregnant. However, it is risky and may reduce the chances of conceiving. Being overweight or having a high BMI is often associated with other medical conditions such as diabetes, high blood pressure, cardiovascular diseases, and more. It can independently affect fertility too. Hence, some women may need to treat these health conditions before undergoing fertility treatments. You are advised to always consult your doctor before opting for treatments. How does the weight problem affect fertility in women? Weight problems can affect your fertility in several ways. Being overweight or obese can disrupt the hormone balance and may cause difficulties to ovulate. Additionally, it also increases the risk of infertility-related conditions such as polycystic ovary syndrome (PCOS) and endometrial hyperplasia. Being underweight can also cause problems in ovulation. Hence, it is commonly advised to maintain a normal BMI when you are planning to get pregnant.      How does weight problem affect male fertility? Being overweight or obese can affect male fertility in several ways. Excess weight may lead to decreased testosterone level and causes sperm count to be low. Some researches have shown that men with a higher body fat percentage tend to have lower sperm counts, and lower sperm motility. These conditions can make it difficult for the couple to conceive naturally. Additionally, weight gain may increase the risk of metabolic disorders such as diabetes that can lead to infertility issues. Obesity may also decrease libido and cause erectile dysfunction in men. Thus, it is important for men to maintain a healthy weight to preserve their fertility. Can Maternal Obesity Cause Adverse Pregnancy Outcomes? (High BMI & Malaysia Overweight Rate) Maternal obesity refers to a woman being overweight or obese during pregnancy. Obesity or overweight problems, in general, is a growing concern in Malaysia. According to statistics from the National Health and Morbidity Survey (NHMS) conducted by the Ministry of Health (MOH) Malaysia, the prevalence of obesity among women of reproductive age increased from 15.1% in 1996 to 22.8% in 2015.  Being overweight or obese can lead to a number of complications for both the mother and the baby if the pregnancy is not well-monitored. Pregnant women with a high BMI can suffer from pregnancy complications like miscarriages, stillbirth, and gestational diabetes. Furthermore, maternal obesity can increase the risk of health problems for the baby such as having a higher risk of getting congenital disorders, growth problems, childhood obesity, or type 2 diabetes.  Getting good pregnancy care such as regular monitoring of weight changes and practicing a healthy lifestyle helps to lessen pregnancy complications. Thus, do not worry if you are currently obese or have a high BMI while pregnant. Always consult your doctor and follow their advice carefully so that you can lead a healthy pregnancy journey.   Is it possible for an obese woman with PCOS to get pregnant?  Yes, it is possible. However, your pregnancy journey may be quite difficult. Polycystic Ovary Syndrome or PCOS is a common condition that affects menstruation and ovulation which leads to difficulty in conceiving. While it is possible for overweight women with PCOS to get pregnant naturally, many of them require additional help to ease their fertility journey. Thus, it is best to consult a fertility specialist and discuss viable options once you are ready to start a family. Having good fertility care and a personalized treatment plan based on your health conditions increases the chances of healthy pregnancy.   What Are the Available Fertility Treatment Options for Couples with High BMI?  Several fertility treatment options can be considered by couples facing overweight or obesity problems to help them conceive. Some of the treatment options are ovulation induction, Intrauterine Insemination (IUI), and In-Vitro Fertilization (IVF). The doctor may also suggest men with obesity or overweight problems opt for Intracytoplasmic Sperm Injection (ICSI) treatment to increase the fertility treatment’s success rate. Thus, do not

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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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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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