Standfirst: Fertility specialist Dr Navdeep Singh Pannu
talks babies, the myth about infertility, advancements and obstacles in the field, the importance of now and the joy that only parents feel.
Hope after 50
“There has been quite a number over the years. My oldest patient was 52. She had tried fertility treatments in four different countries before she came to me and asked me to try,“ he shared. Attributing these successes to luck, Dr Navdeep says he could not really explain why it worked with him other than having the help of the latest advancements in fertility treatments and technology to boost the chances of pregnancy. “One thing we do is keep ourselves abreast of the latest developments in procedures and technologies in fertility science. We also have a good lab that adheres to the highest standards and measures to ensure the best chances of creating and growing embryos to facilitate successful pregnancies.”
Procedures such as Preimplantation Genetic Testing (PGT), which ensures that the best embryo can be selected for transfer, Endometrial Receptivity Analysis (ERA), which helps doctors determine the best time to transfer the embryo plus improvements in medication, which has reduced the injections needed to be administered to women in preparation for IVF from six weeks to just 10 days, have all contributed to increased success in pregnancy and decrease in miscarriages. “Success rate of pregnancy through IVF is almost 60% now compared to 20% previously.”
Still, how is it possible that a woman who is in her 50s and above is able to conceive? “The uterus remains completely functional in most women of advanced age. Most infertility problems in women are due to germ cell deterioration, which is related to ageing. By the time women turn 40, their ovarian reserve or eggs reduce markedly. For women above 50 to conceive, they need an egg donor whose eggs will be inseminated by the husband’s sperm to create an embryo. The embryo is then implanted in the woman’s womb, which carries the baby to term,“ explained Dr Navdeep.
While it is a possibility, advanced age pregnancy is not for everyone, he cautions. Just because it can be done, doesn’t mean it should be done. Ethically, fertility specialists first need to ascertain if the woman is healthy enough to carry a child. “We don’t want a woman having difficulties during pregnancy or we would be creating another problem.”
The Earlier the Better
For this reason, Dr Navdeep still emphasises the ideal convention – early pregnancy (preferably between 20s and 30s). “The older you are, not only does your chances of getting pregnant decrease, the possibility of having an abnormal child increases.” If for some reason, a woman is not ready to have children in her 20s or even 30s, she can still ensure her chances of having a healthy embryo when she is ready to have children years later by preserving her eggs while she is still young with oocyte cryopreservation or egg freezing. “When it comes to fertility, the fundamental message is –don’t wait until it becomes a challenge,” asserted Dr Navdeep.
Similarly, he also stresses the need to deal with fertility problems as soon as the warning signs are apparent. To be exact, couples should see a fertility specialist after six to twelve months of trying but failing to conceive. “Here’s the truth: nobody is infertile; some people just need a little bit of help, that is all. Fertility is a potentially treatable problem. We have many tests these days to investigate the cause and to treat the problems such as sperm analysis, transvaginal ultrasound to check fertility potential, hormonal tests and fallopian tube assessment to see if there are any blockages affecting the chances for pregnancy.”
The downside is everything comes with a dollar sign. It is the only limiting factor when it comes to infertility, admits Dr Navdeep. “It is sad because there are so many things we can do to help increase the success rate of pregnancy but the constraint often is the couple’s financial status.” According to him, the problem lies in the fact that infertility is generally not considered a medical problem. Instead, it is seen more as a social issue. “It may not be a life or death case, but the fact is infertility is a long-term condition. People can be childless for life and this can contribute to mental and emotional health problems, marriage breakdowns and career failures. There needs to be a shift on how infertility is perceived overall by the medical fraternity and especially, insurance companies. Ideally it should be treated as a chronic disease and insurance policies should allocate a certain amount of money for fertility treatments.”
Making Dreams Come True
Though he will soon be leading TMC Fertility Centre as the newly appointed Medical Director when its new centre opens in Puchong in the first quarter of 2020, Dr Navdeep says his career goal has not changed since specialising in fertility treatment and investigation; and it likely won’t in the future because for him it has always been about helping as many couples as possible to be blessed with children as he and his wife was 16 years ago. “When you see patients who have been trying for years finally get pregnant and feel the overwhelming happiness when you deliver their baby, there is just nothing like it. It is moments like this that drive me every day.”